Accident in all its forms, either auto, domestic, aero, explosive, or work-related all involves the collision of the victim’s body part with solid objects. What is blunt force trauma? Blunt force trauma is the result of such collision with blunt objects without penetration of the skin. Assaults and sport-related collisions are also sources of blunt force trauma.
What is Blunt Force Trauma?
A physical injury to a part of the body from an object striking or hitting the body without penetration is termed Blunt Force Trauma. It can also be referred to as Blunt Trauma, it is defined as an injury due to a blunt object having an impact on parts of the body.
Blunt force trauma meaning is quite different from penetrating trauma as the latter involves a sharp object piercing the body part for instance a knife or a bullet. Blunt trauma can happen due to collisions, automobile accidents, hitting with a fist, bat, sport-related accidents, a hard-hitting fall, and so on.
Death tolls have been due to blunt force trauma in the United States and all over the world. It has been estimated according to a CDC injury data that each year, in the United States, 214, 000 people die due to injuries, and about 26 million others are treated in emergency departments. In the United States in 2015, more than 2.8 million people were hospitalized for fall injuries. In 2012, more than 329 000 children were treated for sports-related injuries in the emergency departments.
A motor vehicle accident is the most common cause of blunt force trauma. Sports injuries, falls and physical assaults are also common sources of this condition. Like penetrative traumas, blunt trauma can be very fatal depending on the severity of the force and the nature of the blunt object.
Blunt Force Trauma Symptoms
Symptoms of blunt force trauma can vary depending on how hard the impact was and the part of the body that received the impact. With a slight force, the symptoms can just be mild pain with a bruise. With a high impact on the head, for instance, there could be severe symptoms like concussion and death.
Parts of the body like the abdomen or pelvic if are the primary recipient of the force can show symptoms like internal hemorrhage, contusion, and damage to internal organs. The severity of the force is proportional to the severity of the symptoms. Generally, the most prevalent signs and symptoms of blunt force trauma are:
- Bruising: a dark coloration of the skin due to internal bleeding of capillaries under the skin surface due to a damaging force.
- Pain: aching or bodily suffering due to an injury.
- Swelling: an increase in the size of the skin due to engorgement with fluids like blood.
- Redness: an abnormal inflammation of the skin due to increased blood circulation around the skin surface.
- Tenderness: this is a softening of the skin due to pressure from a force.
- Hypoxia: this is a shortage of oxygen in the body tissues hindering the sustenance of body functions.
- Abrasions: is the wearing away or scraping of the skin.
- Internal Hemorrhage: this is a heavy release of blood within the body, it is bleeding inside the body.
- ventilation-perfusion mismatch is a condition when the lungs receive blood without oxygen supply or vice versa.
- Hypovolemia: is a condition when the plasma of the blood is too low many times due to excessive bleeding.
- Contusion: is the rupturing of blood capillaries in an injured tissue or skin.
- Bone fracture: this is a breakage in a bone.
- Lacerations: an opening of the skin due to a blunt impact in the skin.
Classification of Blunt Trauma
Based on the part of the body that is affected by the impact, blunt force trauma can be classified into four major types:
Blunt Force Trauma to the Head
What is blunt force trauma to the head? Blunt cranial trauma as it can also be called is the resultant of a blunt force on the head usually from fall, motor vehicle accident, sport-related accidents, and assault. The injury can be very fatal and mild in some cases. The main concern in a blunt force trauma to the head is the brain with structures like the neck, orbits, face, and skull also at risk of damage.
To effectively assess the harm done by the impact of blunt force on the brain, a Computed Tomography (CT) scan may be required. Physical examination is also carried out for signs like a contusion, bruises, blurred vision, diminished coordination, blurred speech, loss of consciousness, convulsion, severe headache, partial paralysis of limbs, abrasion, and lacerations. Three types of injuries are mainly observed with blunt force trauma to the head, concussion, contusion, and contrecoup.
A concussion is a temporary traumatic injury to the brain that can result in headaches and momentary impairment of brain functions like memory and coordination. In severe head injuries, contusion frequently occurs. It is characterized by microhemorrhages and bruising of the brain tissues. Contrecoup is sustained when a moving brain collides with a stationary blunt object. This usually causes an injury to the brain part opposite the impact.
Blunt force trauma to the head can leave a permanent detrimental effect on the brain. Some important brain functions like vision, speech, and language coordination may be permanently affected. Traumatic brain damage can result in specific intracranial injuries such as intracranial bleeding, subarachnoid hemorrhage, hematoma (subdural and epidural), and diffuse axonal injuries.
Severe blunt force trauma to the head (Traumatic brain injury) has been said to account for many deaths of patients below the age of 25. Fatal injuries to the brain in most cases require surgery and may take a while for full brain functions to be restored.
Generally, the use of head protection gears like a safety helmet is a common way to prevent blunt force trauma to the head. It is advisable for cyclists to always wear their helmets in case of a fall or crash. Headgears should also be used in sporting activities to guard against damages to the brain as a result of collisions.
Blunt Force Trauma to the Chest
Non-penetrating impacts on the chest including direct blunt force, compression, and shear forces are the causes of blunt force trauma to the chest or blunt thoracic trauma. It can affect any of the components of the chest such as the lungs, trachea, heart, diaphragm, the blood vessels of the thorax, the rib, sternum, and clavicle.
Major symptoms associated with blunt chest trauma are bruising, hypoxia, ventilation-perfusion mismatch, hypovolemia, reduced cardiac output, and contusion. This trauma can be life-threatening causing serious injuries such as hemothorax, flail chest, tension pneumothorax, airway obstruction, and esophageal perforation.
Fracture of the ribs is a common result of this type of trauma and more serious force can lead to a direct injury to the lungs. These injuries can lead to difficulty in breathing causing impairment of oxygenation. Further complications can result from the fluid pressure caused by tension pneumothorax which can lead to shock and circulatory compromise. These injuries in most cases do not show immediate signs and so often require CT scan or sonography for proper diagnosis.
Blunt force trauma to the chest is estimated to be sustained by 12 persons out of a million per day in the United States. Death can result before appropriate medicare can be administered when cardiac injuries are sustained by the victims. The loss of cardiac pump functions causes cardiogenic shock and death. Sepsis can also occur when there is leakage of food materials from the esophagus due to the impact.
Serious injuries such as flail chest, hemothorax, and others can require the use of a chest pump or intercostal drain. The major aim of the chest pump is to relieve the pressure around the lungs so that the pump function can be restored.
Misplaced air or blood around the heart can also hinder the proper blood circulation function of the heart. Pericardiocentesis is a procedure that can be employed to remove the excess blood surrounding the heart so that its normal blood circulation function can be restored.
Blunt Force Trauma to Abdomen
Blunt abdominal trauma is the most common type of blunt force trauma. It is usually a result of motor accidents, falls, and sports activities. In extreme cases, it affects internal organs like the spleen, kidney, liver, colorectum, bladder, small intestine, and pancreas.
The liver and spleen are the most affected with the small intestine and kidney following them. Statistically, blunt force trauma to the abdomen accounts for about 79% of all blunt force cases. Motor vehicle collisions account for about 73% of deaths between the age of 15-25 years.
Due to the difficulties in properly assessing the state of internal damage due to blunt abdominal trauma, serious intra-abdominal complications like the accumulation of blood in the peritoneal cavity may not be initially discovered. Usual signs and symptoms include tenderness, pain, gastrointestinal hemorrhage, and hypovolemia.
Intra-abdominal trauma due to blunt force trauma to the abdomen can be predicted with physical signs like ecchymosis, abdominal distension, abdominal bruit, lap belt mark, doughty feel on palpation, and crepitation.
During collision in an auto accident or a fall or sporting activities, there are forces of acceleration and deceleration in action. These forces act on the internal organs of the victims of such accidents. The rapid deceleration can cause tears and bleed in the internal organs. A direct blow from blunt objects involved in the collision can lead to the crushing of the solid internal organs through impact from the thoracic cage, abdominal wall, and the vertebral column.
Compressive forces are also a cause of blunt force trauma to the abdomen. The compression can lead to a sudden increase in intra-abdominal pressure with the potential of causing rupturing of hollow visceral organs.
Since vehicular accidents account for the majority of blunt force trauma to the abdomen, safety precautions and proper adjustment of motor vehicle restraints are important for reducing the injury. It is advisable to adhere to the proper use of seat belts and restraints in the vehicle. It is also advisable to ensure there is enough space between the seat and the steering wheel to guard against a collision with the dashboard and steering wheel in the case of an accident.
Blunt Pelvic Trauma
The pelvic region is also susceptible to blunt force trauma. Falls and motor vehicle accidents are also the major causes of blunt pelvic trauma. The pelvic bones, the bladder, the reproductive organs, the proximal femur, the rectum, and the blood vessels are the structures at risk. Blunt pelvic trauma is not as rampant as the other types of blunt force trauma as it occurs in about one out of ten cases of blunt force trauma.
Fracture of the pelvic bone is the main concern because it can result in complications like damage to the bladder and urethra. It can also result in internal bleeding due to damaged blood vessels and nerves can also be affected. To ascertain the fracture and the extent of the damage caused by the blunt pelvic trauma, a CT scan may be used. The fracture if minor can heal without surgical intervention but if severe, will require surgery.
Injury to the iliac blood vessels and the aorta can result in life-threatening hemorrhage. Retroperitoneal hematoma can occur when there is bleeding into the retroperitoneal space. The control of this bleeding may require surgery or other endovascular methods. Uncontrolled hemorrhage due to blunt pelvic trauma accounts for most of the mortality rate associated with this condition.
The most prevalent cause of blunt force trauma is motor vehicle accidents followed closely by falls, sporting activities, and assaults. Depending on the severity of the force, the trauma can range from mild to life-threatening conditions.
To prevent most of the blunt force trauma types, it is important for motorists, motorcyclists, bicyclists, sportsmen and women, factory workers, and every other person to strictly adhere to safety rules and guidelines. Seat belts and other vehicle restraints should be put to use in inappropriate ways with head protective gear used by cyclists.
Prevention has always proven to be safer and cheaper than cure. Practice safe driving, to save your life and that of other road users. Workplaces and homes should also be guarded by safety precautions to prevent falls and collision incidents. More lives can be preserved by committing to reducing accidents that result in blunt force trauma.