Mechanism of Injury

EO 3.1

Reference
MAC Manual Chapter 3

Mechanics of injury

Aims

Introduce Mechanics of injury (MOI) as a tool to aid in the recognition of injuries or potential injuries

Causes of Injury

Penetrating trauma, high and low velocity GSW, Blast injuries, shrapnel, knife wounds Blunt Trauma RTA, falls, blast injuries, crush injuries Climate Heat and cold injuries Chemical Burns Medical

Timings of Trauma Death

Instantaneous
Early Late

Hazard spectrum - Mechanisms of Injury

Penetrating Trauma - High Velocity - Low Velocity Blast Injuries (including traumatic
amputation) Blunt Trauma (e.g. RTAs) Crush Injuries

Effects of GSW and Fragments

Factors affecting injuries caused by fragments and bullets Mass and Velocity Shape and stability Tissue density Length of wound tract Cavitation Contamination

Penetrating injuries

The energy transferred determines the amount of damage Energy transferred is effected by Speed Frontal surface area

Hazard spectrum - Mechanisms of Injury

Three energy level categories

Low energy

2
3

Medium energy
High energy

Hazard spectrum - Mechanisms of Injury

Hazard spectrum Mechanisms of Injury

Blast Injuries
There are 4 distinct stages to blast injuries Primary Secondary Tertiary Quaternary

Blunt Trauma
The most common cause of blunt trauma are RTAs. Important points to remember: Two forces are involved in blunt trauma Compression Shear

Hazard spectrum - Mechanisms of Injury

Motor Vehicle Collisions

Frontal (head on) impact Rear impact Lateral or side impact Rotational impact Rollover

Stages of Impact

The vehicle collides with an object or other vehicle The unrestrained occupant collides with the inside of the vehicle The occupants internal organs collide with each other or the wall of the cavity that contains them

Frontal or head on impact

The occupant if unrestrained will follow one of two pathways Down and under Up and over

Down and under

Up and over

Rear impact

The velocity is the difference between two vehicles speeds

If windscreen is damaged assume a C spine injury

Lateral or side impact

Entire side of vehicle is thrust against occupant

Lateral or side impact

Rotational impact
Occurs when one corner of a car unmovable object strikes an

The rollover

The car may undergo several impacts at many different angles

Rollover

Crush Injuries
Effects:
Cardiac arrest Renal failure

Hazard spectrum - Mechanisms of Injury

Extreme Heat

Extreme Cold

Mechanisms of Injury
Medical: Underlying disease (e.g. clogged
arteries).

Toxicological: Chemical Weapons. Industrial Chemicals. Overdose.

Medical Emergencies
Diabetes Tropical diseases Appendicitis Cardiac

Burns
Multi-system injuries as they can effect:
Airway

Breathing
Circulation

Chemical Injuries
Systemic toxicity
Local damage to skin and eyes

Any Questions?