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36 Cards in this Set
- Front
- Back
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What is Newtons first law of motion? |
A body at rest remains at rest and a body in motion remains in motion unless acted on by an outside force. eg - pedistrians hit by a veichle, blast and gunshot victums. |
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What is the Lw of conservation of enery? |
Energy is neither created nor destroyed, but changes form. eg - as a car is breaking, the energy of motion is converted to friction heat in braking. |
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What is Newtons second law of motion? |
The force that an abject exerts on another object is equal to the ass of the object multiplied by its acceleration. Multiplying an objects acceleration by its mass gives the force of impact absorbed by the object stopping it. |
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What is the Law of Moving objects? |
Kinetic energy is the energy associated with motionnd reflects the connec tion between weight (mass) and speed (velocity). The equation to calculate kinetic energy is Ek = 1/2 mv(2)
- Doubling the weight of the moving object doubles the impact, but... - Doubling the speed quadruples the impact. |
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What causes acidosis? |
Inadeqyte tissue perfusion and is also a contributing factor that is worsened by the presence of hypothermia and coagulopathy. Acidosis can be an independent predictor of mortality and morbidity in major trauma.
- Class 4 haemorrhage = metabolic cidosis and respiratory alkalosis. |
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Class 1 Hemorrhage? |
- Up to 15% blood loss (<750mL)
- Slightly anxious - Pulse <100bpm - Skin - warm and dry - Normal bp - Normal pulse pressure or increased - Normal resps
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Class 2 Haemorrhage? |
- 15-30% blood loss (750-1,500mL)
- Mildly anxious - 100-120bpm - Skin - slightly cool - Normal bp - Resps - 20-30 breaths/min |
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Class 3 Haemorrhage? |
- 30-40% blood loss (1,500 - 2,000mL)
- COnfusion and agitation - 120 - 140 bpm - Skin - cool, pale, diaphorretic - Decreased bp - Narrowed pulse pressure - Resps - 30-40 breaths/min |
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Class 4 Haemorrhage? |
- >-40% blood loss (>2,000mL)
- COnfused, lethargic, decreased ALOC - > 140 bpm - thready pulse - Skin - pale, cool, diaphoretic - Severrely decreased blood pressure - >35 breaths/min - Narrowed pulse pressure - ABGs = metbolic cidosis and resp alkalosis |
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Hypothermia, what happenes? |
- Mild - 34 - 36C - Moderate - 30 - 34C - Severe - <32C - Peripheral casoconstriction and decreased tissue perfusion - Impared O2 delivery to tissue - Decreased production of clotting factors - Impairement of platelet aggregation adherence |
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What happens in a patient with shock secondary to and active traumatic haemorrhage? |
- Tachycardia, hypotension, peripheral shutdown, capillary refill >2 secs, cool, pale, diaphoretic, weak and thready pulse. Decreased unrine output, decreased GCS, increased dydtemic vascular resistance, ll syptos increasing with increasing shock. |
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List the Different mechansims of motion of injury. |
- Acceleration/decelleration, axial loading (force applied upwards and downwards with no posterior or laterial bending of the neck), cavtation, compression, compresive strength, distration (sepecation - hangings), elastivity, force, high velocity, inertial resistance, injury, kinematics, kinetic energy, low velocity, muxxle blst (cloud of hot gass and bursing power from muzzle of gun), Shearing, stress, tensile strength, tumnining and yaw. |
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What is the triad of death? |
- hypothermia - acidosis - coagulopathy |
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What are the different types of trauma? |
- Blunt trauma - Falls - Interpersonal violence - Hanging and self inflected strangulation - Penetrating trauma - High/ Low velocity penetrating wounds - Blast injurits (Primary, secondary and tertiary) - Aditional weapons - Inhalation/pulmonary Injuries |
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In regards to MVAs, what are the different mechanisms that the pt may have had? |
- Frontal Impact - Down and under - Up and over - Rear impact - Side impact - Rotational Impact - Vehicle rollover - Ejection - restraint injury |
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What are the three stages that occur during deaceleration? |
Pefore a collision occures, the occupant and behicle are moving at the same speed.
1) when the vehicle impacts with another object 2) deceleration of the occupant (compression/shearing trauma) 3) Internal structures continue to moce until they collide with another internal structure. |
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What are injuries commonly seen with steerting wheel injuries? |
- Spinal fractures - soft tissue neck injuries - Laryns and tracheal injuries - fractured sternum - myocardial contusion - pericardial tamponade - Intraabdominal injuries - bowel injuries - pneumothorax, haeothorax, flale chest - chest injuries |
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What are the potential injury sites in lateral-impact collision? |
- Head jerked laterally - fractured clavical - flail - fractured femer |
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What happens during frontal impact? |
Depending on the levels of energy involved and the speed, multiple injuries can occure (especially if pt not restrained and no airbags). After the vehicle stops, unrestrained occupants in the front seat continue to move down and under, or up and over, the dashboard. |
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What happens in a down and under mechanism? |
Knees impact the dashboard. The upper legs absorb most of the energy. This causes patella dislocations, midshaft fractures and posterior dislocations or fractures of acetabulum or femoral head. |
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What happens in and up and over mechanism? |
The fronal collision carries the unrestrained body up and over, so that the chest and abdomen hit the steering wheel. Head injuries; contusions, skull and facial fracuers, scalp lacerations, cerebral haemorrhage of cerebral contusions.
The brain can often continue to more foward within the skull, brusing when it hits the shell and tearing of vessels at the oppisite end. Therefore there are two seperate brain injuries. |
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What happens in rear impact mechanism? |
Vehicle suddenly accelerates causing hyperextension of the neck. If head rests are not in place or are poorly adjusted, serious neck injury can occur. pt may have strained or torn next ligaments. There are mostly two points of impact, rear and frontal. |
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What happens in side impact mechansim? |
Most injuries are on the same side of the body as the impact. The head and sholder of one occupnt may ipact the other occupants head and sholder. |
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What happens in rotational impact mechansim? |
The part that is hit on the second behicle stops foward motion, whereas the rest of the behicle rotates around untill all energy is transormed. The occupants motion continues until it impacts with the side of the behicle as the vehicle begins rotating. Injuries are a comnination of those seen in frontal and lateral impacts. |
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What happens in vehicle roll over? |
Injuries are sometimes diffucult to predict. Pts frequently have injuries on the same sides as the vehicle. Often at many angles and several time = multisystem trauma. |
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What happens during occupant ejection? |
Pts sustain injuries at the point of impact when energy is tranferred to the entire body. Increased mortality is associated with ejection. Unrestrained patients are at greater risk. |
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What happens with restraint injuries? |
The sholder and lap belt reduces facial, head, abdo injuries and long bone fractures. Seatbelt bruising patterns on the absoen or chest implu significant energy enxhange. If the belt is positoned bove the rim of the pelvic, abdominal organs are trapped between the posterior wall and the belt. Injuries to the pancreas and other retroperitoneal orgns, as well as blowout ruptures of the small intestine and colon can result. |
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Moterbike Colisions? What are the three main types of impacts? |
Clues - look at the damage to the bike (often the pt will be in the same form as the bike) - look for length of skid marks, deformits to the helmut and stationary objects impacted.
1) Head on impact (bilteral femor fractures) 2) angulr impact 3) ejection |
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Bicycle Injuries? |
The most common injury is through falls and collicions with stationary or moving objects. Spokes of the wheels can fracture feet, pts can be thrown over the handle bars. Injuries with the straddle or seat can cause vaginal tears, scrotal injuries and perineal contusions. Helmuts reduce the risk of head, brain and severe brain injury by 63-88%. Upper and id-fcial areas are reduced by 65%. |
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Pedestrian trauma? What are the three phases of injury? |
1) The inital inpact when the bumper of the behicle impacts with the lower extremity of the pedistrian.
2) Following this, the head, chest and abdominal injuries occure as the pedestrial hits the bonnet or windscreen
3) The pt may then fall to the ground, resulting in further head, chest and upper extremity injuries. |
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What is Waddells triad? What is it in reference to? |
Charaterised by injuries to the chrst, head and femurs.
It is when a child is struck by a vehicle. The turn and face the car whereas an adult turns to the side.
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What is interpersonal violence? |
Interpersonal violence is often devided into intiate partner, acquaintance and stranger ciolence. Injuries vary depending on the object used. The cost common injury sites are the head, neck or face. Minor abrasions to multisystem trauma. Males are more likely to be injured by kicks, head butts of droken glass bottles, females are more exposed to blunt violence. Defensive injuries are commonly found on the upper libs, hands and back. |
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Handings and self inflected strangulation. |
Self-inflected strangulation is the most common form of successful suicide methods worldwide. More severe associated injuries are hypoxia brain injury and vascular, vertebral and/or spinal injuries. |
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Describe raised intercrainal pressure. Cushings reflex and cushings triad. |
Cushings reflex - Increase in bp to accomidate for the brain tissue not getting blood and becoming hypoxic. Barrowreceptors counteract this by decreasing pulse rate.
Cushings triad - Irregular respirations due to coning of the brain through the froman magnum. This puts pressure on the respiratory centre causing the change in respirations. |
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Pericardial tamponade. |
Usually follows penetrating injyry to the chest wall or epigastrium. It results when an abnormally increased colume of pericardial fliod becomes brapped between the beating heart and the rigid overlying fibrous pericardium, copressing the cardiac chabers and thus reducing cardiac output as a result of diinished vencticular filling during diastole. |
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What is Becks triad? |
Consists of hypotension, distant or diished heart sounds on auscultation and elevated central venous pressure as evidenced by destension of neck veins. Cardiac tamponade is often chacterised by Becks triad. |
