Presentation on theme: "Quantum Physics and the Time-Space Continuum"— Presentation transcript:
1Quantum Physics and the Time-Space Continuum An in depth and highly detailed analysis of the physical universe and it’s relevance to the pre-hospital emergency medical practicum.
2An Introduction to the Physics of Trauma TRAUMA KINEMATICSAn Introduction to the Physics of Trauma
3Trauma Statistics Over 150,000 trauma deaths/year Over 40, 000 are auto relatedLeading cause of death for ages 1-40One-third are preventableCost exceeds $220 billion (2001)Unnecessary deaths are often caused by injuries missed because of low index of suspicion
4Kinematics Physics of Trauma Understanding kinematics allows prediction of injuries based on forces and motion involved in an injury event.
5Basic Principles Conservation of Energy Law Newton’s First Law of MotionNewton’s Second Law of MotionKinetic Energy
6Newton’s First LawBody in motion stays in motion unless acted on by outside forceBody at rest stays at rest unless acted on by outside force
7Major factor is velocity Newton’s Second LawForce of an object = mass (weight) x acceleration or deceleration (change in velocity)Major factor is velocity“Speed Kills”Kinetic energy is the energy of a moving object and is calculated with the formula: K.E.=1/2mv2 (m = mass, v2 = velocity X 2). This means that the energy that is available to cause injury doubles when an object’s weight doubles, but quadruples when it’s speed doubles.Note: Increasing he speed limit from 50 mph to 70 mph quadruples the energy that is available to cause injury. In GSW, consideration of firearm type/caliber must be determined as the speed of the bullet (high- velocity compared with low-velocity) has a greater impact on producing injury than the mass (size) of the bullet.The amount of kinetic injury that is converted to do work on the body dictates the severity of the injury!
8Law of Conservation of Energy For every action there is an opposite and equal reactionEnergy cannot be created or destroyedEnergy can only change from one form to another
9Kinetic energy = ½ mass of an object X (velocity)2 Energy of MotionKinetic energy = ½ mass of an object X (velocity)2Injury doubles when weight doubles but quadruples when velocity doubles
10So…When a moving body is acted on by an outside force and changes its motion, then kinetic energy must change to some other form of energy. If the moving body is a human being and the energy transfer occurs too rapidly, then trauma results.
11Cavitation towards or away from the injury Blunt Force TraumaForce withoutpenetration“Unseen injuries”Cavitation towards or away from the injury
12Penetrating TraumaPiercing or penetration of body with damage to soft tissues and organsDepth of injury
17Head-on Collision Vehicle stops Occupants continue forward Two pathwaysDown and underUp and over
18Frontal Collision Down and under pathway Knees impact dash, causing knee dislocation/patella fractureForce fractures femur, hip, posterior rim of acetabulum (hip socket)Pelvic injuries kill!
19Frontal Collision Down and under pathway Upper body hits steering wheelBroken ribsFlail chestPulmonary/myocardial contusionRuptured liver/spleen
20Frontal Collision Down and under pathway Paper bag pneumothorax Aortic tear from decelerationHead thrown forwardC-spine injuryTracheal injury
21Frontal Collision Up and over pathway Chest/abdomen hit steering wheel Rib fractures/flail chestCardiac/pulmonary contusions/aortic tearsAbdominal organ ruptureDiaphragm ruptureLiver/mesenteric lacerations
22Frontal Collision Up and over pathway Head impacts windshield Scalp lacerationsSkull fracturesCerebral contusions/hemorrhagesC-spine fracture
24Rear-end Collision Car (and everything touching it) moves forward Body moves, head does not, causing whiplashVehicle may strike other object causing frontal impactWorst patients in vehicles with two impacts
30Rotational Collision Off-center impact Car rotates around impact point Patients thrown toward impact pointInjuries combination of head-on, lateralPoint of greatest damage = point of greatest deceleration = worst patients
36Motorcycle Collisions Rider impacts motorcycle partsRider ejected over motorcycle or trapped between motorcycle and vehicleNo protection from effects of decelerationLimited protection from gear
37Pedestrian vs. Vehicle Child Faces oncoming vehicle Waddell’s Triad Bumper Femur fractureHood Chest injuriesGround Head injuries
38Pedestrian vs. Vehicle Adult Turns from oncoming vehicle O’Donohue’s TriadBumper Tib-fib fracture Knee injuriesHood Femur/pelvic
39Falls Critical Factor Height Surface Objects struck during fall Increased height + Increased injurySurfaceType of impact surface increases injuryObjects struck during fallBody part of first impactFeetHead ButtocksParallel
40FallsAssess body part that impacts first, usually sustains the bulk of injuryThink about the path of energy through body and what other organs/systems could be impacted (index of suspicion)
41Falls onto Head/Spine Injuries may not be obvious C-spine precautions! Watch for delayed head injury S/S
42Falls onto Hands Bilateral colles fractures Potential for radial/ulna fractures and dislocations
48Stabbings Always maintain high degree of suspicion with stab wounds Remember: small stab wounds do NOT mean small damage
49Gunshot WoundsDamage CANNOT be determined by location of entrance/exit woundsMissiles tumbleSecondary missiles from bone impactsRemote damage fromBlast effectCavitation
50Gunshot WoundsSeverity cannot be evaluated in the field or Emergency DepartmentSeverity can only be evaluated in OR
51Significant ALS MOI Multi-system trauma Fractures in more than one locationMVA – death in same vehicle, high speed or significant vehicle damageFalls > 2 X body heightThrown > 10 – 15 feetPenetrating trauma to the “box”Age co-factors: < 6 or > 60“Lucky Victim”
52Conclusion Think about mechanisms of injury Always maintain an increased index of suspicionDoing YOUR job as an EMT will lead to:Fewer missed injuriesIncreased patient survival