Blunt Trauma.ppt

blunttrauma,introductiontoblunttraumakineticsofblunttraumatypesoftraumablunttraumaexplosionotherblunttrauma,sections,mostcommoncauseoftraumadeathanddisabilityenergyexchangebetweenanobjectandthehumanbody,withoutintrusionthroughtheskin,introductiontoblunttrauma,kinematics,processofexaminingthescenetodeterminepotentialinjuriesthatresultfromtheforcesofmotion,moi,mechanismofinjurydescriptionofthemechanicalandphysiologicalchangesthatresultinanatomicalorfunctionaldamageoftissue,indexofsuspicion,basedonthemoiandkineticspredictexpectedinjuries,kineticsofblunttrauma,inertia“abodyinmotionwillremaininmotionunlessacteduponbyanoutsideforce.”“abodyatrestwillremainatrestunlessacteduponbyanoutsideforce.”conservationofenergy“energycanneitherbecreatednordestroyed.itisonlychangedfromoneformtoanother.”kineticversuspotentialenergy,kineticenergyenergyinmotiondoubleweight=doubleenergydoublespeed=quadrupleenergyspeedisthegreatestdeterminant,kineticsofblunttrauma,forceemphasizestheimportanceofrateatwhichanobjectchangesspeed(accelerationordeceleration),kineticsofblunttrauma,bluntclosedinjuryindirectinjurytounderlyingstructurestransmissionofenergyintothebodytearingofmuscle,vesselsandboneruptureofsolidorgansorganinjuryligamentumterespenetratingopeninjurydirectinjurytounderlyingstructures,typesoftrauma,44,000peopledieeachyearonushighwayseventsofimpactvehiclecollisionbodycollisionorgancollisionsecondarycollisionsobjectsinsidevehiclestrikeoccupantadditionalinjuriesvehiclereceivesasecondimpact,blunttrauma:automobilecrashes,inertiaandmvcs,restraintsseatbeltsoccupantslowswiththevehicleshoulderandlapbeltsmustbeworntogetherinjuriesifwornseparatelyairbags(srs)reducebluntchesttraumacause:hand,forearm,iflowerdensityisadjacenttohigherdensitysurfacetissueofdensertissueisdisrupted-“spalling”aswavetransversesthewallsofthealveoli(highdensity),theyruptureasthewaveencounterstheairwithinthealveoli(lowdensity);massivedestructionofalveolianddiffusehemorrhageinlung,implosionpressurewavepassesthroughthelung,itforcesbloodoutofthevascularspaceandintothealveoliwaveofhighpressureisfollowedbywaveoflowpressureallowingalveolitoexpandrapidlywithfurthertearingofthelungparenchyma,atelecasis,hemorrhage,secondaryinjury,resultsfromflyingdebriscreatedbytheexplosionandcarriedbyblastwindsinjuriesaretypicallysevereandpenetratingduetohighkeofprojectiles,tertiaryinjuries,blastwindsaresufficientforcetocausevictimstobecomehumanmissilesvictimstrikestheground,associatedinjuries,injuriesresultingfromchangesintheenvironmentasaconsequenceoftheexplosionfire;burnscombustionoftoxicproducts;poisoningleaksoftoxicchemicals;asphyxiation,explosion,pressurewavestructuralcollapseblastwindburnsprojectilespersonneldisplacementblastinjuryphasesprimary:heatoftheexplosionsecondary:traumacausedbyprojectilestertiary:personneldisplacementandstructuralcollapse,blastinjuryassessmentbealertforsecondarydeviceinitialscenesize-upimportantestablishincidentcommandsystem(ics)evaluateforsecondaryhazardsinjurypatternsruptureofairorfluidfilledorganslung:latemanifestation(heatoragriculturalgreatforcetosofttissueandbonestissuestretchingandcompressionextendedpressureresultsinanaerobicmetabolismdistaltocompressionreturnofbloodflow,toxinstoentirebodyseverehemorrhageduetoseveredamagedbloodvesselscareprolongedcrushmedicationssodiumbicarbon