Prehospital Trauma Life Support

Lesson

Kinematics of Trauma

Developed by the

National Association of Emergency Medical Technicians

In cooperation with

The Committee on Trauma, American College of Surgeons

This slide presentation is intended for use only in approved PHTLS courses.

2-1B

Lesson 2 Objectives

Discuss the laws of energy and motion.

Discuss trauma associated with blunt impact and penetrating injury. Overview of the effects of energy distribution in MVCs.

Review the kinematics of blast and violent injuries.

Use kinematics to predict injury patterns.
2-2

Kinetic Energy
mass (weight) x velocity (speed)2 KE = 2

or
mv2 KE = 2

Kinetic energy is the energy of motion.

2-3

Example of Kinetic Energy

The KE of a 150-lb. person traveling

at 30 mph would be:

150 x 30 x 30
= 67,500 KE units

2-4

Velocity vs. Mass

150 lb. person traveling at 30 mph = 67,500 KE units

180 lb. person traveling at 30 mph = 81,000 KE units

150 lb. person traveling at 40 mph = 120,000 KE units

What is more important: velocity or mass?

2-5

Velocity

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Newtons First Law of Motion

A body at rest will stay at rest. A body in motion will remain in motion. Unless what?

2-7

Newtons First Law and Blunt Trauma

Car strikes pole. Driver continues moving forward.

Anterior surface of body strikes steering wheel. Posterior body continues moving forward.
Organs compressed within body.
2-8

Law of Conservation of Energy

Energy cannot be created.

Energy cannot be destroyed.

But, energy can 0 change forms and can be transferred.

Can you give an example?

2-9

How does the Law of Conservation of Energy pertain to trauma?

Can you give some examples?

2-10

Deceleration and Acceleration

Compression Injury
2-11

Deceleration and Acceleration

Shear Injury
2-12

Organ Injury

In a 50 mph MVC, what types injuries would occur if the patient were to strike the windshield?
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Head Injury
Fractures.

Ligamentous injuries.
Soft tissue injury. Brain injury. Cord damage.

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Torso Injury
Rib fractures.
Heart & lung damage. Abdominal organ damage.

Major vessel damage.

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Extremity Injury
Fractures.

Ligamentous injury.
Soft tissue injury.

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Types of Motor Vehicle Collisions

Frontal impact.

Lateral impact.
Rotational impact. Rear impact.

Rollover.
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What type of injury patterns might you see in a frontal impact?

2-18

Frontal Impact - Occupant Pathways

What injuries would you expect with an up and over pathway?

2-19

Injuries with Up & Over Pathway

continued...

Head injuries.

Spine injuries.
Chest injuries.

Fractures. Pneumothorax. Hemothorax. Contusions. Great vessel injury.

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Injuries with Up & Over Pathway

continued...

Abdominal injuries.

Solid organs. Hollow organs. Diaphragm.

Fractured pelvis.

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Frontal Impact - Occupant Pathways

What injuries would you expect with a down and under pathway?
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Injuries with Down & Under Pathway

Posterior knee/hip dislocations. Femur fractures.

Lower extremity fractures.

Pelvic/acetabular fractures.

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Rear Impact

What types of injuries would you expect?

2-24

Lateral Impact

What types of injuries would you expect?

2-25

Body Motion during Lateral Impacts

Neck Chest Pelvis

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Rotational Impact

What types of injuries would you expect?

2-27

Rollover

What injury patterns might you see following this collision?

2-28

Lap Restraint Device

Properly positioned lap restraint.

Improperly positioned lap restraint.

What types of injuries should you anticipate?

2-29

Lap & Shoulder Restraint System

Shoulder harness only; lap belt not used.
(Victim moves down and under).

Lap restraint only; shoulder harness not used. (Victim moves up and over)
What types of injuries should you anticipate?

2-30

Airbag Deployment
What types of injuries would you expect to see? What injuries would occur in a second collision?

2-31

Airbag Deployment
What concerns would you have about a:

Small patient?

Child in a car seat?

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