外科急诊创伤(英文)-贯通伤PPT.ppt

Penetrating Trauma;Sections ;38,000 Deaths in US annually due to shootings. Mechanisms of penetrating trauma Knives, Arrows, Nails, etc Understanding principles of energy exchange increase the Index of Suspicion associated with the MOI;Recall Kinetic Energy Equation Greater the mass the greater the energy Double mass = double KE Greater the speed the greater the energy Double speed = 4x increase KE;;Physics of Penetrating Trauma;Ballistics;Energy Dissipation;;Aspects of Ballistics;Aspects of Ballistics;Aspects of Ballistics;Bullet Gyroscopic Effect;Aspects of Ballistics;;Aspects of Ballistics;Handguns Small caliber, short barrel, medium-velocity Effective at close range Severity of injury based upon organs damaged Rifle High-velocity, longer barrel, large caliber Increased accuracy at far distances Assault Rifles Large magazine, semi- or full-automatic Similar injury to hunting rifles Multiple wounds;Shotgun Slug or pellets at medium velocity 00 (1/3”) to #9 (pin head sized) Larger the load, the smaller the number of projectiles Deadly at close range Knives Arrows Low-energy low-velocity Damage related to depth and angle of attack Movement of the victim can increase damage;Damage Pathway;;Damage Pathway;Ballistics Cavitation;Low-Velocity Wounds;Density of tissue affects the efficiency of energy transmission Resiliency Strength and elasticity of an object Connective Tissue Absorbs energy and limits tissue damage Organs Solid Organs Dense and low resilience Hollow Organs Fluid filled: transmit energy = increased damage Air filled: absorbs energy = less damage;Lungs Air in lung absorbs energy Parenchyma is compressed and rebounds Pneumothorax or hemothorax can result Bone Resists displacement until it shatters Alters projectile path;General Body Regions;General Body Regions;Wound Characteristics;;Scene Size-Up Law-Enforcement DO NOT ENTER UNTIL SCENE IS SAFE! Weapons: Victim or Assailant Assailants IF A CRIME SCENE DOCUMENT DO NOT DISTURB EVIDENCE RETAIN CLOTHI