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TRAUMA KINEMATICS. An Introduction to the Physics of Trauma. Trauma Statistics. Over 150,000 trauma deaths/yearOver 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
Quantum Physics and the Time-Space Continuum

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1. Quantum 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.

2. TRAUMA KINEMATICS An Introduction to the Physics of Trauma

3. Trauma Statistics Over 150,000 trauma deaths/year Over 40, 000 are auto related Leading cause of death for ages 1-40 One-third are preventable Cost exceeds $220 billion (2001) Unnecessary deaths are often caused by injuries missed because of low index of suspicion

4. Kinematics Physics of Trauma Understanding kinematics allows prediction of injuries based on forces and motion involved in an injury event.

5. Basic Principles Conservation of Energy Law Newton?s First Law of Motion Newton?s Second Law of Motion Kinetic Energy

6. Newton?s First Law Body in motion stays in motion unless acted on by outside force Body at rest stays at rest unless acted on by outside force

7. Newton?s Second Law Force 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!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!

8. Law of Conservation of Energy For every action there is an opposite and equal reaction Energy cannot be created or destroyed Energy can only change from one form to another

9. Kinetic Energy Energy of Motion Kinetic energy = ? mass of an object X (velocity)2 Injury doubles when weight doubles but quadruples when velocity doubles

10. So? 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.

11. Blunt Force Trauma Force without penetration ?Unseen injuries? Cavitation towards or away from the injury

12. Penetrating Trauma Piercing or penetration of body with damage to soft tissues and organs Depth of injury

13. Mechanism of Injury Profiles

14. Motor Vehicle Collisions Five major types of motor vehicle collisions: Head-on Rear-end Lateral Rotational Roll-over

15. Motor Vehicle Collisions In each collision, three impacts occur: Vehicle Occupants Occupant organs

16. Head-On Collision

17. Head-on Collision Vehicle stops Occupants continue forward Two pathways Down and under Up and over

18. Frontal Collision Down and under pathway Knees impact dash, causing knee dislocation/patella fracture Force fractures femur, hip, posterior rim of acetabulum (hip socket) Pelvic injuries kill!

19. Frontal Collision Down and under pathway Upper body hits steering wheel Broken ribs Flail chest Pulmonary/myocardial contusion Ruptured liver/spleen

20. Frontal Collision Down and under pathway Paper bag pneumothorax Aortic tear from deceleration Head thrown forward C-spine injury Tracheal injury

21. Frontal Collision Up and over pathway Chest/abdomen hit steering wheel Rib fractures/flail chest Cardiac/pulmonary contusions/aortic tears Abdominal organ rupture Diaphragm rupture Liver/mesenteric lacerations

22. Frontal Collision Up and over pathway Head impacts windshield Scalp lacerations Skull fractures Cerebral contusions/hemorrhages C-spine fracture

23. Rear-end Collision

24. Rear-end Collision Car (and everything touching it) moves forward Body moves, head does not, causing whiplash Vehicle may strike other object causing frontal impact Worst patients in vehicles with two impacts

25. Lateral Collision

26. Lateral Collision Car appears to move from under patient Patient moves toward point of impact Increased potential for ?shearing? injuries Increased cervical spine injury

27. Lateral Collision Chest hits door Lateral rib fractures Lateral flail chest Pulmonary contusion Abdominal solid organ rupture Suspect upper extremity fractures and dislocations

28. Lateral Collision Hip hits door Head of femur driven through acetabulum Pelvic fractures C-spine injury Head injury

29. Rotational Collision

30. Rotational Collision Off-center impact Car rotates around impact point Patients thrown toward impact point Injuries combination of head-on, lateral Point of greatest damage = point of greatest deceleration = worst patients

31. Rollover

32. Roll-Over Multiple impacts each time vehicle rolls Injuries unpredictable Assume presence of severe injury Justification for Transport to Level I or II Trauma Center

33. Restrained vs Unrestrained Patients Ejection causes 27% of motor vehicle collision deaths 1 in 13 suffers a spinal injury Probability of death increases six-fold

34. Restrained with Improper Positioning Seatbelts Above Iliac Crest Compression injuries to abdominal organs T12 - L2 compression fractures Seatbelts Too Low Hip dislocations

35. Restrained with Improper Positioning Seatbelts Alone Head, C-Spine, Maxillofacial injuries Shoulder Straps Alone Neck injuries Decapitation

36. Motorcycle Collisions Rider impacts motorcycle parts Rider ejected over motorcycle or trapped between motorcycle and vehicle No protection from effects of deceleration Limited protection from gear


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