21: kinematics of trauma. 1.describe the “three collisions” associated with motor vehicle...

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21: Kinematics of Trauma

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Page 1: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

21: Kinematics of Trauma

Page 2: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

1. Describe the “three collisions” associated with motor vehicle crashes.

2. Relate how the fundamental principles of physics apply to motor vehicle crashes and other types of accidents.

3. State Newton’s three laws.

Cognitive Objectives

Page 3: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Psychomotor Objectives

• There are no affective objectives for this chapter.

4. Observe various high-energy injuries and identify potential damage to the patient.

Page 4: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Kinematics of Trauma

• Injuries are the leading cause of death among children and young adults.

• Kinematics introduces the basic physical concepts that dictate how injuries occur and affect the human body.

Page 5: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Energy and Trauma

• Work– Force acting over distance

• Kinetic energy– Energy of moving object

• Potential energy– Product of weight, gravity, and

height

Page 6: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Traumatic Injuries

• Blunt trauma – Caused by a force to the body– Injuries do not penetrate soft tissue or organs

• Penetrating trauma – Caused by objects such as knives and bullets– Injuries pierce the surface of the body

Page 7: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Mechanism of Injury (MOI)

• MOI is the way in which traumatic injuries occur. • Different MOIs produce many types of injuries.

– Isolated to one body system– Injuries to many body systems

Page 8: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Vehicular Crashes and MOI

• By assessing the crash, the MOI may be determined.

• By determining the MOI, you may be able to predict the types of injuries that may have happened at the time of impact.

Page 9: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Vehicular Collisions

• Three types of crashes– Collision of car against another car or

object– Collision of passenger(s) against interior

of car– Collision of passenger’s internal organs

against the solid structures of the body

Page 10: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Significant MOI

• Severe deformities to the frontal part of the vehicle

• Moderate intrusion from a T-bone accident• Severe damage from the rear• Collisions in which rotation is involved

Page 11: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Types of Motor Vehicle Collisions

• Frontal• Lateral• Rear-end• Rollovers• Spins

Page 12: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Frontal Collisions (1 of 2)

• Evaluate seat belts and airbags.

• Remember that supplemental restraint systems cannot prevent all injuries.– You should still

suspect that serious injuries have occurred.

Page 13: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Frontal Collisions (2 of 2)

• Check for contact points.

• Steering wheels can also cause chest injuries, especially if no airbag is present.

Page 14: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Rear-End Collisions

• Commonly cause whiplash-type injuries

• Unrestrained passengers will be thrust forward into the dashboard.

• Back seat passengers wearing only lap belts might have a higher incidence of lumbar and thoracic spine injury.

Page 15: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Lateral Collisions

• Responsible for the highest incidence of deaths.

• Lateral whiplash injury is the result.

• There may be intrusion into the passenger compartment.

Page 16: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Rollover Crashes

• Injury patterns differ if patients are unrestrained.

• The most unpredictable injuries are to unrestrained passengers.

• Ejection is the most common life-threatening injury.

Page 17: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Spins

• Vehicle is put into rotational motion.• Vehicle often strikes a fixed object,

combining forces of rotation with lateral impact.

Page 18: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Car-Versus-Pedestrian Collisions

• Often cause serious injuries to body systems• Evaluate MOI to determine:

– Whether patient was thrown and how far.– Whether patient was struck and pulled under car.

• Presume injury to the spinal cord and maintain immobilization.

Page 19: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Falls

• Injury potential is related to the height of the fall.

• A fall either 15' or three times the person’s height is considered significant.

• Suspect internal injuries from a significant fall.

Page 20: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Considerations for Falls

• The height of the fall

• The surface struck

• The part of the body that hit first, followed by the path of energy displacement

• Always consider syncope or other medical conditions as an underlying cause.

Page 21: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Penetrating Trauma

• Second largest cause of death in the United States after blunt trauma

• Penetration can be low-energy, or medium- or high-velocity.

• The greater the speed of penetration, the greater the injuries.

Page 22: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Low-Energy Penetrating Trauma

• Caused accidentally by an object or intentionally with a weapon

• Injury caused by the sharp edges of the object moving through the body

Page 23: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Medium-Velocity and High-Velocity Penetrating Trauma

• Usually caused by bullets

• Bullets can change shape and ricochet within the body.

• Pressure waves cause cavitation.

• If possible, identify weapon caliber and shooting distance.

Page 24: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

High-Velocity Penetrating Trauma

Page 25: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Newton’s First Law

Objects at rest tend to stay at rest, and objects in motion tend to stay in motion, unless they are acted upon by some force.

Page 26: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Newton’s Second Law

Force (F) equals Mass (M) times Acceleration (A)

F=MA

Page 27: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Newton’s Third Law

For every action, there is an equal and opposite reaction.

Page 28: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Injuries to the Head

• Bruising or tearing of the brain• Bleeding or swelling inside the skull is often life

threatening.• Some patients may not have signs and symptoms.

Page 29: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Injuries to the Neck

• Tearing or swelling of trachea can cause life-threatening airway problems.

• Injury to large blood vessels in the neck may produce swelling that prevents blood flow to the brain.

• Open wounds to neck vein bleed heavily or allow air to enter the circulatory system.

Page 30: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Injuries to the Chest

• Broken ribs may interfere with chest’s ability to expand normally.

• Large vessels may tear, causing massive bleeding.

Page 31: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Pneumothorax

• Air collecting between lung tissue and chest wall• Compression of lung tissue interferes with oxygen

exchange. • May also interfere with the functioning of the heart

(tension pneumothorax)

Page 32: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Abdominal Injuries

• Solid organs can tear, lacerate, or fracture, causing serious bleeding and death.

• Hollow organs can leak digestive fluids. • Trauma patients who complain of abdominal pain

may have abdominal bleeding.

Page 33: 21: Kinematics of Trauma. 1.Describe the “three collisions” associated with motor vehicle crashes. 2.Relate how the fundamental principles of physics

Mutisystem Trauma Patient

• A patient whose injuries involve more than one body system