Blunt trauma
Blunt trauma, also known as blunt force trauma or non-penetrating trauma, describes a physical trauma due to a forceful impact without penetration of the body's surface. Blunt trauma stands in contrast with penetrating trauma, which occurs when an object pierces the skin, enters body tissue, and creates an open wound. Blunt trauma occurs due to direct physical trauma or impactful force to a body part. Such incidents often occur with road traffic collisions, assaults, and sports-related injuries, and are notably common among the elderly who experience falls.[1][2]
"Blunt force trauma" redirects here. For other uses, see Blunt Force Trauma.Blunt trauma
Blunt injury, non-penetrating trauma, trauma
bruising, occasionally complicated as hypoxia, ventilation-perfusion mismatch, hypovolemia, reduced cardiac output
Blunt trauma can lead to a wide range of injuries including contusions, concussions, abrasions, lacerations, internal or external hemorrhages, and bone fractures.[1] The severity of these injuries depends on factors such as the force of 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.[1] Blunt trauma to the head and/or severe blood loss are the most likely causes of death due to blunt force traumatic injury.[1]
In most settings, 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.[8] The assessment typically begins by ensuring that 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 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,[33] such as diagnostic peritoneal lavage (DPL), or bedside ultrasound examination (FAST)[34] before proceeding to laparotomy if required. If time and the patient's stability permit, a CT examination may be carried out if available.[35] Its advantages include superior definition of 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 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.[8]
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.[36]