TCAR Comprehensive Exam Questions
With Verified Solutions.
What is the Causative Agent in Trauma? - Answer Energy
Understanding injury potential in a trauma patient involves analyzing WHAT 4
FACTORS? - Answer 1) The Nature and amt of force. 2)Various patient
characteristics. 3)Characteristics of the wounding agent.
4)Tissue characteristics.
What does the Nature and amount of force mean? - Answer Force is the dose of
kinetic energy involved. Force=weight x speed *2
What was the dose of energy? A small increase in speed produces a significant
increase in force.
In car accidents....going fast isn't really the problem. It's not the speed but the ____ that
kills. - Answer Stop. Stop is when energy gets applied to the tissues. Both a patients
SPEED and Deceleration distance predict potential injuries.
What is the benefit of safety devices in vehicles? - Answer They add deceleration
distance. Airbags give occupants 12+ inches to dissipate energy. Seatbelts are
designed to have stretch, allowing to "ride down" the energy. Flexible crash barriers
(helmets, knee pads) add decel distance.
Indicators of force. The force went somewhere...so where did it go? - Answer Some
indicators of force are readily notated on physical exam but others may not be evident
for hours or days. Obvious, delayed and subtle.
What is the gender risk of trauma? - Answer More than 2/3 major trauma patients are
MALE.
Trauma incidence peaks at what age? - Answer Teen and young adult years.
What age trauma patient has the worse outcomes? - Answer Extremes of age.
What are some environmental risks for trauma? - Answer High risk jobs, associate
with dangerous people, engage in extreme sport, abuse alcohol and other drugs, use
weapons
,What is the two most popular forces associated with injury? - Answer Mechanical or
gravitational forces.
What are the 6 types of injuring energy forces? - Answer Mechanical, Gravitational,
Thermal, Chemical, Electrical, Radiant
What is injury Mechanism? - Answer The Means by which energy is transferred to the
tissues.
What are 5 injury mechanisms? - Answer Blunt, penetrating, Crush, Burn, Blast
Energy is generally applied in characteristic patterns. By analyzing
_________ ,_________, _______,_________, and __________ it is possible to predict
fairly accurately the injuries a patient will sustain. - Answer Type, amount, location,
direction, and duration.
What are 4 blunt trauma classifications? - Answer Motor Vehicle Collisions, Auto-
Pedestrian Incidences, Falls, Struck by or against an object.
Rear Impact Collisions - Answer Commonly low velocity (backing up or both moving
forward). Rear seat occupants are greater risk. The body if first thrown forward while
head lags behind.
Frontal collisions - Answer 65% of all crashes, most vehicle safety devices are
engineered primarily for frontal impacts.
Neck Hyperextension followed by hyperflexion (Cervical Strain or whiplash) - Answer
Rear impact collisions
Lateral impact collisions (AKA broadside or T-bone) - Answer Side blow. There are
only 6-8 inches between the occupant of one vehicle and the bumper of the other. Steel
side beams and lateral airbags reduce force transmission.
Look for indicators of force on anterior body surfaces. - Answer Frontal Collisions.
Look for massive unilateral patient injury. - Answer Lateral impact collisions (AKA
broadside or T-bone)
Rollover Collisions - Answer Energy transmission depends primarily on deceleration
distance because energy is dissipated over the distance of the roll (vs driving in a wall).
Depends on whether or not the occupants were restrained.
Unrestrained occupants become free-floating objects, subject to the centrifugal forces.
Can be spun out of the vehicle. - Answer Rollover collision
,Auto Vs. Pedestrian Injuries laws of physics - Answer Mass of the vehicle times its
velocity ^2, Majority of this force is transmitted to the pedestrian.
Energy is transmitted to the Pedestrian at the _________________ __ ___________
with the vehicle. - Answer Points of contact.
Auto Vs. Pedestrian Injuries variables include: (x5) - Answer 1)Height of the hood.
2)Height of the bumper.
3)Size and weight of the particular vehicle.
4)Height of the pedestrian.
5)Direction the pedestrian was facing when struck.
Falls - Answer Most common mechanism of injury in all age groups.
The velocity of a fall is.... - Answer The speed of gravity=32ft/sec/sec
What is the acceleration of a fall? - Answer For every second of fall time, seed
increases by about 20mph (until terminal velocity is achieved)
What are the three factors predicting fall injuries? - Answer 1)Drop Height(velocity)?
2)Landing surface (deceleration distance)?
3)Point of impact on the body (Where the energy was initially applied; follow the force.)
Whats the acceleration speed for the listed Drop Height
3'4'' ?
13'4"?
30' 1"?
53'6"?
83'6"? - Answer Whats the Drop Height?
10MPH
20MPH
30MPH
40MPH
50MPH
Biomechanics of being struck by or against? - Answer Blows of any kind, often
multiple to various body sites. The force of a blow is equal to the bass of the object
times its velocity squared.
Even small objects can exert significant force.
What are the types of penetrating injury mechanisms? - Answer Firearm injuries
Stab injuries
Impalement injuries
Wound ballistics - The size of the permanent cavity is? - Answer is a function of the
size, shape, and characteristics of the the missile (Mass).
, Wound Ballistics - The size of the Temporary cavity is? - Answer is the result of the
bullet blast wave; a function of the bullet's speed (velocity).
What influences the size of the temporary cavity of a wound ballistic? - Answer The
Characteristics of the tissues involved.
Guns - Which ones have low velocities and which ones have high velocities? - Answer
Handguns = low
Rifles/long guns = High
Military -grade weapons achieve _______velocities - Answer Even higher Velocities
Facts about Shotguns - Answer Spherical pellets in shells rather than bullets.
Shot comes in various sizes.
Pellets disperse with distance.
The combination of the pellet size and distance from the muzzle influence the effects of
the shotgun blast.
Stab injures facts - Answer Low velocity= no significant temporary cavity.
The permanent cavity is the size and shape of the stabbing instrument.
Damage is limited to structures directly in the objects path.
Impalement injury facts - Answer A penetrating wound that doesn't involve an
instrument designed to cut. Especially if the wound wasn't deliberately inflicted. A
relatively low velocity of impalement injuries often pushes vital structures aside as the
object enters the tissues.
Crush injury facts - Answer Associated with massive tissue destruction. Machinery,
pin-in road traffic collisions, animal bites, structure collapse, pedestrians who are run
over
What are 4 types of burn injuries? - Answer Thermal, Chemical, Electrical, Radiant
What is the only mechanism of injury that does not involve mechanical or gravitational
force? - Answer Burn injuries
What makes blast injuries complex? - Answer MULITIPLE TRAUMA including delayed
and subtle findings.
It can consist of several potential mechanism types including Blast wave (shock wave,
over pressurization wave), Fragment penetration (small flying objects), Blunt trauma
(fall, thrown, hit), Crush injury (structure collapse, falling objects), Burns (thermal,
chemical), Contamination (bilogical material, chemicals, or radiation).
What are three mechanisms of injury for tissues? - Answer Solid structures = Crack
Hollow Structures = PoP
