Questions and Answers
Hanging is the least common method of suicide, accounting for 41% of all suicides in individuals aged 10 years and older.
False
A short drop in hanging typically causes death by fracture-dislocation of the upper cervical vertebrae.
False
Elevation of the legs may prolong the tolerance of a casualty in suspension if safely done by the rescuer.
True
There is a specified height requirement for determining the type of drop in hanging incidents.
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Loss of consciousness can occur due to compression of the inferior vena cava from abdominal pressure.
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In the context of suspension trauma, it is recommended to wait for emergency services rather than attempting a rescue.
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Hanging can occur either accidentally or as a deliberate act.
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A long drop in hanging results in death primarily from asphyxia.
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The quaternary category of blast injuries refers to penetrating injuries from the blast wave propelling a patient against objects.
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Secondary injuries from blasts are primarily caused by flying fragments and debris, leading to lacerations and fractures.
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Tertiary injuries are classified as those resulting from burns caused by additives such as bacteria and radiation.
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The primary category of blast injuries is characterized by damage to gas containing organs from a blast shock wave.
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Quinary injuries refer to injuries caused primarily by sharp objects like shrapnel that result from an explosion.
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Stab wounds are classified as high energy penetrating trauma.
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Common weapons for causing stab wounds include knife, scissors, and ice picks.
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Gunshot wounds are characterized by their low velocity in delivering energy into a patient.
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A single stab wound often results in multiple injuries due to the weapon's nature.
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Stab wounds typically cause significant external visible injuries.
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The airway should take priority over C spine management when managing a patient post hanging.
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If CPR is not commenced, it is advisable to disturb the scene to assist the police with their investigations.
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Patients rescued from hanging are often likely to be hyperoxic and calm.
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It is important for staff involved in a hanging incident to have access to wellbeing services.
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Specialist on-screen care is unnecessary when managing patients post hanging.
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A dynamic risk assessment is the first step in managing a hanging incident.
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In case of a hanging, all signs of life should be thoroughly checked before any ligatures are removed.
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Witnesses and families do not require support services following a hanging incident.
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Gunshot wounds create both a permanent cavity and a temporary cavity in the body.
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Higher velocity weapons produce a lesser potential for injury compared to lower velocity weapons.
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Cavitation from a projectile has no effect on the size of the exit wound.
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The pathway of a ricochet bullet is always predictable and straight.
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The kinetic energy of a projectile is irrelevant when it does not produce an exit wound.
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The size of the entrance wound is usually smaller than that of the exit wound.
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More energy in a projectile leads to a smaller temporary cavity.
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Scene safety and patient care are equally prioritized in gunshot wound scenarios.
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The temporary cavity formed by a projectile is less important than the permanent cavity.
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The exit wound of a projectile can occur in unexpected places.
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Study Notes
Suspension Trauma
- Compression of the inferior vena cava from harness and abdominal pressure can lead to loss of consciousness.
- Standard UK first aid guidance recommends ABC management for casualties.
- Elevating the legs of a suspended casualty can help prolong their tolerance to suspension.
- Immediate rescue is crucial when possible.
Hanging
- Accounts for 61% of all suicides in individuals aged 10 and over; can be accidental or deliberate.
- Short drop resulting in asphyxia differs from a long drop causing fracture-dislocation of cervical vertebrae.
- No specific height is defined for short or long drops; approximate height should be documented.
Management of Hanging
- Conduct a dynamic risk assessment and check for signs of life or need for resuscitation.
- Remove ligatures carefully, considering spinal precautions.
- Prioritize airway management, which may be complicated by potential injuries.
- Avoid disturbing the scene if CPR is not initiated to aid police investigation.
Post-Resuscitation Care
- Be aware of the likelihood of hypoxia and agitation in patients post-ROSC.
- Maintain consideration of possible spine or spinal cord injuries.
Staff Welfare
- Staff may experience emotional effects from these incidents and should have access to support services and debriefing.
- Bystanders and families may also require guidance towards support services.
Blast Injuries
- Can occur in contexts such as warfare, terrorism, and industrial accidents (gas leaks, factories).
- Classified by cause:
- Primary injuries from blast shock waves affecting gas-filled organs.
- Secondary injuries from flying debris causing lacerations or fractures.
- Tertiary injuries from being propelled against objects.
- Quaternary injuries include blunt and crush injuries.
- Quinary injuries involve burns from additives like bacteria or radiation.
Penetrating Trauma
- Encompasses stab and gunshot wounds.
- Stab wounds are low-energy trauma with limited external marks but potentially significant internal damage.
- Common weapons include knives, scissors, and ice picks.
Gunshot Wounds
- High-velocity weapons deliver greater energy, resulting in extensive body damage.
- Cavitation occurs, forming both permanent and temporary cavities that can lead to severe injuries.
- Ricochets from bullets can increase tissue damage as the projectile’s path becomes erratic.
- Entry wounds are typically the size of the projectile, while exit wounds are often larger and unpredictable.
Considerations for Gunshot Wounds
- Evaluate scene safety, weapon types, and anatomic structures along the projectile path.
- Prioritize patient care while maintaining crime scene integrity.
- Understand the kinetic energy involved in gunshot injuries.
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Description
This quiz covers the essentials of managing suspension trauma, including the physiological effects of abdominal pressure on the inferior vena cava and the standard UK first aid guidance for response. Test your knowledge on the critical steps needed in such emergencies.
