EMT-Chapter 27-Trauma Overview: the Trauma Patient and the Trauma System

  1. Mechanism of Injury(MOI)
    The factors and force that cause traumatic injury
  2. Kinetics of Trauma
    The science of analyzing MOI
  3. Three Impacts
    • Vehicle collision
    • Body collision
    • Organ collision
  4. High Index of Suspicion to the Followings
    • Death of another occupant of the vehicle.
    • An unresponsive patient with an AMS.
    • Intrusion of greater than 12 inches for the occupant site or greater than 18 inches anywhere to the vehicle.
    • Ejection from the motor vehicle.
  5. Frontal Impact
    • Partial ejection
    • Injuries to the abdomen, chest, face, head, and neck
    • Dashboard
  6. Rear-end Impact
    • Whiplash injury
    • Improper positioned headrest
    • Up-and-over or down-and-under injuries
  7. Lateral Impact
    • T-bone
    • Injuries to the head, neck, chest, abdomen, and the pelvis
  8. Rotational or Rollover
    • Multiple injuries
    • Vehicles with high center of gravity
  9. Vehicle-Pedestrian
    • Adult-up and over, usually from the side of the vehicle
    • Child-down and under, usually facing the vehicle
  10. Restraints
    • Hidden injuries
    • Belts, airbags
  11. Motorcycle Collisions
    • Head-on Impact: the bike tips forwards
    • Angular Impact: the rider strikes an object at an angle
    • Ejection: after the collision, the rider is ejected
  12. Falls
    Greater than 15 ft or 2 times the patient's height.
  13. Penetrating Injuries
    • Low velocity
    • Medium velocity
    • High velocity
  14. Medium and High velocity Injuries
    • Dissipation of Energy: How energy is transferred to the human body by the forces acting on it. It is affected by 
    • 1. Drag: The factors that slow a projectile
    • 2. Profile: The size and shape of a bullet's point of impact
    • 3. Cavitation: A cavity formed by a pressure wave resulting from the kinetic energy of a bullet travelling through body tissue; also called pathway expansion
    • 4. Fragmentation: The braking up of a bullet into small pieces on impact
  15. Low-velocity Injuries
    • Slash marks
    • stabbing
  16. Blast Injuries
    • Primary phase
    • Secondary phase
    • Tertiary phase
  17. Primary Phase Injuries
    • Due to the pressure wave of the blast
    • Primarily affects the gas containing organs
    • Severe damage and death might occur without any external signs of injury
  18. Secondary Phase Injuries
    • Due to flying debris propelled by the force of the blast, or blast wind.
    • Lacerations, impaled objects, fractures, and burns
  19. Tertiary Phase Injuries
    • Occur when the patient is thrown away from the source of the blast.
    • Ejections
  20. The Golden Period
    The hour from the onset of injury to the ER
  21. The Platinum 10 minutes
    10 from arrival to transportation.
  22. Indication of On-scene time 0f 10min or Rapid Transport
    • Airway occlusion
    • Respiratory rate < 10 or > 29
    • Inadequate tidal volume
    • Hypoxia (SpO2<95%)
    • Respiratory distress, failure, or arrest
    • Suspected skull fracture
    • Flail chest
    • Suspected pneumothorax, hemothorax, or tension pneumothoroax
    • Pelvic fracture
    • Two or more proximal long bone fracture
    • Crushed or mangled extremity
    • Uncontrolled external hemorrhage
    • Suspected internal hemorrhage
    • Signs and symptoms of shock
    • Significant external blood loss
    • Glascow Coma Scale <15
    • AMS
    • Seizure activity
    • Sensory or motor deficit
    • Any penetrating trauma to head, neck, anterior or posterior chest or abdomen, and above elbow or knee
    • Amputation of an extremity proximal to the finger
    • Trauma in patient with significant medical history(cardiac condition, pregnancy)
    • Multisystem trauma
    • Open or depressed skull fracture
    • Suspected brain injury
    • Paralysis
  23. The Trauma System
    • Level I-Regional Trauma Center: All trauma 24-7+ research
    • Level II-Area Trauma Center: All trauma 24-7
    • Level III-Community Trauma Center: stablizing patient for transport
    • Level IV-Trauma Facility: stablizing
Card Set
EMT-Chapter 27-Trauma Overview: the Trauma Patient and the Trauma System