EMT- Trauma

arterial air embolism
air bubbles in the arterial blood vessels
blunt trauma
An impact on the body by objects that cause injury without penetrating soft tissues or internal organs and cavaties
cavitation
A phenomenon in which speed causes a bullet to generate pressure waves, which cause damage distant from the bullets path
coup-contrecoup brain injury
A brain injury that occurs when force is applied to the head and energy transmission through brain tissue causes injury on the opposite side of original impact
Deceleration
the slowing of an object
Drag
resistance that slows a projectile, such as air.
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Glasgow Come Scale (GCS) score
An evaluation tool used to determine level of consciousness, which evaluates and assigns point values (scores) for eye opening, verbal response, and motor response, which are then totaled; effective in helping predict patient outcomes.
Index of Suspicion
Awareness that unseen life-threatening injuries may exist when determining the mechanism of injury
kinetic energy
the energy of a moving object
Mechanism of Injury (MOI)
the forces, or energy transmission, applied to the body that cause injury
medical emergencies
emergencies that require EMS attention because of illnesses or conditions not caused by an outside force.
multisystem trauma
trauma that affects more than one body system
penetrating trauma
injury caused by objects, such as knives and bullets, that pierce the surface of the body and damage internal tissues and organs.
potential energy
the product of mass, gravity, and height, which is converted into kinetic energy and results in injury, such as from a fall.
projectile
Any object propelled by force, such as a bullet by a weapon
Pulmonary blast injury
pulmonary trauma resulting from short-range exposure to the detonation of explosives
Revised Trauma Score (RTS)
A scoring system used for patients with head trauma
Trajectory
The path a projectile takes once it is propelled
Trauma Emergencies
Emergencies that are the result of physical forces applied to a patients body
Trauma score
A score calculated from 1 to 16, with 16 being the best possible score. It relates to the likelihood of patient survival with the exception of a severe head injury. It takes into account the Glasgow Coma Scale score, respiratory rate, respiratory expansion, systolic blood pressure, and capillary refill.
Tympanic membrane
the eardrum, a thing, semi-transparent membrane in the middle of the ear that transmits sound vibrations to the internal ear by means of auditory ossicles
Work
the measure of force over distance
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According to ACS-COT (American College of Surgeon’s Committee on Trauma, how many levels of trauma centers are there?
Level 1 trauma center
Comprehensive regional resource that is a tertiary care facility; capable of providing total care for every aspect of injury – from prevention through rehabilitation
Level 2 trauma center
Able to initiate definitive care for all injured patients
Level 3 trauma center
Able to provide prompt assessment, resuscitation, and stabilization of injured patients and emergency operations
Level 4 trauma center
Able to provide advanced trauma life support (ATLS) before transfer of patients to a higher level trauma center
Examples of significant mechanisms of injury
Death of an occupant in the vehicle;
Severe deformity of the vehicle or intrusion into the vehicle
Severe deformities of the frontal part of the vehicle; with or without intrusion into the passenger compartment
Moderate intrusions from a lateral (T-Bone) type of accident
Severe damage from the rear
Crashes in which rotation is involved (rollover or spin)
Ejection from the vehicle
(child = medium-to-high-speed vehicle crash >25mph)
Lateral crashes cause approximately (%)
25% of all severe injuries to the aorta and approximately 30% of all fatalities that occur in motor vehicle
Different types of motorcycle crashes
Head-on Crash
Angular Crash
Ejection
Controlled Crash
Distance falling to be considered significant
20 feet (Adult)
10 feed (child) or 2 -3 times the height of the child
Blast injuries
Primary blast injury – damage to the body is caused by the pressure wave generated by the explosion
Secondary blast injury – Damaging by being stuck by flying debris
Tertiarty blast injury – occurs when patient is hurled by the force of the explosion against stationary object (ground shock-when body hits the ground)
Quaternary blast injury – category of miscellaneous injuries (burns, respiratory injury, suffocation, poisoning etc)
Pulmonary edema
Buildup of fluid in the lungs, usually as a result of congestive heart failure
Congestive Heart Failure
A disorder in which the heart loses part of its ability to effectively pump blood, usually as a result of damage to the heart muscle and usually resulting in a backup of fluid into the lungs
Pneumothorax
A partial or complete accumulation of air in the pleural space
Pleural space
The potential space between the parietal pleura and the visceral pleura; described as “potential” because under normal conditions, the space does not exist
Pleura
The serous membranes covering the lungs and lining the thorax, completely enclosing a potential space known as the pleural space
Pneumonitis
Inflammation of the lung
Major components of patient trauma
Scene size-up
Primary assessment
History taking
Secondary assessment
Reassessment
DCAP-BTLS
Deformities
Contusions
Abrasions
Punctures / penetrations
Burns
Tenderness
Lacerations
Swelling
SAMPLE history
Signs / symptoms
Allergies
Medications
Pertinent past history
last Oral intake
Events leading to illness or injury
The chest contains:
Heart, lungs, large blood vessels of the body
Solid organs:
liver, spleen, pancreas, and kidneys
Hallow organs
Stomach, large and small intestines, and urinary bladder
According to 2006 white paper, consideration for using air transport are:
-there is an extended period required to access or extricate a remote or trapped patient, which depletes the time window to the patient to the trauma center by ground
-distance to the trauma center is greater than 20-25miles
-The patient needs medical care and stabilization at the ALS level, and none are available in reasonable time
-Traffic conditions or hospital availability
-EMS systems require bringing the patient to the nearest hospital for initial evaluation and stabilization, rather than bypassing those facilities & going directly to trauma center
-There is a mass-casualty incident
Three concepts of energy:
Potential energy, kinetic energy, and work
Traumatic injuries can be described as ____ & ___ trauma
blunt trauma & penetrating trauma
In every crash there are ____ (#) collisions that occur:
3: The collision of the vehicle against some type of object;
Collision of the passenger against the interior of the vehicle; and the collision of the passenger’s internal organs against the solid structures of the body