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65-402: Blunt force trauma is a medical term referring to a type of physical trauma. Blunt Force Trauma may also refer to: Blunt force trauma Blunt trauma can lead to a wide range of injuries including contusions , concussions , abrasions , lacerations , internal or external hemorrhages , and bone fractures . The severity of these injuries depends on factors such as the force of

130-427: A cervical collar may be placed if there is suspicion of trauma to the neck. Evaluation of blunt trauma to the head continues with the secondary survey for evidence of cranial trauma, including bruises, contusions, lacerations, and abrasions. In addition to noting external injury, a comprehensive neurologic exam is typically performed to assess for damage to the brain. Depending on the mechanism of injury and examination,

195-441: A hemicraniectomy , in which part of the skull is removed. Injury to extremities (like arms, legs, hands, feet) is extremely common. Falls are the most common etiology , making up as much as 30% of upper and 60% of lower extremity injuries. The most common mechanism for solely upper extremity injuries is machine operation or tool use. Work-related accidents and vehicle crashes are also common causes. The injured extremity

260-770: A pulse oximeter . The goal is to maintain greater than 90% oxygen saturation in the blood. If the patient cannot maintain appropriate blood oxygen levels on their own, mechanical ventilation may be indicated. Mechanical ventilation will add oxygen and remove carbon dioxide in the blood. It is also critically important to avoid low blood pressure in the setting of traumatic brain injuries . Studies have demonstrated improved outcomes in patients with systolic blood pressure greater than or equal to 120mmHg. Lastly, healthcare professionals should conduct consecutive neurological examinations to allow for early identification of elevated intracranial pressure and subsequent implementation of interventions to improve blood flow and reduce stress to

325-412: A CT scan of the skull and brain may be ordered. This is typically done to assess for blood within the skull or fracture of the skull bones . Traumatic brain injury (TBI) is a significant cause of morbidity and mortality and is most commonly caused by falls, motor vehicle crashes, sports- and work-related injuries, and assaults. It is the most common cause of death in patients under the age of 25. TBI

390-622: A blunt chest injury will likely undergo a focused assessment with sonography for trauma ( FAST ) which can reliably detect a significant amount of blood around the heart or in the lung by using a special machine that visualizes sound waves sent through the body. Only 10–15% of thoracic traumas require surgery, but they can have serious impacts on the heart , lungs , and great vessels . The most immediate life-threatening injuries that may occur include tension pneumothorax , open pneumothorax, hemothorax , flail chest , cardiac tamponade , and airway obstruction/rupture . The injuries may necessitate

455-460: A high degree of clinical suspicion. There are two basic physical mechanisms at play with the potential of injury to intra-abdominal organs: compression and deceleration . The former occurs from a direct blow, such as a punch, or compression against a non-yielding object such as a seat belt or steering column. This force may deform a hollow organ, increasing its intraluminal or internal pressure and possibly leading to rupture. Deceleration, on

520-444: A procedure, most commonly the insertion of an intercostal drain , or chest tube. This tube is typically installed because it helps restore a certain balance in pressures (usually due to misplaced air or surrounding blood) that are impeding the lungs' ability to inflate and thus exchange vital gases that allow the body to function. A less common procedure that may be employed is a pericardiocentesis , which, by removing blood surrounding

585-431: A symptom of myocardial infarctions ('heart attack'). If this condition is present in the body, discomfort will be felt in the chest that is similar to a heavy weight placed on the body. Sweating, shortness of breath, lightheadedness , and irregular heartbeat may also be experienced. If a heart attack occurs, the bulk of the damage is caused during the first six hours, so getting the proper treatment as quickly as possible

650-481: A traumatic injury is highly variable and depends upon the specific intracranial injuries that occur. However, there is a significant correlation between the severity of the initial insult as well as the level of neurologic function during the initial assessment and the level of lasting neurologic deficits. Initial treatment may be targeted at reducing the intracranial pressure if there is concern for swelling or bleeding within this skull. This may require surgery, such as

715-596: A variety of injuries to the chest . Broadly, this also includes damage caused by direct blunt force (such as a fist or a bat in an assault), acceleration or deceleration (such as that from a rear-end automotive crash), shear force (a combination of acceleration and deceleration), compression (such as a heavy object falling on a person), and blasts (such as an explosion of some sort). Common signs and symptoms include something as simple as bruising , but occasionally as complicated as hypoxia , ventilation-perfusion mismatch , hypovolemia , and reduced cardiac output due to

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780-430: Is "yes", an injured extremity index or ankle-brachial index may be used to help guide whether further evaluation with computed tomography arteriography . This uses a special scanner and a substance that makes it easier to examine the vessels in finer detail than what the human hand can feel or the human eye can see. Soft tissue damage can lead to rhabdomyolysis (a rapid breakdown of injured muscle that can overwhelm

845-481: Is a serious concern due to its tremendous infectious potential. In these cases, it is essential to perform exploratory surgery to assess the internal damage, drain infected fluid in the abdomen, and clean the wound with saline. Prophylactic antibiotics are often necessary. In the case of multiple holes or significant damage to the blood supply of the intestines , the affected segment of tissue may need to be removed entirely. The treatment of blunt cranial trauma

910-401: Is blocked and traps air. The blockage may be caused by something inside the bronchus , such as a plug of mucus, a tumour , or an inhaled foreign object such as a coin, piece of food, or a toy. It is possible for something outside of the bronchus to cause the blockage. Pneumothorax is the condition where air or gas can build up in the pleural space. It can occur without a known cause or as

975-538: Is complicated by 'internal injury,' the liver and spleen (see blunt splenic trauma ) are most frequently involved, followed by the small intestine . In rare cases, this injury has been attributed to medical techniques such as the Heimlich maneuver , attempts at CPR and manual thrusts to clear an airway . Although these are rare examples, it has been suggested that they are caused by applying excessive pressure when performing these life-saving techniques. Finally,

1040-437: Is concern for life-threatening bleeding, patients should receive an X-ray of the pelvis. Following initial treatment of the patient, fractures may need to be treated surgically if significant, while some minor fractures may heal without requiring surgery. A life-threatening concern is hemorrhage , which may result from damage to the aorta , iliac arteries, or veins in the pelvis. The majority of bleeding due to pelvic trauma

1105-421: Is dependent on the extent of the injury. A discussion between the patient and healthcare professionals will take place in order to carefully assess the patient's condition and determine the best approach for treatment. When considering the management of cranial trauma, it is crucial to ensure that the patient can breathe effectively. Effective breathing can be monitored using the patient's blood oxygen content via

1170-567: Is due to injury to the veins. Fluid (often blood) may be detected in the pelvis via ultrasound during the FAST scan that is often performed following traumatic injuries. Should a patient appear hemodynamically unstable in the absence of obvious blood on the FAST scan, there may be concern for bleeding into the retroperitoneal space , known as retroperitoneal hematoma . Stopping the bleeding may require endovascular intervention or surgery, depending on

1235-407: Is examined for four major functional components which include soft tissues , nerves , vessels , and bones . Vessels are examined for expanding hematoma , bruit , distal pulse exam, and signs/symptoms of ischemia , essentially asking, "Does blood seem to be getting through the injured area in a way that enough is getting to the parts past the injury?" When it is not obvious that the answer

1300-404: Is generally felt when deep breaths are taken or during a cough. Another non-cardiac cause of chest pain is atelectasis . It is a condition that occurs when a portion of the lung collapses from being airless. When bronchial tubes are blocked, this condition develops and causes patients to feel shortness of breath. The most common cause of atelectasis is when a bronchi that extends from the windpipe

1365-457: Is graded from mild to severe, with greater severity correlating with increased morbidity and mortality. Most patients with more severe traumatic brain injury have a combination of intracranial injuries, which can include diffuse axonal injury , cerebral contusions , and intracranial bleeding, including subarachnoid hemorrhage , subdural hematoma , epidural hematoma , and intraparenchymal hemorrhage . The recovery of brain function following

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1430-526: Is important. Some people, especially those who are elderly or have diabetes, may not have typical chest pain but may have many of the other symptoms of a heart attack. It is important that these patients and their caregivers have a good understanding of heart attack symptoms. Just like with a heart attack, not all chest pain is caused by conditions involving the heart . Chest wall pain can be experienced after an increase in activity. Persons who add exercise to their daily routine generally feel this type of pain at

1495-433: Is significant enough to require evaluation by a healthcare provider, treatment is typically aimed at treating life-threatening injuries, such as maintaining the patient's airway and preventing ongoing blood loss . Patients who have suffered blunt trauma and meet specific triage criteria have shown improved outcomes when they are cared for in a trauma center . The management of patients with blunt force trauma necessitates

1560-471: Is sometimes given the mnemonic " SAMPLE ". The amount of time spent on diagnosis should be minimized and expedited by a combination of clinical assessment and appropriate use of technology, such as diagnostic peritoneal lavage (DPL), or bedside ultrasound examination (FAST) before proceeding to laparotomy if required. If time and the patient's stability permit, a CT examination may be carried out if available. Its advantages include superior definition of

1625-526: Is suspected, emergency medical services personnel may place a pelvic binder on patients to stabilize the patient's pelvis and prevent further damage to these structures while patients are transported to a hospital. During the evaluation of trauma patients in an emergency department, the stability of the pelvis is typically assessed by the healthcare provider to determine whether a fracture may have occurred. Providers may then decide to order imaging such as an X-ray or CT scan to detect fractures; however, if there

1690-525: Is the most common example of this injury. Seventy-five percent of BAT occurs in motor vehicle crashes, in which rapid deceleration may propel the driver into the steering wheel , dashboard , or seatbelt, causing contusions in less serious cases, or rupture of internal organs from briefly increased intraluminal pressure in the more serious, depending on the force applied. Initially, there may be few indications that serious internal abdominal injury has occurred, making assessment more challenging and requiring

1755-414: The axillae and the heads of the humeri . In the middle line the suprasternal notch is seen above, while about three fingers' breadth below it a transverse ridge can be felt, which is known as the sternal angle and this marks the junction between the manubrium and body of the sternum . Level with this line the second ribs join the sternum, and when these are found the lower ribs can often be counted. At

1820-516: The axillary , radial , and median nerves in the upper extremity as well as the femoral , sciatic , deep peroneal , and tibial nerves in the lower extremity . Depending on the extent of injury and involved structures, surgical treatment may be necessary, but many are managed nonoperatively. The most common causes of blunt pelvic trauma are motor vehicle crashes and multiple-story falls, and thus pelvic injuries are commonly associated with additional traumatic injuries in other locations. In

1885-441: The diaphragm , the esophagus , the trachea , and a part of the sternum known as the xiphoid process . Arteries and veins are also contained – ( aorta , superior vena cava , inferior vena cava and the pulmonary artery ); bones (the shoulder socket containing the upper part of the humerus , the scapula , sternum , thoracic portion of the spine , collarbone , and the rib cage and floating ribs ). External structures are

1950-417: The kidneys ) or may potentially develop compartment syndrome (when pressure builds up in muscle compartments damages the nerves and vessels in the same compartment). Bones are evaluated with plain film X-ray or computed tomography if deformity (misshapen), bruising, or joint laxity (looser or more flexible than usual) are observed. Neurologic evaluation involves testing the major nerve functions of

2015-429: The skin and nipples . In the human body , the region of the thorax between the neck and diaphragm in the front of the body is called the chest. The corresponding area in an animal can also be referred to as the chest. The shape of the chest does not correspond to that part of the thoracic skeleton that encloses the heart and lungs . All the breadth of the shoulders is due to the shoulder girdle, and contains

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2080-470: The thoracic cavity and the thoracic wall . It contains organs including the heart , lungs , and thymus gland, as well as muscles and various other internal structures. Many diseases may affect the chest, and one of the most common symptoms is chest pain . The word thorax comes from the Greek θώραξ thṓrax " breastplate , cuirass , corslet " via Latin : thorax . In humans and other hominids ,

2145-567: The United States. The major pathophysiologies encountered in blunt chest trauma involve derangements in the flow of air, blood, or both in combination. Sepsis due to leakage of alimentary tract contents, as in esophageal perforations, also must be considered. Blunt trauma commonly results in chest wall injuries (e.g., rib fractures). The pain associated with these injuries can make breathing difficult, and this may compromise ventilation. Direct lung injuries, such as pulmonary contusions (see

2210-402: The ability to breathe properly on their own, encourages the excretion of pulmonary secretions, and decreases the aggravation of inflammation and low oxygen levels in the blood. Nonsteroidal anti-inflammatory drugs , opioids , or regional pain management methods, such as local anesthetic , can be used for pain control. Worldwide, a significant cause of disability and death in people under

2275-452: The age of 35 is trauma, of which most are due to blunt trauma. Thorax The thorax ( pl. : thoraces or thoraxes ) or chest is a part of the anatomy of mammals and other tetrapod animals located between the neck and the abdomen . In insects , crustaceans , and the extinct trilobites , the thorax is one of the three main divisions of the body, each in turn composed of multiple segments. The human thorax includes

2340-429: The beginning. It is important to monitor the pain to ensure that it is not a sign of something more serious. Pain can also be experienced in persons who have an upper respiratory infection . This virus is also accompanied by a fever and cough. Shingles is another viral infection that can give symptoms of chest or rib pain before a rash develops. Injuries to the rib cage or sternum is also a common cause of chest pain. It

2405-503: The best approach, tailored to the patient's specific condition and injury. Conservative measures such as maintaining a clear and open airway, oxygen support, tube thoracostomy , and volume resuscitation are often given to manage blunt thoracic trauma. Oftentimes, pain control is the most basic and effective treatment approach because the presence of severe pain may lead to impairment of proper breathing, further exacerbating impaired lungs. Pain management in thoracic trauma patients improves

2470-447: The body. Of note, patients taking anticoagulant or antiplatelet therapy during the time of blunt cranial trauma should undergo rapid reversal of anticoagulating agents. Nine out of ten patients with thoracic trauma can be treated effectively without a surgical operation . If surgery is indicated, there are numerous options available. A comprehensive discussion between the patient and the surgeon will take place to carefully evaluate

2535-425: The cartilage attached to the sternum, as 1 through 7 are, and therefore are termed "floating". Whereas ribs 8 through 10 are termed false ribs as their costal cartilage articulates with the costal cartilage of the rib above. The thorax bones also have the main function of protecting the heart, lungs, and major blood vessels in the thorax area, such as the aorta . The anatomy of the chest can also be described through

2600-421: The cause of the pain. While cardiac issues cause feelings of sudden pressure in the chest or a crushing pain in the back, neck, and arms, pain that is felt due to noncardiac issues gives a burning feeling along the digestive tract or pain when deep breaths are attempted. Different people feel pains differently for the same condition. Only a patient truly knows if the symptoms are mild or serious. Chest pain may be

2665-428: The collaboration of an interpersonal healthcare team, which may include but is not limited to; a trauma surgeon , emergency department physician, anesthesiologist , and emergency and trauma nursing staff. In cases of blunt abdominal injury, the most frequent damage occurs in the small intestines , and in severe situations, this can result in small intestine perforation . Perforation of the small or large intestines

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2730-414: The extinct trilobites , the thorax is one of the three main divisions of the creature's body, each of which is in turn composed of multiple segments. It is the area where the wings and legs attach in insects, or an area of multiple articulating plates in trilobites. In most insects, the thorax itself is composed of three segments; the prothorax , the mesothorax , and the metathorax . In extant insects,

2795-434: The functional thorax is composed of four segments, and is therefore typically called the mesosoma to distinguish it from the "thorax" of other insects. Each thoracic segment in an insect is further subdivided into various parts, the most significant of which are the dorsal portion (the notum ), the lateral portion (the pleuron ; one on each side), and the ventral portion (the sternum ). In some insects, each of these parts

2860-407: The heart, permits the heart to regain some ability to appropriately pump blood. In certain dire circumstances an emergent thoracotomy may be employed. The primary clinical concern with blunt trauma to the head is damage to the brain, although other structures, including the skull, face, orbits , and neck are also at risk. Following assessment of the patient's airway, circulation, and breathing,

2925-445: The image below), are frequently associated with major chest trauma and may impair ventilation by a similar mechanism. Chest pain can be the result of multiple issues, including respiratory problems, digestive issues, and musculoskeletal complications. The pain can trigger cardiac issues as well. Not all pain that is felt is associated with the heart, but it should not be taken lightly either. Symptoms can be different depending on

2990-407: The impact, the area of the body affected, and the underlying comorbidities of the affected individual. In some cases, blunt force trauma can be life-threatening and may require immediate medical attention. Blunt trauma to the head and/or severe blood loss are the most likely causes of death due to blunt force traumatic injury. Blunt abdominal trauma (BAT) represents 75% of all blunt trauma and

3055-505: The initial assessment. These algorithms take into account the mechanism of injury, physical examination , and patient's vital signs to determine whether patients should have imaging or proceed directly to surgery. In 2011, criteria were defined that might allow patients with blunt abdominal trauma to be discharged safely without further evaluation. The characteristics of such patients include: To be considered low-risk, patients would need to meet all low-risk criteria. When blunt trauma

3120-687: The initial evaluation and stabilization of traumatic injury follows the same general principles of identifying and treating immediately life-threatening injuries. In the US, the American College of Surgeons publishes the Advanced Trauma Life Support guidelines, which provide a step-by-step approach to the initial assessment, stabilization, diagnostic reasoning, and treatment of traumatic injuries that codifies this general principle. The assessment typically begins by ensuring that

3185-484: The injury, leading to grading of the injury and sometimes the confidence to avoid or postpone surgery. Its disadvantages include the time taken to acquire images, although this gets shorter with each generation of scanners, and the removal of the patient from the immediate view of the emergency or surgical staff. Many providers use the aid of an algorithm such as the ATLS guidelines to determine which images to obtain following

3250-592: The location and severity. Blunt cardiac trauma, also known as Blunt Cardiac Injury (BCI), encompasses a spectrum of cardiac injuries resulting from blunt force trauma to the chest. While BCIs necessitate a substantial amount of force to occur because the heart is well-protected by the rib cage and sternum , the majority of patients are asymptomatic. Clinical presentations may range from minor, clinically insignificant changes to heartbeat or may progress to severe cardiac failure and death . Oftentimes, chest wall injuries are seen in conjunction with BCI, which confounds

3315-491: The lower part of the sternum, where the seventh or last true ribs join it, the ensiform cartilage begins, and above this there is often a depression known as the pit of the stomach . The bones of the thorax, called the "thoracic skeleton" is a component of the axial skeleton . It consists of the ribs and sternum . The ribs of the thorax are numbered in ascending order from 1–12. 11 and 12 are known as floating ribs because they have no anterior attachment point in particular

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3380-514: The lung or as a shortness of breath. In mammals , the thorax is the region of the body formed by the sternum , the thoracic vertebrae , and the ribs . It extends from the neck to the diaphragm , and does not include the upper limbs . The heart and the lungs reside in the thoracic cavity , as well as many blood vessels . The inner organs are protected by the rib cage and the sternum. Thoracic vertebrae are also distinguished in birds , but not in reptiles . In insects , crustaceans , and

3445-600: The mechanism of injury. The priority in assessing blunt trauma in sports injuries is separating contusions and musculo-tendinous injuries from injuries to solid organs and the gut. It is also crucial to recognize the potential for developing blood loss and to react accordingly. Blunt injuries to the kidney from helmets, shoulder pads, and knees are described in American football, association football, martial arts, and all-terrain vehicle crashes. The term blunt thoracic trauma, or, more informally, blunt chest injury , encompasses

3510-408: The most common condition, chest pain. These conditions can be hereditary or caused by birth defects or trauma . Any condition that lowers the ability to either breathe deeply or to cough is considered a chest disease or condition. Injury to the chest (also referred to as chest trauma, thoracic injury, or thoracic trauma) results in up to ⁠ 1 / 4 ⁠ of all deaths due to trauma in

3575-474: The occurrence of splenic rupture with mild blunt abdominal trauma in those recovering from infectious mononucleosis or 'mono' (also known as 'glandular fever' in non-U.S. countries, specifically the UK) is well reported. The supervised environment in which most sports injuries occur allows for mild deviations from the traditional trauma treatment algorithms, such as ATLS , due to the greater precision in identifying

3640-413: The other hand, causes stretching and shearing at the points where mobile contents in the abdomen , like the bowel , are anchored. This can cause tearing of the mesentery of the bowel and injury to the blood vessels that travel within the mesentery. Classic examples of these mechanisms are a hepatic tear along the ligamentum teres and injuries to the renal arteries . When blunt abdominal trauma

3705-430: The pelvis specifically, the structures at risk include the pelvic bones , the proximal femur , major blood vessels such as the iliac arteries , the urinary tract , reproductive organs , and the rectum . One of the primary concerns is the risk of pelvic fracture , which itself is associated with a myriad of complications including bleeding, damage to the urethra and bladder , and nerve damage . If pelvic trauma

3770-578: The presence of chest pain experienced by most patients. To evaluate the spectrum of cardiac injury, the American Association for the Surgery of Trauma (AAST) organ injury scale may be used to aid in determining the extent of the injury (see Evaluation and Diagnosis below). BCI may be broken down into pericardial injury, valvular injuries, coronary artery injuries, cardiac chamber rupture, and myocardial contusion . In most settings,

3835-417: The prothorax never has wings, though legs are always present in adults; wings (when present) are restricted to at least the mesothorax, and typically also the metathorax, though the wings may be reduced or modified on either or both segments. In the apocritan Hymenoptera , the first abdominal segment is fused to the metathorax, where it forms a structure known as the propodeum . Accordingly, in these insects,

3900-413: The result of a lung disease or acute lung injury. The size of the pneumothorax changes as air or gas builds up, so a medical procedure can release the pressure with a needle. If it is untreated, blood flow can be interrupted and cause a drop in blood pressure known as tension pneumothorax. It is possible for smaller cases to clear up on their own. Symptoms of this condition are often felt only on one side of

3965-436: The second to the sixth rib vertically and from the edge of the sternum to the mid-axillary line laterally. The female nipple is surrounded for half an inch by a more or less pigmented disc, the areola . The apex of a normal heart is in the fifth left intercostal space, three and a half inches from the mid-line. Different types of diseases or conditions that affect the chest include pleurisy , flail chest , atelectasis , and

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4030-515: The subject's airway is open and competent, that breathing is unlabored, and that circulation—i.e. pulses that can be felt—is present. This is sometimes described as the "A, B, C's"—Airway, Breathing, and Circulation—and is the first step in any resuscitation or triage. Then, the history of the accident or injury is amplified with any medical, dietary (timing of last oral intake) and history, from whatever sources that might be available such as family, friends, and previous treating physicians. This method

4095-422: The thorax is the chest region of the body between the neck and the abdomen , along with its internal organs and other contents. It is mostly protected and supported by the rib cage , spine , and shoulder girdle . The contents of the thorax include the heart and lungs (and the thymus gland); the major and minor pectoral muscles, trapezius muscles , and neck muscle; and internal structures such as

4160-427: The use of anatomical landmarks . The nipple in the male is situated in front of the fourth rib or a little below; vertically it lies a little external to a line drawn down from the middle of the clavicle ; in the female it is not so constant. A little below it the lower limit of the great pectoral muscle is seen running upward and outward to the axilla; in the female this is obscured by the breast , which extends from

4225-431: The way the thoracic organs may have been affected. Blunt thoracic trauma is not always visible from the outside and such internal injuries may not show signs or symptoms at the time the trauma initially occurs or even until hours after. A high degree of clinical suspicion may sometimes be required to identify such injuries, a CT scan may prove useful in such instances. Those experiencing more obvious complications from

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