# National Ski Patrol, Outdoor Emergency Care, 5 th Ed. ©2012 by Pearson Education, Inc., Upper Saddle River, NJ BRADY Chapter 17 Principles of Trauma.

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National Ski Patrol, Outdoor Emergency Care, 5 th Ed. ©2012 by Pearson Education, Inc., Upper Saddle River, NJ BRADY Chapter 17 Principles of Trauma

National Ski Patrol, Outdoor Emergency Care, 5 th Ed. ©2012 by Pearson Education, Inc., Upper Saddle River, NJ BRADY Kinematics and Mechanism of Injury Kinematics: laws of motion. Consider : ◦ Mass of patient or object that struck patient ◦ Speed of patient or object that struck patient ◦ Energy transmitted

National Ski Patrol, Outdoor Emergency Care, 5 th Ed. ©2012 by Pearson Education, Inc., Upper Saddle River, NJ BRADY Kinematics and Mechanism of Injury Kinematics ◦ Kinetic Energy (KE) = mass x velocity 2 2 This means that the speed the patient is traveling is more important than their weight. continued

National Ski Patrol, Outdoor Emergency Care, 5 th Ed. ©2012 by Pearson Education, Inc., Upper Saddle River, NJ BRADY Kinematics and Mechanism of Injury Kinematics ◦ Stopping Distance ◦ Kinetic energy to the body of a patient traveling at a constant speed More=hitting a tree Less= hitting a pliable net continued

National Ski Patrol, Outdoor Emergency Care, 5 th Ed. ©2012 by Pearson Education, Inc., Upper Saddle River, NJ BRADY Pathophysiology Severity of bodily injuries is directly related to Mechanism of Injury (MOI) MOI = amount of kinetic energy absorbed + direction the energy travels + density of the structures impacted continued

National Ski Patrol, Outdoor Emergency Care, 5 th Ed. ©2012 by Pearson Education, Inc., Upper Saddle River, NJ BRADY Pathophysiology Five Mechanisms of Injury: ◦ Blunt ◦ Penetrating ◦ Rotational ◦ Crush ◦ Blast continued

National Ski Patrol, Outdoor Emergency Care, 5 th Ed. ©2012 by Pearson Education, Inc., Upper Saddle River, NJ BRADY

National Ski Patrol, Outdoor Emergency Care, 5 th Ed. ©2012 by Pearson Education, Inc., Upper Saddle River, NJ BRADY Injury Phases Pre-injury ◦ Events and conditions leading up to injury ◦ Includes preventive intervention efforts Injury ◦ Energy transfer damages Patroller will develop an index of suspicion based on MOI continued

National Ski Patrol, Outdoor Emergency Care, 5 th Ed. ©2012 by Pearson Education, Inc., Upper Saddle River, NJ BRADY Injury Phases Post-Injury ◦ Immediately after energy transfer ◦ Three “peaks” when death generally occurs First few seconds to minutes – Life saving interventions Minutes to an hour – “Golden Hour” Days to weeks – Complications ◦ Back country rescues increase difficulty of care and transport continued

National Ski Patrol, Outdoor Emergency Care, 5 th Ed. ©2012 by Pearson Education, Inc., Upper Saddle River, NJ BRADY Trauma Systems Designations for patient destinations Levels I to V based on staff qualifications and experience with trauma ◦ More severe injuries = higher trauma level ◦ Specialized centers are available for pediatrics

National Ski Patrol, Outdoor Emergency Care, 5 th Ed. ©2012 by Pearson Education, Inc., Upper Saddle River, NJ BRADY Assessment Trauma assessment implements all previously covered skills (Ch 7) Additional topics may include ◦ MOI and the forces involved ◦ Treatment rendered before your arrival Determine treatment and transportation plan Reassessment is vital

National Ski Patrol, Outdoor Emergency Care, 5 th Ed. ©2012 by Pearson Education, Inc., Upper Saddle River, NJ BRADY Management Mitigate hazards Correct immediate life threats ◦ Spinal stabilization Use oxygen Monitor/treat for shock Prepare patient for transport Document your assessment and treatment

National Ski Patrol, Outdoor Emergency Care, 5 th Ed. ©2012 by Pearson Education, Inc., Upper Saddle River, NJ BRADY Chapter Summary Trauma prevention is as important as trauma management. Injuries can be divided into three phases: pre-injury, injury, and post- injury. The five mechanisms of trauma are penetrating injury, blunt injury, crush injury, rotational injury, and blast injury. continued

National Ski Patrol, Outdoor Emergency Care, 5 th Ed. ©2012 by Pearson Education, Inc., Upper Saddle River, NJ BRADY Chapter Summary A trauma center is a specialized medical facility geared toward addressing the specific needs of trauma patients. Whenever possible, multi-system trauma patients should be taken to a trauma center. continued

National Ski Patrol, Outdoor Emergency Care, 5 th Ed. ©2012 by Pearson Education, Inc., Upper Saddle River, NJ BRADY Chapter Summary When indicated by the MOI, early immobilization of a trauma patient’s spine is essential. The three goals of serious trauma management are early recognition, correction of threats to life, and rapid transportation to a trauma center.