Trauma Mechanics and Biomechanics Overview

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Questions and Answers

What is the primary focus when obtaining vital signs for a patient?

  • To establish a baseline for current health status (correct)
  • To determine the patient's psychological state
  • To assess the patient's response to treatment
  • To identify previous medical history

Which of the following vital signs should be included in the initial assessment?

  • Pulse and blood glucose level
  • Respirations and pulse oximetry
  • Blood pressure and cardiac monitoring
  • All of the above (correct)

In a physical examination of the head and neck, which finding indicates a potentially serious condition?

  • Equal pupil reaction
  • Presence of abrasions
  • Palpable swelling
  • Jugular vein distention (correct)

What should be assessed when examining the abdomen during a physical examination?

<p>Upper and lower quadrant tenderness. (D)</p> Signup and view all the answers

What is the purpose of reassessing vital signs every five minutes for patients in serious condition?

<p>To monitor changes and adjust treatment accordingly (A)</p> Signup and view all the answers

Which method should be used to examine the back of a patient during assessment?

<p>The patient should be positioned on their side. (D)</p> Signup and view all the answers

Which of the following is an important consideration while assessing the extremities?

<p>Assessing for distal pulse, motion, and sensation (A)</p> Signup and view all the answers

What is one of the key components to include in a rapid full-body scan during reassessment?

<p>Re-evaluating vital signs (C)</p> Signup and view all the answers

What should be evaluated if the patient is breathing?

<p>Rate and quality of respirations (A)</p> Signup and view all the answers

What action should be taken if a sucking chest injury is observed?

<p>Seal the wound instantly (A)</p> Signup and view all the answers

Which of the following indicates a need for immediate patient transport?

<p>Unresponsiveness of the patient (C)</p> Signup and view all the answers

What should be assessed during the disability evaluation?

<p>Evaluate Glasgow Coma Scale (GCS) score (A)</p> Signup and view all the answers

What information is crucial to obtain in a SAMPLE history?

<p>Last oral intake and symptoms (B)</p> Signup and view all the answers

What type of injury can result from a motorcycle with a low riding seat where the gas tank acts as a wedge on the pelvis?

<p>Severe anterior-posterior compression injuries (C)</p> Signup and view all the answers

What type of trauma patient allows immediate focus on the main problem?

<p>Isolated injury (D)</p> Signup and view all the answers

Which of the following is a potential consequence of angular impact when a motorcycle strikes another object?

<p>Severe open and comminuted lower extremity injuries (A)</p> Signup and view all the answers

How should the on-scene time be managed for trauma patients?

<p>Limited to 10 minutes or less (A)</p> Signup and view all the answers

What type of crash has the greatest potential for lethal injury?

<p>Rollovers (D)</p> Signup and view all the answers

What might prompt the careful removal of a helmet?

<p>Airway management techniques cannot be performed with the helmet in place (B)</p> Signup and view all the answers

What sign indicates compromised circulation during a patient assessment?

<p>Skin color changes (A)</p> Signup and view all the answers

Which injury is commonly associated with improper seat belt use?

<p>Cervical fractures (B)</p> Signup and view all the answers

In lateral crashes, what type of injury is most likely to affect occupants?

<p>Lateral injuries (D)</p> Signup and view all the answers

What occurs during the first impact in pedestrian injuries?

<p>The vehicle strikes the pedestrian's body with its bumpers (B)</p> Signup and view all the answers

According to the Waddell triad, what is the first point of impact for a child when struck by a vehicle?

<p>The pelvis and femur (C)</p> Signup and view all the answers

How much has the use of airbags reduced deaths in direct frontal motor vehicle collisions?

<p>30% (D)</p> Signup and view all the answers

What is the acceleration due to gravity when a fall occurs?

<p>9.8 m/s² (D)</p> Signup and view all the answers

What is one common misconception about three-point seat belts?

<p>They are ineffective in crashes angled up to 45°. (D)</p> Signup and view all the answers

What effect does laying the bike down have during an accident?

<p>It separates the rider from the motorcycle and the object to be hit (C)</p> Signup and view all the answers

During a motorcycle crash assessment, which factor is NOT typically considered?

<p>Extent of damage to roadway (A)</p> Signup and view all the answers

What assumption should be made about any visible dents and abrasions after a motorcycle accident?

<p>They may indicate cervical spine fractures (C)</p> Signup and view all the answers

What happens to the risk of death if a patient is ejected from a vehicle during a rollover?

<p>Increased by 91 times (D)</p> Signup and view all the answers

Which safety device is essential for motorcycle riders to minimize injuries?

<p>Helmets (A)</p> Signup and view all the answers

What is a possible outcome of compression injuries of the chest?

<p>Diaphragm tearing (C)</p> Signup and view all the answers

Which injury is least likely to result from the down-and-under trajectory in a vehicle accident?

<p>Shoulder dislocation (C)</p> Signup and view all the answers

What type of injury is most common from lateral impacts in a vehicle?

<p>Rib fractures (B)</p> Signup and view all the answers

What injury could occur if a passenger takes a deep breath before impact during a collision?

<p>Lung contusion (C)</p> Signup and view all the answers

In the context of vehicle collision injuries, what does the up-and-over pathway indicate?

<p>The head is the lead point of impact. (A)</p> Signup and view all the answers

Which injury would you expect to see from compression against the seat belt?

<p>Bowel rupture (D)</p> Signup and view all the answers

What is a probable pelvic injury pattern in side impact collisions?

<p>Pelvic ring disruption (A)</p> Signup and view all the answers

What factor contributes to spinal injuries during lateral or side impacts?

<p>Head movement towards the impact (A)</p> Signup and view all the answers

What component of the trauma lethal triad increases the risk of mortality and contributes to coagulopathy?

<p>Hypothermia (D)</p> Signup and view all the answers

Which of the following criteria indicates that a patient should be transported to the highest-level trauma center?

<p>Penetrating trauma to the torso (B)</p> Signup and view all the answers

Which statement accurately describes the management of a patient with multisystem trauma?

<p>Maintaining normothermia is important. (D)</p> Signup and view all the answers

What is a consequence of coagulopathy in trauma patients?

<p>Ineffective blood clotting (D)</p> Signup and view all the answers

When should tranexamic acid (TXA) be considered in managing trauma patients?

<p>If protocols allow and to control internal bleeding (D)</p> Signup and view all the answers

Falls greater than which height in adults are indicators for trauma center transport?

<p>20 ft (D)</p> Signup and view all the answers

What role does acidosis play in trauma patients?

<p>Contributes to coagulopathy and complicates treatment (A)</p> Signup and view all the answers

Which of the following is NOT a physiologic criterion for referral to a trauma center?

<p>Heart rate of 100 beats/min (A)</p> Signup and view all the answers

Flashcards

Rotational or Quarter-Panel Impact

A type of collision where the impact occurs to the side of the vehicle, but not directly in the center.

Rear Impact

A type of collision where the vehicle's back end is hit by another vehicle.

Whiplash Injury

Injury to the neck caused by sudden forceful movement, often from a rear-impact collision.

Rollover

A type of collision where the vehicle rolls over on its side or roof.

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Seat Belt

A device that helps prevent the occupant from flying forward in the event of a crash.

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Airbag

A safety feature that deploys in a frontal collision, providing a cushion between the occupant and the steering wheel.

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Head-on Motorcycle Impact

A type of crash involving a motorcycle striking an object head-on.

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Motorcycle Protective Devices

Protective gear worn by motorcycle riders, such as helmets and abrasion-resistant clothing.

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Ejection (Motorcycle)

Occurs when a rider is thrown from a motorcycle at high speed and collides with a stationary object, another vehicle, or the road.

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Laying the Bike Down

A technique used to separate the rider from the motorcycle during a crash, reducing the risk of serious injury.

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Rider Continues Forward

The rider continues moving forward until stopped by an external force. This can result in serious injuries.

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Angular Impact (Motorcycle)

Impacting an object at an angle, causing crushing injuries to the lower extremity.

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Waddell Triad (Pedestrian)

A pattern of injuries common in children and short adults, where the bumper hits the pelvis, the chest hits the grille, and the head strikes the vehicle and then the ground.

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First Impact (Pedestrian)

The first impact in a pedestrian collision, where the bumper hits the adult's body.

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Third Impact (Pedestrian)

The third impact in a pedestrian collision, where the body strikes the ground or another object.

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Fall Acceleration

The force of gravity pulls a person downwards at 9.8 m/s² during a fall.

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Down-and-under pathway

A common injury pattern in unrestrained occupants where the occupant slides under the steering wheel or dashboard, causing multiple injuries to the lower extremities, pelvis, and torso.

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Up-and-over pathway

The occupant's head is the primary point of impact, leading to potential head and cervical spine trauma.

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Lateral impact injury

A specific injury pattern in side impact collisions where the hips and chest are directly impacted, potentially causing pelvic fractures, rib fractures, and lung contusions.

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Lateral compression injury

A pattern of pelvic injury in side impacts where the pelvis is compressed from the side, leading to a disruption of the pelvic ring.

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Flail chest

A severe injury that occurs in the chest when multiple ribs are broken, leading to a paradoxical movement of the chest wall.

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Lung contusion

A serious condition where the lungs are compressed, leading to difficulty breathing and even respiratory distress.

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Spinal injury

Injury to the spine caused by compression or shearing forces, often resulting in paralysis or loss of sensation.

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Brain injury / Swelling

Injury to the brain caused by swelling of the brain tissue within the skull, which can lead to increased pressure and potentially death.

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Primary Survey (ABCDE)

The initial assessment of a patient to determine their level of consciousness, airway, breathing, circulation, disability, and exposure. This is the most important step in assessing a patient and determining their priority for treatment.

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Vital Signs Assessment

Evaluating a patient's vital signs, which include pulse, respiration, blood pressure, pulse oximetry, blood glucose, cardiac monitoring, and automatic blood pressure monitoring. This provides vital information about the patient's overall health condition.

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Physical Examination

A systematic examination of the head, neck, chest (including abdomen and pelvis), extremities, and back, searching for any injuries. It is conducted to identify any signs of injury or trauma.

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Critical Conditions

Any condition or problem that is potentially life-threatening and requires immediate attention. This includes conditions that have a severe impact on the patient's health, such as respiratory distress, cardiac arrest, or major bleeding.

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Multisystem Traumatic Injury

Injuries that occur in multiple body systems or involve two or more different areas of the body. It requires a comprehensive assessment and management strategy.

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Trauma Score

A system used to evaluate the severity of the injury based on various criteria such as blood pressure, respiration rate, and Glasgow Coma Scale score. This helps determine the patient's priority for treatment and allocate resources accordingly.

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Patient History and Assessment

Assessing the patient's general well-being through physical examinations, vital signs, and reviewing past medical history. This helps identify any underlying conditions and factors that may influence treatment.

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Reassessment

A rapid full-body scan performed while the patient is being transported to the hospital. This helps monitor their condition and identify any changes in their symptoms or vital signs.

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Hypothermia

A state of abnormally low body temperature, even mild hypothermia can decrease survival rate and contribute to coagulopathy.

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Coagulopathy

A condition where the blood's ability to clot is impaired, leading to excessive bleeding and poor perfusion.

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Acidosis

A build-up of acid in the blood, often caused by excessive bleeding and treatments like IV fluids.

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Trauma Lethal Triad

A life-threatening combination of hypothermia, coagulopathy, and acidosis often seen in trauma patients.

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Field Triage Decision Scheme

The American College of Surgeons Committee on Trauma (ACS-COT) and the Centers for Disease Control and Prevention have developed a system to decide which patients need transport to a trauma center.

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Physiologic Criteria

A Glasgow Coma Scale score of 13 or less, systolic blood pressure less than 90 mm Hg, or respiratory rate less than 10 or more than 29 breaths/min indicate a need for transport to a trauma center.

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Anatomic Criteria

Penetrating trauma to head, neck, torso, extremities proximal to elbow or knee, chest wall instability, two or more proximal long bone fractures, crushed/mangled extremity, amputation, pelvic fracture, open/depressed skull fracture, paralysis.

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MOI Criteria

Falls over 20 ft for adults, falls more than 10 ft or two or three times the child's height for children, indicate transport to a trauma center.

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Study Notes

Introduction

  • Trauma is a leading cause of death and disability in individuals aged 1 to 44 years.
  • Understanding trauma mechanics and biomechanics is crucial in patient analysis and management.
  • Accurate documentation is essential for physicians to understand trauma events.

Trauma, Energy, and Kinetics

  • Trauma results from external energy exceeding the body's capacity to sustain and dissipate it.
  • Different energy types (mechanical, chemical, thermal, electrical, barometric) cause distinct trauma types.
  • Mechanical energy includes kinetic (motion) and potential (stored) energy.
  • Biomechanics is the study of living organisms' physiology and mechanics.
  • Kinetics analyzes the relationships between speed, mass, force direction, and resulting injuries.
  • The body's ability to disperse delivered energy influences the sustained injury.
  • External factors like force, size, velocity, acceleration, and affected body area determine injury type.

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