Blunt injuries

Atkinson, P.J., Ewers, B.J., and Haut, R.C. Blunt injuries to the pateUofemoral joint resulting from transarticular loading are influenced by impactor energy and mass, J. Biomech. Eng., 123, 293, 2001. Cooper, G.J. et al. The biomechanical response of the thorax to nonpenetrating impact with particular... 

It is indicated in ankylosing spondylitis, rheumatoid arthritis, rheumatic fever, osteoarthritis, after blunt injuries, fractures, tooth extraction, vasectomy and acute gout. 

An interesting application is the use of bromelain in the debridement of third degree bums [112], in the treatment of blunt injuries to the musculoskeletal... 

Penetrating and blunt injuries are commonly sustained following an explosion therefore, standard Advanced Trauma Life Supporf and Advanced Cardiac Life Support principles can be applied. Llowever, unique injuries occur due to the mechanism of blast waves. 

Cervical Spine and Neck Visualize, palpate, and auscultate the patient s neck. Maintain spine precautions. Surgical assessment is necessary for penetrating neck wounds. Blunt injuries of the neck require frequent reassessment as signs develop late. Spine injuries should be ruled out as soon as possible as the patient is at risk for pressure ulcers from spine immobilization techniques. 

Whereas penetrating injuries are less common today, the number of blunt injuries has increased, frequently accompanied by liver rupture. A liver injury is involved in up to 40% of patients with blunt abdominal trauma. Conservative treatment is recommended as far as possible in order to avoid unnecessary laparotomy. (353) The overall mortality rates were 11.8% and 16.8%, respectively. (345, 347) In many cases, the urgency of the situation does not allow the requisite examinations (e.g. US, CT (350, 352), angiography, laparoscopy) to be made -an emergency operation has to be performed. Such an operation must even be done under shock if the patient does not respond directly to conservative methods. 

An interesting application is the use of bromelain in the debridement of third degree bums [112], in the treatment of blunt injuries to the musculoskeletal system [113], and in frostbite eschar removal [114]. It is also used as a potentiating agent in antibiotic therapy [115]. In laboratory medicine it is used extensively in blood group serology [116] and in immunology research [117]. 

YIELD (KT) Range in km for given probability of Blunt injuries fractures Range in km for given probability of fatal injuries ... 

Lau, I.V. and Viano, D.C., How and When Blunt Injury Occurs ImpUcations to Frontal and Side Impact Protection. Proceedings of the 32nd Stapp Car Crash Conference, pp. 81-100, SAE Paper No. 881714, Society of Automotive Engineers, Warrendale, PA, 1988. 

Cervical spine immobilisation should be routine in blunt injury but should be used as appropriate in penetrating injury, taking into account the precise nature of the injuries. In the semi-permissive environment simple airway adjuncts are preferred. 

Blunt injury may result from the patient falling to the floor in an uncontrolled manner or may occur rarely from violent muscular contractions. Electrical burns are rare and usually superficial. Cardiac side effects appear to be very rare, although it is theoretically possible for the TASER to interfere with the functioning of pacemakers or implanted defibrillators. Electrode barb strike in sensitive areas such as the eyes, mouth and external genitalia may have more serious consequences than strikes elsewhere. The electrode barbs are not long enough to cause a pneumothorax. 

Baton rounds cause blunt injuries due to direct impact. These may range from bruising and laceration of the skin to serious or fatal internal injuries to the face, brain or thoraco-abdominal organs. Impact on the chest characteristically results in pulmonary contusion with bloodstained sputum and dyspnoea. 

Mahajna, A. et al. Blunt and penetrating injuries caused by rubber bullets during the IsraeU-Arab conflict in October 2000 A retrospective study. Lancet, 359, 1795-1800, 2002. 

Bowel injuries caused by penetrating, blunt, or iatrogenic trauma that are repaired within 12 hours and intraoperative contamination of the operative field by enteric contents under other circumstances should be treated with antibiotics 24 hours. 

Blunt chest injury Mechanical artificial heart Atrial septal defect Ventricular septal defect Patent foramen ovale Pulmonary arteriovenous fistula Particularly with right to left shunt Catheterization, angioplasty Primary oxalosis, hydatid cyst... 

Penetrating and blunt traumatic injuries that occur as the result of an explosion are similar to those associated with other mechanisms of injury. Primary blast injuries present unique situations and affect selected body systems. Every body system may be affected following an explosion and subsequent blast wave, the associated injuries and their care are discussed in a head-to-toe manner. 

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