KINEMATICS OF TRAUMA IN ROAD TRAFFIC ACCIDENTS

This ppt gives a brief insight into various types of traumas and the injuries associated with it especially in road traffic accidents

1. KINEMATICS OF TRAUMA: RTA MODERATOR: DR ABHINOV PRESENTER: DEEKSHA N

2. TRAUMA Trauma can be defined as any harm imparted to the body of a living organism,which can threaten life or limb.

3. KINETICS OF TRAUMA LAW OF INERTIA ( NEWTONS FIRST LAW OF MOTION) A body in motion continues to be in motion unless acted upon by an outside force Example : 1) Car stopping for stop sign – car (body in motion) brakes (outside force) 2) Car hitting a brick wall – car (body in motion) brick wall (outside force) KINETIC ENERGY: summarised by newtons second law of motion Force= Mass x Acceleration

4. KINETICS OF TRAUMA Injury is produced as a result of transfer of energy to the body of the patient. Energy can neither be produced nor destroyed and can only change form Energy produced is the product of mass and velocity KE(kinetic energy)= 1/2m (mass) x v2 (velocity) Therefore the severity and distribution of injuries are dependent on the site of impact, direction of force of vector, mass and velocity

5. FACTORS AFFECTING TYPES OF INJURIES Size and mass of the vehicle Location of the person within the vehicle Use and type of restraint Direction of impact - I njuries are due to sudden loss of inertia of motion as the vehicle along with the body comes to a sudden halt

6. WHAT IS KINEMATICS OF TRAUMA??? The kinematics of trauma deals with looking at a trauma scene and attempting to determine what injuries might have resulted from the incident that took place

7. MOTOR VEHICLE CRASHES Five phases of trauma: Phase 1 : Deceleration of the vehicle Phase 2 : Deceleration of occupant Phase 3 : Deceleration of internal organs Phase 4 : Secondary collisions Phase 5 : Additional impacts received by the vehicle

8. IMPACT PATTERNS Frontal or Head-on impacts Lateral or Side impacts Rear impacts Rotational or Quarter- panel impacts Roll overs

9. FRONTAL OR HEAD-ON IMPACTS These occur when the vehicle crashes headon Seatbelts and airbags are maximally effective in preventing serious injuries In frontal collision, the occupant continues to move forward at the same speed the vehicle was moving

10. FRONTAL OR HEAD-ON IMPACTS :TYPES Unrestrained occupants usually follow one of two tragectories Down and under pathway Up and over pathway

11. FRONTAL IMPACT INJURIES Injuries with up a nd over pathway - Head injuries - Spine injuries - Chest injuries - Abdominal injuries - F ractured pelvis Injuries with down and under pathway Posterior Knee/Hip dislocation - Femur fracture Pelvic/ Acetabular fracture

12. FRONTAL IMPACT INJURIES A deformed steering wheel indicates possible chest or abdominal injury The “PAPER BAG” syndrome results from compression of the chest against the steering column Impact marks or cracking to a windshield indicates a possible head injury

13. PAPER BAG SYNDROME

14. LATERAL OR SIDE IMPACTS These are side-on collisions Impart energy to the near side occupant Seat belts offer little protection The body is pushed in one direction while the head moves towards the impacting objects

15. LATERAL IMPACT INJURIES TO SUSPECT Lateral impact causes injury to head, shoulder, lateral chest, lateral abdomen, lateral pelvis ,femur and flexion injury to cervical spine

16. REAR IMPACT Injuries are less severe when vehicle is hit from behind as the luggage compartment absorbs most of the injuries Passengers get injuries as they are frequently unrestrained and due to the impact are tossed against the front seats

17. REAR IMPACTS Injuries to suspect: head or neck (a) in a rear impact with an unrestrained occupant, initial movement is backward,causing potential neck injury (b) the occupant then moves forward, causing impact to the head and chest.

18. ROTATIONAL OR QUARTER-PANEL IMPACTS Occurs when a lateral crash is off center The vehicles forward motion stops,but the side continues in rotational motion Usually results in multisystem injury Ejection and crush injuries are common

19. ROLLOVERS These produce unpredictable injury patterns as force vectors change directions In restrained passengers, injuries are minimised. Patients may be struck hard against the inferior of the vehicle Unrestrained passengers can be ejected out of the vehicle and cause severe injuries

20. ROLL-OVER IMPACT

21. MOTORCYCLE CRASHES Any structural protection afforded to victims is derived from protective devices worn by the drivers - HELMETS LEATHER OR ABRASION RESISTANT CLOTHING BOOTS OR SHOES

22. MOTORCYCLE CRASHES Attention should be given to Deformity of motorcycle Side damaged Distance of skid Deformity of objects or vehicles Helmet deformity

23. TYPES OF MOTORCYCLE CRASHES Four types of motor cycle impacts Head on impacts Angular impact Ejected Laying the bike down

24. PEDESTRIAN INJURIES Pedestrians hit by a moving vehicle produce 3 types of injuries Primary injuries : these are caused when the vehicle hits the pedestrian, usually causing injuries to lower extremities Secondary injuries : these occur when the pedestrian after the first impact is thrown and hits against the hood or windscreen of the vehicle causing injuries to the head, face ,thorax or abdomen Tertiary injuries : these are caused when the victim impacts the ground after being hit and can be run over causing injuries to head thorax, abdomen , pelvis or extremities.

25. PEDESTRIAN INJURIES WADDELL TRIAD : Pattern of injuries in children and people of short stature. Bumper hits pelvis and femur Chest and abdomen hit grille Head strikes vehicle and ground

26. LEGAL DUTIES OF TREATING DOCTOR

27. TAKE HOME MESSAGE

28. REFERENCES: TEXTBOOK OF EMERGENCY AND TRAUMA CARE TINTINALLI’S EMERGENCY MEDICINE (9 TH EDITION)