Mechanism of Injury (MOI)
A patient falls from 20 ft and lands on their feet. Which abdominal organ is most likely injured?
Kidneys (retroperitoneal shearing/compression)
Muffled heart sounds, JVD, and hypotension.
Cardiac tamponade (Beck’s triad).
Liver
Solid
Air in the pleural space that collapses the lung
Pneumothorax
Best immediate management for an open pneumothorax
Occlusive dressing (vented preferred)
In an MVC, improper seatbelt placement can cause this type of abdominal organ injury.
Compression injury to hollow organs (bowel, bladder)
Unequal chest rise, absent lung sounds, tracheal deviation, hypotension.
Tension pneumothorax
Small intestine
Hollow
Chest wall injury with two or more adjacent ribs fractured in two or more places
Flail chest
First step in managing an abdominal evisceration.
Cover with a moist, sterile dressing; don’t replace organs.
This injury pattern occurs when internal organs continue to move forward after sudden deceleration.
Shearing injury (common in the liver, spleen, and intestines).
Bright red blood in urine after blunt trauma.
Lower urinary tract injury.
Kidneys
Solid (retroperitoneal)
Blood in the pleural space
Hemothorax
IV fluid resuscitation goal in abdominal hemorrhage.
Maintain SBP 80–90 mmHg (permissive hypotension).
A baseball to the chest causes sudden cardiac arrest. What is this called?
Commotio cordis.
Patient with abdominal distention, guarding, and rigidity
Peritonitis from hollow organ rupture
Stomach
Hollow
Traumatic rupture of this large vessel is often fatal at the scene
Aortic disruption.
Proper needle decompression site for tension pneumo.
2nd intercostal space, midclavicular line OR 5th intercostal space, anterior axillary line (depending on protocol).
A blast injury can cause both blunt and penetrating trauma. Name the two phases of injury.
Primary shock wave (blunt compression) and secondary fragments (penetrating).
Paradoxical chest movement on inspiration
Flail chest
Spleen
Solid (highly vascular)
Cyanosis, JVD, swelling in the face/neck/upper chest due to compression injury.
Traumatic asphyxia. (Esophageal Injury)
Trauma patients with suspected abdominal bleeding should be transported to this type of facility.
Trauma center with immediate surgical capability.