Trauma and mechanism of injuries


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Trauma and mechanism of injuries

  1. 1. Mechanism of Injury <ul><li>Dr shabeel pn </li></ul>
  2. 2. Mechanism of Injuries <ul><li>The physician must understand the kinematics of trauma and integrate this knowledge with the trauma producing episode. </li></ul><ul><li>Pre-hospital personnel are the primary source of this important component of the patient’s history. </li></ul>
  3. 3. K = M x V 2 /2
  4. 4. 3 Collisions
  5. 5. 3 Collisions <ul><li>Machine collision into object-deformity of the vehicle (indication of forces involved) </li></ul><ul><li>Body collision into interior of auto-deformity of interior structures (indication of the point of impact on the body </li></ul><ul><li>Organ collision in body-deformity (injury pattern) of the victim (indication of what parts of the body may have been involved in the impact) </li></ul>
  6. 6. Types of Automobile Accidents <ul><li>Head-on collision </li></ul><ul><li>T-bone or side impact collision </li></ul><ul><li>Rear-end collisions </li></ul><ul><li>Rollover collisions </li></ul>
  7. 7. Frontal Deceleration Impact
  8. 8. Head-on Collisions Windshield <ul><li>Deformity-spider web pattern in windshield </li></ul><ul><li>Injuries-Head (CHI), facial fractures and lacerations, c-spine injuries, and airway compromise. </li></ul>
  9. 9. Steering Wheel Injuries
  10. 10. Head-on Collisions Steering Wheel <ul><li>Deformity-broken ring, deformity of ring, steering column displacement </li></ul><ul><li>Injuries-C-spine fractures, chest, heart, rib fractures, pneumothorax and/or hemothorax, fractured sternum, carotid injury, tracheal fracture or injury, upper abdominal injuries (pancreas, liver, spleen) </li></ul>
  11. 11. Head-on Collisions Dashboard <ul><li>Deformity-imprint in dashboard and head </li></ul><ul><li>Injuries-head and neck injuries, chest injuries, fractures/dislocations of the hip and knee, and fractures of the femur. </li></ul>
  12. 12. T-Bone or Side Impact Collisions Drivers Side <ul><li>Deformity-intrusion into vehicle </li></ul><ul><li>Injuries-head (contra coup or brain injuries due to lateral displacement, c-spine fractures or subluxation, chest and spleen </li></ul>
  13. 13. T-Bone or Side Impact Collisions Passengers Side <ul><li>Deformity-intrusion into vehicle </li></ul><ul><li>Injuries-head (contra coup or brain injuries due to lateral displacement, c-spine fractures or subluxation, chest and liver. </li></ul>
  14. 14. Rear Impact Collision
  15. 15. Rear-end Collisions <ul><li>Deformity-head rest, steering wheel, windshield and dashboard </li></ul><ul><li>Injuries-c-spine fractures or subluxation, and may have all the injuries associated with head-on collisions. </li></ul>
  16. 16. Rollover Collisions <ul><li>Deformity-potentially entire auto. </li></ul><ul><li>Injuries-greatest potential for fatality if unrestrained-all those listed above, axial loading injuries (spine compression fractures, lower extremity fractures and pelvic fractures) </li></ul>
  17. 17. Seat Belt Without Shoulder Belt
  18. 18. Restraint Injuries <ul><li>Seat Belts-lacerations and injuries to the bowel and mesentery, clavicular fractures. </li></ul><ul><li>Air Bag-c-spine fractures, facial injuries. </li></ul>
  19. 19. Associated Injuries with Orthopedic Injuries <ul><li>Temporal or parietal bone fractures-epidural hematoma </li></ul><ul><li>Maxillofacial fractures-cervical spine fractures </li></ul><ul><li>Sternal fracture-cardiac contusion </li></ul><ul><li>First or second rib fracture-descending thoracic aortic injury and brachial plexus injuries </li></ul>
  20. 20. Associated Injuries with Orthopedic Injuries <ul><li>Scapular fracture-Pulmonary contusion, hemo or pneumothorax. </li></ul><ul><li>Fractured right 8 th -12 th ribs-liver laceration </li></ul><ul><li>Fractured left 8 th -12 th ribs-splenic injury </li></ul><ul><li>Pelvic fracture-ruptured bladder and/or urethral injury, rectal and perineal lacerations </li></ul><ul><li>Distal radial fracture-brachial artery or nerve injury </li></ul>
  21. 21. Associated Injuries with Orthopedic Injuries <ul><li>Supracondylar fracture or dislocation-popliteal artery injury </li></ul><ul><li>Anterior dislocation of shoulder-axillary nerve injury </li></ul><ul><li>Posterior hip dislocation-sciatic nerve injury </li></ul><ul><li>Posterior knee dislocation-popliteal artery injury </li></ul>
  22. 22. Immediate Transfer to Trauma Center <ul><li>Inadequate resources at referring facilitity </li></ul><ul><li>Closed Head Injury </li></ul><ul><li>Flail Chest </li></ul><ul><li>Grade 2 pelvic fractures-ring deformity </li></ul><ul><li>Blood pressure <90, heart rate >120 and abdominal injury </li></ul><ul><li>Two or more proximal long bone fractures </li></ul>
  23. 23. Immediate Transfer to Trauma Center <ul><li>High speed motor vehicle crash, intrusion into passenger compartment >12 inches. </li></ul><ul><li>Roll over with ejection </li></ul><ul><li>Multiple organ system injuries </li></ul><ul><li>All penetrating injuries to the head, neck, torso, and extremities proximal to elbow and knee. </li></ul><ul><li>If in doubt, transfer to a trauma center </li></ul>