EMS 113 EXAM || A+ Guaranteed.
(Trauma Overview)
How to predict injuries and their possible extent correct answers MOI/NOI velocity and mass
velocity is more harmful than mass
2-3 Types of MVC injuries based on suspicion of injury due to type of impact correct answers
Frontal Patterns of injury seen as the occupants of the vehicle continue to move forward at the
same speed the vehicle is traveling
Up and over Occupants move up and over objects such as the steering wheel or dashboard
causing injuries to the head, neck, chest, and abdomen with possible ejection through the
windshield. Unrestrained occupants that travel in this direction may be ejected from the vehicle.
Partial ejection is also possible; for example the head could protrude through the windshield
causing severe soft tissue injuries including avulsions and lacerations.
Down and under Occupants move down and under object such as the steering wheel, causing
injuries to the knees, femurs, hips, acetabulum, and spine.
Rear-end Patterns of injury seen as the occupants of the vehicle move forward when the vehicle
they are in is propelled forward by the vehicle which struck them.
"Whiplash" injuries The patient's head and neck are immediately whipped backwards as the seat
propels the body forward. The law of inertia indicates that the head and neck tend to remain at
rest but because the weight of the body exceeds the weight of the head, the body keeps moving
while the head slows. When a headrest is properly positioned and the patient is wearing a
seatbelt, injury can be minimized. However, if the headrest is not available, or in use and
improperly positioned, the neck is hyperextended and the anterior spine ligaments are often
stretched or torn.
Lateral Patterns of injury include injuries to the head, neck, chest, abdomen, and pelvis, from the
vehicle being crushed inward and impinging on the occupants. During impact the body is pushed
laterally from under the head, causing the head to move in the opposite direction. The structures
in the lateral areas of the neck are not as strong as in the anterior/posterior portion
Pedestrian - vehicle patterns of adult vs child injuries correct answers ADULT- Adults generally
turn away from the oncoming vehicle causing injuries most commonly to the side of the body
including: Vehicle striking the lower leg causing fractures of the tibia and fibula The legs are
then propelled forward and the adult generally falls backward landing on the hood or into the
windshield of the vehicle, resulting in injuries to: back, chest, shoulders, abdomen, head, neck
Once the vehicle stops the adult may suffer further injury as they are thrown from the hood to the
ground
CHILD- Children generally turn toward the oncoming vehicle causing a typical type of injury
pattern including: Injuries to the front of the body Injuries involving the femur, chest, abdomen,
and head Waddell's triad is a pattern of injury seen in pedestrian children who are struck by
,motor vehicles. The triad is characterized by: fractured femoral shaft. intrathoracic or intra-
abdominal injuries. head injury.
Pattern of child seat injuries during MVC correct answers During a collision the parts of the
child's body which are not restrained continued forward at the same speed the vehicle was
traveling prior to the impact. The child's head will snap forward, and the neck will stretch against
the resistance of the shoulder restraints. This can cause a spinal cord injury without injury to the
vertebrae (children's bones are still very pliable). To prevent head snapping, the proper position
for the car seat is facing backward and reclined at a 45° angle. Children should always be
restrained in the backseat to avoid injury from airbag deployment.
6-7 Injury patterns seen in motorcycle collisions correct answers HEAD ON- Head-on impact
occurs when the bike tips forward. The rider travels into the handlebars and depending on what
part of the rider's anatomy strikes initially; a variety of injuries may occur.
ANGULAR- Angular impact causes the rider to strike an object, usually a protruding object, at
an angle. The object impacts whatever body part it comes into contact with, usually breaking or
collapsing in on the rider.
EJECTION- Ejection occurs after any collision if the rider clears the handlebars. Ejection
continues until the body part impacts an object. Riders not wearing a helmet have a > 300%
chance of severe head injury and death
LAYING BIKE DOWN- "Laying the bike down" is an evasive technique used by riders to
prevent ejection and separation of the rider and the motorcycle during an impending collision,
but rather the rider lays the bike down and slides across the terrain. Massive skin debridement
may occur (road rash) based on clothing or protective gear the rider is wearing.
ATVS- ATVs are easily tipped over. They're quite unstable and can easily cause collisions
similar to those found in motorcycle collisions. Riders can also be decapitated by low objects
such as fences that lay upon a horizontal plane to the rider.
Predicting injury from a fall correct answers FEET FIRST- Energy travels up the skeletal system
Fractures of the heels and fractures or dislocations of the ankles are common primary impact
injuries Landing in a knee flexed position dissipates energy at the knees and preserves the rest of
the skeletal system Landing flat-footed with the knees locked causes energy to transmit up
through the femurs to the hips and pelvis possibly causing secondary fractures The spine absorbs
the force at every curve of the lumbar, mid thoracic and cervical spine A patient who falls three
times or more their own height will likely have a spinal injury Falls greater than 20 feet cause
internal organs to be injured from deceleration forces. Common organ injury includes the liver,
spleen, kidney, and heart Extending the arms to break a fall will result in energy dissipation at
the wrist. Fractures of the wrist are known as Colles or "silver fork" fractures and are quite
common. As energy travels the straight line the elbow and shoulder are the next point of
potential injury. If a body is thrown backward, the most common injuries are to the head, back,
and pelvis.
, HEAD FIRST- The pattern of injury begins with the arms and extends up the shoulders The head
may be forcibly hyperextended, hyperflexed, or compressed which all cause extensive damage to
the cervical spine As the body continues in a downward motion the torso and legs are thrown
either forward or backward Chest, lower spine, and pelvic injuries are common
Differentiating factors of low, medium and high velocity injuries correct answers LOW- These
are commonly caused by a knife or other impaled object which exerts damage to the immediate
area of impact as well as the underlying structures. The length of the object used in a stabbing
provides valuable clues to possible injuries. Both anterior and posterior penetrating injury to the
chest cavity may cause a pneumothorax. Other injuries may include lacerated pulmonary veins,
lacerated aorta, or even a lacerated heart. For this reason, an EMT should try to ascertain the
length of the penetrating object and report this information to hospital staff. The most important
thing to remember is that an injury that is not suspected won't be assessed. Therefore have a high
index of suspicion that any penetrating object has damaged all structures in it's path and assess
for signs and symptoms to support that suspicion. Due diligence must be exercised during
reassessment, If the penetrating object is still embedded, it should NEVER be removed. The
object may be tamponading an internal bleed and removal will allow the injured vessel to bleed
freely and possibly cause death through internal bleeding.
MEDIUM/HIGH- Trajectory The path or motion a projectile takes during its travel. Once a
bullet is fired the projectile follows a curved trajectory or path. As the projectile increases the
distance from the weapon, it loses velocity and gravity tends to pull it in a downward path.
However, a faster bullet will flatten the curve of trajectory and result in a straighter path of the
bullet, and greater damage due to velocity.
Drag Factors such as wind resistance which slow the bullet down Profile The impact point of the
bullet, the greater the size of the impact point, the more energy is transferred Cavitation The
cavity created in the body tissues formed by the pressure wave which results from the kinetic
energy of the bul
10-11 GSW injury patterns based on body area struck correct answers HEAD- The interior of the
skull is a fixed space with little room for expansion. When a projectile enters the skull, brain
tissue is severely compressed. Gunshot wounds to the face will also result in major soft tissue
injuries that immediately threaten the airway. This creates a problem when attempting to get a
good seal while ventilating a patient of gunshot wound.
CHEST- Lung tissue is relatively tolerant of cavitation caused by projectiles. Pneumothorax is
common, and any openings must be covered first by a gloved hand, then by a dressing or
commercial chest seal. Due diligence to evolving tension pneumothorax must be exercised and
frequent reassessment of systolic blood pressure and lung sounds are of paramount importance.
The heart is not as tolerant of projectiles is likely to suffer from significant wounds such as
pericardial tamponade
ABDOMEN- Quite often the abdomen suffers secondary injuries when the chest is injured. Air
filled and fluid filled structures are more tolerant of cavitation than the solid organs. Air filled
structures include the stomach and fluid filled structures include the bladder.
(Trauma Overview)
How to predict injuries and their possible extent correct answers MOI/NOI velocity and mass
velocity is more harmful than mass
2-3 Types of MVC injuries based on suspicion of injury due to type of impact correct answers
Frontal Patterns of injury seen as the occupants of the vehicle continue to move forward at the
same speed the vehicle is traveling
Up and over Occupants move up and over objects such as the steering wheel or dashboard
causing injuries to the head, neck, chest, and abdomen with possible ejection through the
windshield. Unrestrained occupants that travel in this direction may be ejected from the vehicle.
Partial ejection is also possible; for example the head could protrude through the windshield
causing severe soft tissue injuries including avulsions and lacerations.
Down and under Occupants move down and under object such as the steering wheel, causing
injuries to the knees, femurs, hips, acetabulum, and spine.
Rear-end Patterns of injury seen as the occupants of the vehicle move forward when the vehicle
they are in is propelled forward by the vehicle which struck them.
"Whiplash" injuries The patient's head and neck are immediately whipped backwards as the seat
propels the body forward. The law of inertia indicates that the head and neck tend to remain at
rest but because the weight of the body exceeds the weight of the head, the body keeps moving
while the head slows. When a headrest is properly positioned and the patient is wearing a
seatbelt, injury can be minimized. However, if the headrest is not available, or in use and
improperly positioned, the neck is hyperextended and the anterior spine ligaments are often
stretched or torn.
Lateral Patterns of injury include injuries to the head, neck, chest, abdomen, and pelvis, from the
vehicle being crushed inward and impinging on the occupants. During impact the body is pushed
laterally from under the head, causing the head to move in the opposite direction. The structures
in the lateral areas of the neck are not as strong as in the anterior/posterior portion
Pedestrian - vehicle patterns of adult vs child injuries correct answers ADULT- Adults generally
turn away from the oncoming vehicle causing injuries most commonly to the side of the body
including: Vehicle striking the lower leg causing fractures of the tibia and fibula The legs are
then propelled forward and the adult generally falls backward landing on the hood or into the
windshield of the vehicle, resulting in injuries to: back, chest, shoulders, abdomen, head, neck
Once the vehicle stops the adult may suffer further injury as they are thrown from the hood to the
ground
CHILD- Children generally turn toward the oncoming vehicle causing a typical type of injury
pattern including: Injuries to the front of the body Injuries involving the femur, chest, abdomen,
and head Waddell's triad is a pattern of injury seen in pedestrian children who are struck by
,motor vehicles. The triad is characterized by: fractured femoral shaft. intrathoracic or intra-
abdominal injuries. head injury.
Pattern of child seat injuries during MVC correct answers During a collision the parts of the
child's body which are not restrained continued forward at the same speed the vehicle was
traveling prior to the impact. The child's head will snap forward, and the neck will stretch against
the resistance of the shoulder restraints. This can cause a spinal cord injury without injury to the
vertebrae (children's bones are still very pliable). To prevent head snapping, the proper position
for the car seat is facing backward and reclined at a 45° angle. Children should always be
restrained in the backseat to avoid injury from airbag deployment.
6-7 Injury patterns seen in motorcycle collisions correct answers HEAD ON- Head-on impact
occurs when the bike tips forward. The rider travels into the handlebars and depending on what
part of the rider's anatomy strikes initially; a variety of injuries may occur.
ANGULAR- Angular impact causes the rider to strike an object, usually a protruding object, at
an angle. The object impacts whatever body part it comes into contact with, usually breaking or
collapsing in on the rider.
EJECTION- Ejection occurs after any collision if the rider clears the handlebars. Ejection
continues until the body part impacts an object. Riders not wearing a helmet have a > 300%
chance of severe head injury and death
LAYING BIKE DOWN- "Laying the bike down" is an evasive technique used by riders to
prevent ejection and separation of the rider and the motorcycle during an impending collision,
but rather the rider lays the bike down and slides across the terrain. Massive skin debridement
may occur (road rash) based on clothing or protective gear the rider is wearing.
ATVS- ATVs are easily tipped over. They're quite unstable and can easily cause collisions
similar to those found in motorcycle collisions. Riders can also be decapitated by low objects
such as fences that lay upon a horizontal plane to the rider.
Predicting injury from a fall correct answers FEET FIRST- Energy travels up the skeletal system
Fractures of the heels and fractures or dislocations of the ankles are common primary impact
injuries Landing in a knee flexed position dissipates energy at the knees and preserves the rest of
the skeletal system Landing flat-footed with the knees locked causes energy to transmit up
through the femurs to the hips and pelvis possibly causing secondary fractures The spine absorbs
the force at every curve of the lumbar, mid thoracic and cervical spine A patient who falls three
times or more their own height will likely have a spinal injury Falls greater than 20 feet cause
internal organs to be injured from deceleration forces. Common organ injury includes the liver,
spleen, kidney, and heart Extending the arms to break a fall will result in energy dissipation at
the wrist. Fractures of the wrist are known as Colles or "silver fork" fractures and are quite
common. As energy travels the straight line the elbow and shoulder are the next point of
potential injury. If a body is thrown backward, the most common injuries are to the head, back,
and pelvis.
, HEAD FIRST- The pattern of injury begins with the arms and extends up the shoulders The head
may be forcibly hyperextended, hyperflexed, or compressed which all cause extensive damage to
the cervical spine As the body continues in a downward motion the torso and legs are thrown
either forward or backward Chest, lower spine, and pelvic injuries are common
Differentiating factors of low, medium and high velocity injuries correct answers LOW- These
are commonly caused by a knife or other impaled object which exerts damage to the immediate
area of impact as well as the underlying structures. The length of the object used in a stabbing
provides valuable clues to possible injuries. Both anterior and posterior penetrating injury to the
chest cavity may cause a pneumothorax. Other injuries may include lacerated pulmonary veins,
lacerated aorta, or even a lacerated heart. For this reason, an EMT should try to ascertain the
length of the penetrating object and report this information to hospital staff. The most important
thing to remember is that an injury that is not suspected won't be assessed. Therefore have a high
index of suspicion that any penetrating object has damaged all structures in it's path and assess
for signs and symptoms to support that suspicion. Due diligence must be exercised during
reassessment, If the penetrating object is still embedded, it should NEVER be removed. The
object may be tamponading an internal bleed and removal will allow the injured vessel to bleed
freely and possibly cause death through internal bleeding.
MEDIUM/HIGH- Trajectory The path or motion a projectile takes during its travel. Once a
bullet is fired the projectile follows a curved trajectory or path. As the projectile increases the
distance from the weapon, it loses velocity and gravity tends to pull it in a downward path.
However, a faster bullet will flatten the curve of trajectory and result in a straighter path of the
bullet, and greater damage due to velocity.
Drag Factors such as wind resistance which slow the bullet down Profile The impact point of the
bullet, the greater the size of the impact point, the more energy is transferred Cavitation The
cavity created in the body tissues formed by the pressure wave which results from the kinetic
energy of the bul
10-11 GSW injury patterns based on body area struck correct answers HEAD- The interior of the
skull is a fixed space with little room for expansion. When a projectile enters the skull, brain
tissue is severely compressed. Gunshot wounds to the face will also result in major soft tissue
injuries that immediately threaten the airway. This creates a problem when attempting to get a
good seal while ventilating a patient of gunshot wound.
CHEST- Lung tissue is relatively tolerant of cavitation caused by projectiles. Pneumothorax is
common, and any openings must be covered first by a gloved hand, then by a dressing or
commercial chest seal. Due diligence to evolving tension pneumothorax must be exercised and
frequent reassessment of systolic blood pressure and lung sounds are of paramount importance.
The heart is not as tolerant of projectiles is likely to suffer from significant wounds such as
pericardial tamponade
ABDOMEN- Quite often the abdomen suffers secondary injuries when the chest is injured. Air
filled and fluid filled structures are more tolerant of cavitation than the solid organs. Air filled
structures include the stomach and fluid filled structures include the bladder.
