kinamatics of trauma.ppt
TRANSCRIPT
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Kinematics of Trauma
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Learning Objectives Define energy in the context of injury
production. Describe relationship of injury and energy
exchange. List phases of assessment and their
characteristics Describe the mechanical principles of trauma Identify types of injuries and their kinematics
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Kinematics of Trauma It can help explain the type of injury, outcomes and
injury combinations. It indicates the need for additional diagnostic workup
and reassessment. It is related to the type of injuring force and subsequent
tissue response. The effect of injury depends on personal and
environmental factors. Crash: is the energy exchange that occurs when an
energy force (usually solid object) impacts the human body.
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Phases of Assessment and Management
Precrash phase: include the events that precede the incident
E.g.: alcohol ingestion, past Hx, drugs,
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Phases of Assessment and Management
Crash phase: begins at time of impact between one moving object and a second object.
Considerations include: The direction of energy exchange The amount of energy exchanged The effect of force on the patient
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Phases of Assessment and Management
Postcrash phase: begins as soon as energy from crash is absorbed.
Information gathered about crash and precrash is used to manage patient.
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General Principles To understand the effects of force on body it
is important to understand two components (Energy and Anatomy)
Laws of Energy and Motion: Newton’s first law of motion Conservation of energy
Force = mass x acceleration (deceleration)
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Factors Affecting Energy Exchange between Solid Object and Human Body
Tissue Density Air filled organs Fluid filled organs Solid organs
Contact area Cavitation
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Mechanical Principles Blunt Trauma Penetrating Trauma
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Blunt Trauma Forces involved are shear (changing speed)
and compression (squeezing). Multiple injuries are common with blunt
trauma They are more life threatening than
penetrating injuries It includes MVCs, falls, assaults and contact
sports, blast injuries
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Types of MVCs Frontal impact Rear impact Lateral impact Rotational impact Rollover
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Phases of pedestrian injuries The initial impact to the legs and sometimes
the hips. The torso onto the hood of the vehicle. The victims falls off the vehicle and onto the
ground, usually head first, with possible cervical spine trauma.
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Falls kinematics assessment An estimation of height of the fall The surface on which the victim landed
(compressibility) Part of body struck first
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Sports injuries Mechanisms associated are too numerous General principles are the same as for MVCs
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Blast injuries Primary injuries: caused by the pressure wave
of the blast Secondary injuries (fragmentation) Tertiary injury: caused by hitting with object
or object propelled by explosion.
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Penetrating Trauma Injury produced by foreign object penetrating
the tissue Penetrating objects are:
Low Energy Weapons i.e. knife High Energy Weapons i.e. firearms
Severity of injury is related to the structure damaged
Mostly contaminated
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Factors Affecting Severity of Penetrating Injury Profile: initial size of penetrating object. Tumble: angle or direction of entry Fragmentation
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