Kinetic Energy Energy in Motion KE = Mass (weight) X Velocity (speed)² 2 Double Weight = Energy Double Speed = Energy IS THE GREATEST DETERMINANT

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Jemima Baker
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1 1 Chapter 17 Blunt Trauma 2 Introduction to Blunt Trauma Most common cause of trauma death and disability exchange between an object and the human body, without intrusion through the skin 3 Blunt trauma can be because the true nature of the injury is often hidden and evidence of the serious injury is very subtle or even absent. 4 Kinetics of Blunt Trauma (1 of 3) (Newton s First Law): - A body in motion will remain in motion unless acted upon by an outside force. - A body at rest will remain at rest unless acted upon by an outside force. Conservation of -Energy can neither be created nor. It is only changed from one form to another. 5 Kinetics of Blunt Trauma (2 of 3) Kinetic Energy Energy in Motion KE = Mass (weight) X Velocity (speed)² 2 Double Weight = Energy Double Speed = Energy IS THE GREATEST DETERMINANT 6 Kinetics of Blunt Trauma (3 of 3) Force (Newton s Second Law) = Mass X Acceleration (or deceleration) Emphasizes the importance of rate at which an object changes speed (acceleration or ) 7 Types of Trauma Closed injury injury to underlying structures Transmission of energy into the body -Tearing of muscle, vessels and bone, rupture of organs Open injury Direct injury to underlying structures 8 Blunt Trauma: Automobile Crashes 44,000 people die each year on US highways Events of Impact 1

2 - Collision - Collision - Collision - Collisions: objects inside vehicle strike occupant -Additional Injuries: vehicle receives a second impact 9 Inertia and MVC s 10 Seatbelts If seatbelts are worn properly: Occupant with the vehicle Shoulder and Lap belts MUST be worn together Injuries if worn separately Always check abdomen, pelvis, and for injuries due to seatbelt and lap belt usage 11 Airbags Airbags (Supplemental Restraint Systems) (SRS): Reduce blunt trauma Cause:, Forearm, & Facial Injury Check for steering wheel Side Airbags 12 Airbag Dynamics From impact to full deployment of airbags takes seconds Airbags deploy at a speed of over mph Disconnecting the is not always sufficient to deactivate airbags Many automobiles have capacitors that can hold a charge for 2 to 3 seconds up to minutes 13 Airbag Safety The 5, 10, 20 Rule Stay away from undeployed side curtain airbags Stay away from undeployed driver s airbags NEVER get between an undeployed airbag and the Stay away from undeployed passenger airbags 14 Child Safety Seats Infants and Small Children: facing Older Child: facing Child should be immobilized in the safety seat if possible. Use of is not practical Use blankets, towels, etc. to immobilize in seat 15 Automobile Crashes 2

3 Types of Impact: : 32% Lateral: 15% : 38% Rear-end: 9% : 6% 16 Frontal Impact (1 of 3) Up-and-Over: Tenses legs = Bilateral fracture Hollow organ rupture and liver laceration Injuries Axial loading trauma 17 Frontal Impact (2 of 3) Down-and-Under: Knee, femur, and fracture Chest trauma-steering Wheel Paper Syndrome 18 Frontal Impact (2 of 3) Ejection -Due to up-and-over -Contact with the vehicle & object 19 Lateral Impact 15% of MVC s but 22% of deaths extremity injury Rib, clavicle, humerus, pelvis, femur fracture compression -Ruptured diaphragm, Spleen fracture, Aortic injury EVALUATE the occupant 20 Rotational and Rear-end Impact Vehicle struck at oblique angle Less serious injuries unless strike a secondary object Rear-end Seat propels the occupant Head is forced backwards -Stretching of muscles and ligaments -Hyperextension & RARELY see significant injuries if head rest is properly positioned 21 Rollovers 3

4 points of impact or partial ejection Type of injuries are related to the specific vehicle impacts Less injury with 22 Automobile Crashes Vehicle Crash Analysis: Zones Intrusion/Deformity of Vehicle Use of Restraints Intoxication Fatal Accidents: >50% involved ETOH Also highly involved in accidents Rule out other causes 23 Automobile Crashes Vehicular Mortality Head: 48% (Torso): 37% Spinal & Chest fracture: 8% Extremity : 2% All Other: 5% 24 Crash Evaluation Collision Questions How did collision occur??? Similar/Different sized? collisions? 25 Crash Evaluation 1 Cause of Crash Weather & visibility? involved? conditions? Skid marks? 2 Auto Interior of windshield? Steering wheel deformity? deformity?? 26 Motorcycle Crashes Serious injuries can occur at all speeds Types of Impact: 4

5 Angular Sliding -Initial Bike/Object Collision -Rider/Object -Rider/Ground 27 Pedestrian Accidents Adults: Adults turn Bumper strikes lower legs first Victim rolls up and and thrown Children: Children turn Femurs, often injured Thrown away or run over 28 Recreational Vehicle Accidents Lack structure and system Types of Vehicles include: Snowmobiles and personal watercraft Often see injuries in children due to lack of skills and training 29 Blast Injuries Blast Injuries:, Fumes, Explosive Compounds Explosion: Fuel + Oxidant combine instantaneously Produce Heat & Wave 30 Explosion (1 of 2) Pressure Wave: Narrow wave moving rapidly outward Causes a drastic but brief increase, then decrease, in air Rapid compression/decompression can cause injury to middle ear,, sinuses, bowel Collapse 31 Explosion (2 of 2) Blast : Outward movement of heat and expanding combustible 5

6 Less strength, but greater than pressure wave 32 Explosion Injuries from the heat Projectiles from the blast Personnel Displacement: victim can become a Blast Injury Phases -Primary: of the explosion -Secondary: Trauma caused by projectiles - : Personnel displacement and structural collapse 33 Blast Injury Assessment Be alert for device Initial scene size-up important Establish Incident Command System (ICS) Evaluate for secondary hazards Injury Patterns -Rupture of Air or Fluid Filled -Lung: Late manifestation (heat & pressure) - loss 34 Blast Injury Care (1 of 3) Lungs: Forceful compression and distortion of chest cavity Compression and decompression Pulmonary, Dyspnea, Hemoptysis, Treat with oxygen, ventilation, and aggressive airway management if possible 35 Blast Injury Care (2 of 3) Abdomen: Compression & Decompression Release of contents rupture from pushing of organs up into thorax area Treat with oxygen/airway management, therapy if indicated, and shock management 36 Blast Injury Care (3 of 3) Ears: Initial Hearing Loss Injury over time 6

7 Penetrating Wounds: Care as any serious open wound or object Burns: Treatment consistent with traditional management. 37 Other Types of Blunt Trauma 38 Falls Stairs, Force, Surface of Fall Area -Surface Type - Part Elderly are more prone to falls and to serious injuries from falls 39 Sports Injuries Various Injury Patterns: Produced by extreme, fatigue or direct trauma Acceleration, deceleration, compression, rotation, hyperextension, or Unconsciousness, neurological defect or decreased mental status require physician follow-up Protective Gear injury pattern 40 Helmet Removal Remove helmet only if: -Fits too -Unable to control if left on -If helmet is removed, remove pads as well Remove only if possible If tight, remove face mask and immobilize in place Take to hospital if possibility of head injury 41 Crush Injuries (1 of 2) Causes include structural collapse, explosion, industrial; or Great force to soft tissue and bones Tissue stretching and compression Cuts off Extended pressure results in anaerobic metabolism distal to compression resulting in the buildup of acids and other toxins 42 Crush Injuries (2 of 2) Return of blood flow allows toxins to entire body causing acidosis Severe due to severe damaged blood vessels 7

8 Occassionaly the object is occluding a major blood vessel tear or rupture and when pressure is released, the patient rapidly develops shock 43 Care of Crush Injury Prolonged crush Medications Sodium Bicarbonate: Reduce : Improve Kidney Function or Fentanyl: Pain management Medications should be given prior to extrication if possible Treat injuries appropriately 8

McHenry Western Lake County EMS System Paramedic, EMT-B and PHRN Optional Continuing Education 2019 #2 Blunt Trauma

McHenry Western Lake County EMS System Paramedic, EMT-B and PHRN Optional Continuing Education 2019 #2 Blunt Trauma Blunt trauma is the most common cause of traumatic death and disability. The definition