Analysis of trauma studies (Research Paper Sample)

Trauma Studies
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Trauma Studies
Part 1 KinematicsQ1. Safety devices in motor vehicles have been proven to save lives. Explain how they prevent /limit injuries, and provide evidence of the effect? 
According to the Australian Bureau of Statistics, in 2010, there were 1,248 fatal road accidents in Australia, claiming the lives of 1,367 people CITATION ABS24 \l 1033 (ABS, 2012). This means that there are 1,367 lives that could have been saved if appropriate measures had been put in place to prevent the loss of life during motor vehicle accidents. What are the safety devices used to save lives in traffic accidents and how do they save lives?
The first and perhaps most important safety device in a vehicle is the safety belt. Safety belts are basically straps that hold a passenger or driver in the car seat. Safety belts are designed differently for people of different weights and sizes. For instance, safety belts for kids are different from similar belts used by adults. It is henceforth important that people ensure that the right safety belts are installed in their cars. How do safety belts save lives? In an article aptly titled Seat Belts: How They Save Lives, Orenstein (2009) explains that safety belts provide a 5-way protection to users. The first of the five protective ways of safety belts is that they keep the occupants inside the vehicle. People who get thrown out of a vehicle during an accident are four times likely to die opposed to those inside. Secondly, safety belts restrain the stronger parts of the body, preventing hurting. Third, safety belts protect users by spreading any force from the collision and hence minimize injury. Safety belts also protect individuals by slowing down the body, and enabling the body to absorb the change in speed without moving violently. Finally, safety belts protect individuals by holding the body in a position in which the brain and spinal cord is protected CITATION Bet09 \l 1033 (Orenstein, 2009).
The second important safety device used in vehicles is the airbag. Innovation has greatly influenced the use of airbags and they can now be placed in strategic parts of a vehicle in order to prevent injuries to people during an accident. For instance, Ford has inflatable safety belts, which can function as airbags CITATION Uni132 \l 1033 (United States Automobile Association, 2013). An airbag system is composed of crash sensors, air bag modules with ready inflators, and a diagnostic module that has a readiness indicator CITATION Wal13 \l 1033 (Walters Forensic Engineering, 2013). Air bags depend on the crash detection system to be launched. When an accident occurs and the crash is detected, the air bags inflate immediately. Airbags are deployed in less than a second when an accident occurs, and save the life of vehicle occupants by preventing them from hitting the steering wheel, the dashboard, the windshield and other parts of the car that a person may be thrown to hit. Airbags are not a substitute for safety belts and should be used with them CITATION CDC13 \l 1033 (CDC, 2013). Other means that can be used to save lives in accidents are not safety devices per se, but are measures that can reduce the risk of accidents e.g. rearview cameras, impact warning signs etc.
References
ABS. (2012, May 24). Year Book Australia: Transport: Accidents,. Retrieved December 12, 2013, from Australian Bureau of Statistics website: /ausstats/abs@.nsf/Lookup/by%20Subject/1301.0~2012~Main%20Features~Accidents,%20injuries%20and%20fatalities~189
CDC. (2013). Save Lives, Save Dollars: Prevent Motor Vehicle–Related Injuries. Retrieved december 12, 2013, from CDC: /injury/pdfs/cost-MV-a.pdf
Orenstein, B. W. (2009, May 20). Seat Belts: How They Save Lives. Retrieved December 12, 2013, from Every Day Health: /healthy-living/wearing-your-seat-belt.aspx
United States Automobile Association. (2013). 10 Car Safety Features That Could Save Your Life. Retrieved December 12, 2013, from United States Automobile Association: /inet/pages/advice-auto-safetyfeatures?akredirect=true
Walters Forensic Engineering. (2013). Air Bags Save Lives. Retrieved December 12, 2013, from Walters Forensic Engineering: /articles/accident_reconstruction/vol2-no2.htm.
Head Trauma
Q2. Explain how measures taken in the pre-hospital environment can prevent or limit raised intracranial pressure in traumatic brain injuries. Support with evidence.
Q2. Explain how measures taken in the pre-hospital environment can prevent or limit raised intracranial pressure in traumatic brain injuries. Support with evidence.
Traumatic brain injury is the sudden damage suffered by the brain when the head is subjected to a sudden hard blow or a jolt CITATION Nob13 \l 1033 (Andaluz, 2013). Traumatic brain injury occurs in vehicle and motorcycle crashes, in sports injuries, in assaults, falls or any types of blows to the head. In an accident that causes TBI, the head is impacted by a blunt object on one side, making the brain to crash against inside of the skull. The brain is a soft tissue, and when it crashes against the skull, it bruises and bleeds. Intracranial hemorrhage or inflammation caused by TBI increase intracranial pressure. Other causes of increased intracranial pressure after TBI include intracranial hematomas, cerebral ischemia, and cerebral edema CITATION Kee05 \l 1033 (Keefe & LeFlore, 2005). TBI is the leading cause of death in individuals between 1 and 44 years of age.
The pre-hospital care of a patient with TBI is very important, if not the most important phase of treatment. Emergency response to a TBI patient is aimed mainly preventing greater harm or injury, making the patient safe, and preventing elevation of intracranial pressure. In the pre-hospital care of a patient with Traumatic brain injury, it is important that the head and neck movement be minimized or avoided in totality. This is vital because any movement of the neck or head may increase intracranial hemorrhage and henceforth increase intracranial pressure. Movement of the head and neck after traumatic brain injury can also worsen the injury to the head and brain CITATION Mar04 \l 1033 (Henry & Stapleton, 2004).
Pre-hospital care of patients with traumatic head injuries in efforts to limit elevation of intracranial pressure should involve hyperventilation of the patient by placing him or her in recovery position and checking for airway obstruction CITATION The13 \l 1033 (The State Government of Victoria, 2013). One of the causes of raised intracranial pressure is ischemia and hypoxia due to poor ventilation, especially in comatose and unconscious patients. Poor ventilation raises intracranial pressure because carbon dioxide, which is concentrated in tissues with poor ventilation, is a vasodilator. Hyperventilation, or supply of oxygen significantly reduces the diameters of cerebral arterioles, hence decreases intracranial pressure.
Lastly, intracranial pressure can be lowered or prevented from rising in TBI patients through the administration of mannitol or hypertonic saline. Mannitol can be administered through infusion or through a bolus. Mannitol increases the osmotic gradient between the blood and the brain, and hence water is drawn from the edematous brain to the vascular system, reducing intracranial pressure significantly. Hypertonic saline, at a concentration of about 7.5% to 23% is effective in lowering intracranial pressure. This is because hypertonic saline has anti-inflammatory changes and increases the osmotic and hemodynamic pressure, resulting to leaking of water into the vascular system CITATION Shi08 \l 1033 (Stivert & Manley, 2008).
In conclusion, the measures that can be used to limit intracranial pressure due to traumatic head injury include, first, the stabilization of the patient without movement of the head or neck. This is important because it prevents further injury to the head and prevents further increase in intracranial pressure due to traumatic brain injury. Hyperventilation, mannitol administration, and administration of hypertonic saline are also effective in reducing intracranial pressure.
References
Andaluz, N. (2013, February). Traumatic Brain Injury (TBI). Retrieved December 12, 2013, from The May Field Clinic: /PE-TBI.htm
Henry, M. C., & Stapleton, E. R. (2004). EMT Prehospital Care, 3rd Ed. New York, NY: Mosby/Jems.
Keefe, K., & LeFlore, J. (2005). Management of Increased Intracranial Pressure in the Criticall Ill Child With an Acute Neurological Injury. AACN Advanced Critical Care, Vol. 16, No. 2, 212-231.
The State Government of Victoria. (2013, September 24). Head Injuries- First Aid. Retrieved December 12, 2013, from The State Government of Victoria: /bhcv2/bhcarticles.nsf/pages/Head_injuries_first_aid
Stivert, S., & Manley, G. (2008). Prejhospital Management of Traumaric Brain Injury. Neurosurgical Focus, Vol. 25, No. 4, E5.
Spinal Trauma
Q3. Explain how you would treat a patient with neurogenic shock relating your treatment to the pathological process of this type of shock.
Neurogenic shock is a kind of distributive shock that occurs after injury to the spinal cord, especially an injury caused by blunt trauma. Neurogenic shock mainly results to an unopposed vagal tone i.e. there is loss of the sympathetic tone which initiates shock response and a decrease in tissue perfusion CITATION Eli13 \l 1033 (Mack, 2013). The most affected region in neurogenic shock is the cervical region of the vertebra, then the thoracolumbar junction comes second, the thoracic region third, and finally the lumbar region. It is important to differentiate neurogenic shock from spinal shock, which involves a temporary loss of the spinal reflex activity CITATION Eme09 \l 1033 (Emergency Medicine, 2009).
Neurogenic shock is mainly manifested by the triad of bradycardi...