10. Blunt Force Trauma
Injury due to pressure force
Hit by moving object
Hit or fall against solid
object
Object exerts pressure
Tears and hematomas to
solid organs
14. Blunt Force Trauma
Injury because of sudden
halt
MVC most common
Acceleration factor
greatest in air travel
Stretching & linear shearing
of fixed or free organs
72. Blunt Force Trauma
C spine precautions placed when:
– Any neck discomfort or numbness in
extremities
– Not fully alert or AMS
– Other painful injuries
73. Blunt Force Trauma
C spine precautions placed when:
– Any neck discomfort or numbness in
extremities
– Not fully alert or AMS
– Other painful injuries
74. Blunt Force Trauma
Rigid collars, such as the Philadelphia
and the extrication collars, reduce
flexion and extension to about 30%
normal and rotation and lateral
movement to about 50%.
75. Blunt Force Trauma
best immobilization method
– secure patient to a hard board
– place sandbags at either side of head
– rigid collar around the neck
– decreases movement to about 5% of
normal.
76. Blunt Force Trauma
Thoracic
Spine
12 vertebrae
Attached to
rib cage
Ligaments
Anterior
Posterior
83. Head and Spine Injuries
Look for motor or
sensory deficits
Deficit will point to
location of injury
Remember dual
innervation of
cervical cape
Log roll & keep spine
in neutral position
91. Blunt Force Trauma
Rib Fractures
9 - 11 watch for intra-abdominal
injuries
Flail Chest
Three or more consecutive ribs
Broken in 2 or more places
Same side of chest
Paradoxical Chest Movement
92. Blunt Force Trauma
Lung contusions
More common in children
Serious cause of morbidity
Elderly
COPD
121. Blunt Force Trauma
Cardiac Injury
9 - 34% of thoracic injuries
Right atrium most susceptible
to injury
Will lead to EKG changes and
Troponin elevations
Contusio cordis vs commotio
cordis
122. Blunt Force
Trauma
Thoracic Aorta
Disruption
2nd leading cause
of death
93% at desc.
Aorta
Widened
mediastinum most
common finding
85%
123. Blunt Force
Trauma
Thoracic Aorta
Disruption
2nd leading cause
of death
93% at desc.
Aorta
Widened
mediastinum most
common finding
85%
124. Blunt Force
Trauma
Thoracic Aorta
Disruption
2nd leading cause
of death
93% at desc.
Aorta
Widened
mediastinum most
common finding
85%
129. Blunt Force Trauma
Diaphragmatic
injury
Strong
compressive
forces
Intrusion by
abdominal
viscera
Injury mostly
occurs on right
Bowel sounds
in the chest
134. Blunt Force Trauma
Most common type
50 – 70%
Liver & spleen
most commonly
injured
may not manifest
during initial
assessment &
treatment period
1.5L before
distention
appears
135. Blunt Force Trauma
Compression injuries
Liver lacerations
and hematomas
Splenic lacerations
and sequestration
Deceleration injuries
Kidney
Bowel injuries
Vascular injuries
136. Blunt Force Trauma
Hollow organ
injuries
Usually
secondary to
seatbelt
Compressive
forces increase
pressure
Deceleration
disrupts blood
supply from
mesenteric vessels
140. Blunt Force Trauma
Injured from trauma to:
Eighth through twelfth ribs on
right side of body
Upper central part of abdomen
Tear at falciform or direct
injury
Blood and bile will leak into
abdominal cavity
Shock
Peritoneal irritation
142. Blunt Force Trauma
Kidney
Firmly held in the
retroperitoneum
Severe
compression or
rib fractures
Deceleration
leads to shearing
of arteries
Spillage of blood
and urine into
retroperitoneum
143. Blunt Force Trauma
Pelvic Organ
Injuries
Most commonly
associated with
pelvic fractures
Urinary rupture
if compressive
force on full
bladder
154. Blunt Force Trauma
Bleeding
Bruising
Fracture
Laceration
Compartment Syndrome
155. Blunt Force Trauma
Not an acute
occurrence
Symptoms:
Pain out of
proportion/passive
motion
Parasthesias/
Paralysis
Pallor
Pulselessness
Poiklothermia
156. Blunt Force Trauma
Compartment Pressures
Normal about zero; usually less than 10 mm Hg
Capillary blood flow compromised at >20 mm Hg
Muscles/nerves at risk for ischemic necrosis
>30 to 40 mm Hg.
Nerve is most sensitive, followed by muscle
tissue.
157. Blunt Force Trauma
Traumatic Asphyxia Syndrome
Constrictive force to chest wall
Can occur within two minutes
Mechanism of injury - profound
venous hypertension
Cerebral hypoperfusion
158. Blunt Force Trauma
Vital signs
Tachycardia
Tachypnea
Signs of shock
Hypotension
Diaphoresis
Slow cap refill
Mental Status
Neurodeficits
Young will handle better than old