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Wed, 9 Jan 2002 10:06:19 -0700

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In our consideration (the PHTLS curriculum approved by The Committee on =
Trauma of The American College of Surgeons specifically states that) =
there are two types of trauma Blunt and Penetrating. It goes on to teach =
of the kinematics involved but generally a penetrating wound is similar =
to those cause by bullets, knives, etc. In contrast, a compound tib/fib =
fx due to the blunt trauma of a mvc is not considered a penetrating =
injury, even though the definition provided by another poster indicated =
any break in the skin could be.=20

FYI

Nick Nudell, NREMT-P
Glacier County EMS
www.glacierems.com
Northern Rockies Medical Center
Cut Bank, MT

Big Horn County EMS
Hardin/Crow Agency, MT

"Over-reliance on experience leads to making the same mistakes with =
increasing levels of confidence" Unknown

  ----- Original Message -----=20
  From: Enrique y Maritza Montbrun=20
  To: trauma-list@trauma.org=20
  Sent: Tuesday, January 08, 2002 6:20 PM
  Subject: Re: penetrating trauma definition

  I agree with ERF. It is too restrictive.  Consider the option that is =
a trauma caused by an object or projectile to enter a compartment of the =
body. Another option is consider if it  lay across a fascial layer.=20
  Enrique Montbrun=20
    ----- Original Message -----=20
    From: DocRickFry@aol.com=20
    To: trauma-list@trauma.org=20
    Sent: Tuesday, January 08, 2002 7:25 PM
    Subject: Re: penetrating trauma definition

    In a message dated 1/8/2002 4:41:36 PM Eastern Standard Time, =
Greg.Benton@wdbh.hume.org.au writes:

      Trauma Caused by force distributed over a small area of the body =
surface
      causing an object or projectile to enter a body cavity"

    N0--entering a body cavity is certainly too restrictive--a plate =
glass window shattering and lacerating the volar elbow down thru the =
brachial artery is clearly a penetrating injury--as is a GSW or strab in =
same area--yet not violating any body cavity.   By your definition, a =
laceration of the scalp would not be a penetrating injury--which of =
course it is.
    ERF=20

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<STYLE></STYLE>
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<BODY bgColor=3D#ffffff>
<DIV><FONT face=3DTahoma size=3D2>In our consideration (the =
PHTLS&nbsp;curriculum=20
approved by The Committee on Trauma of The American College of Surgeons=20
specifically states that) there are two types of trauma Blunt and =
Penetrating.=20
It goes on to teach of the kinematics involved but generally a =
penetrating wound=20
is similar to those cause by bullets, knives, etc. In contrast, a =
compound=20
tib/fib fx due to the blunt trauma of a mvc is not considered a =
penetrating=20
injury, even though the definition provided by another poster indicated =
any=20
break in the skin could be. </FONT></DIV>
<DIV><FONT face=3DTahoma size=3D2></FONT>&nbsp;</DIV>
<DIV><FONT face=3DTahoma size=3D2>FYI</FONT></DIV>
<DIV><FONT face=3DTahoma size=3D2></FONT>&nbsp;</DIV>
<DIV><FONT face=3DTahoma size=3D2></FONT>&nbsp;</DIV>
<DIV><FONT face=3DTahoma size=3D2>Nick Nudell, NREMT-P<BR>Glacier County =

EMS<BR></FONT><A href=http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2002/3D"http://www.glacierems.com"><FONT face=3DTahoma=20
size=3D2>www.glacierems.com</FONT></A><BR><FONT face=3DTahoma =
size=3D2>Northern=20
Rockies Medical Center<BR>Cut Bank, MT</FONT></DIV>
<DIV><FONT face=3DTahoma size=3D2></FONT>&nbsp;</DIV>
<DIV><FONT face=3DTahoma size=3D2>Big Horn County EMS<BR>Hardin/Crow =
Agency,=20
MT</FONT></DIV>
<DIV><FONT face=3DTahoma size=3D2></FONT>&nbsp;</DIV>
<DIV><FONT face=3DTahoma size=3D2>"Over-reliance on experience leads to =
making the=20
same mistakes with increasing levels of confidence" Unknown</FONT></DIV>
<DIV>&nbsp;</DIV>
<BLOCKQUOTE dir=3Dltr=20
style=3D"PADDING-RIGHT: 0px; PADDING-LEFT: 5px; MARGIN-LEFT: 5px; =
BORDER-LEFT: #000000 2px solid; MARGIN-RIGHT: 0px">
  <DIV style=3D"FONT: 10pt arial">----- Original Message ----- </DIV>
  <DIV=20
  style=3D"BACKGROUND: #e4e4e4; FONT: 10pt arial; font-color: =
black"><B>From:</B>=20
  <A title=3Dmontbrun@internet.ve =
href=3D"mailto:montbrun@internet.ve">Enrique y=20
  Maritza Montbrun</A> </DIV>
  <DIV style=3D"FONT: 10pt arial"><B>To:</B> <A =
title=3Dtrauma-list@trauma.org=20
  href=3D"mailto:trauma-list@trauma.org">trauma-list@trauma.org</A> =
</DIV>
  <DIV style=3D"FONT: 10pt arial"><B>Sent:</B> Tuesday, January 08, 2002 =
6:20=20
  PM</DIV>
  <DIV style=3D"FONT: 10pt arial"><B>Subject:</B> Re: penetrating trauma =

  definition</DIV>
  <DIV><BR></DIV>
  <DIV><FONT face=3DArial size=3D2>I agree with ERF. It is too =
restrictive.&nbsp;=20
  Consider the option that is a trauma caused by an object or projectile =
to=20
  enter a compartment of the body. Another option is consider if =
it&nbsp; lay=20
  across a fascial layer. </FONT></DIV>
  <DIV><FONT face=3DArial size=3D2>Enrique Montbrun</FONT>&nbsp;</DIV>
  <BLOCKQUOTE=20
  style=3D"PADDING-RIGHT: 0px; PADDING-LEFT: 5px; MARGIN-LEFT: 5px; =
BORDER-LEFT: #000000 2px solid; MARGIN-RIGHT: 0px">
    <DIV style=3D"FONT: 10pt arial">----- Original Message ----- </DIV>
    <DIV=20
    style=3D"BACKGROUND: #e4e4e4; FONT: 10pt arial; font-color: =
black"><B>From:</B>=20
    <A title=3DDocRickFry@aol.com=20
    href=3D"mailto:DocRickFry@aol.com">DocRickFry@aol.com</A> </DIV>
    <DIV style=3D"FONT: 10pt arial"><B>To:</B> <A =
title=3Dtrauma-list@trauma.org=20
    href=3D"mailto:trauma-list@trauma.org">trauma-list@trauma.org</A> =
</DIV>
    <DIV style=3D"FONT: 10pt arial"><B>Sent:</B> Tuesday, January 08, =
2002 7:25=20
    PM</DIV>
    <DIV style=3D"FONT: 10pt arial"><B>Subject:</B> Re: penetrating =
trauma=20
    definition</DIV>
    <DIV><BR></DIV><FONT face=3Darial,helvetica><FONT lang=3D0 =
face=3D"Comic Sans MS"=20
    color=3D#0000ff size=3D2 FAMILY=3D"SCRIPT"><B>In a message dated =
1/8/2002 4:41:36=20
    PM Eastern Standard Time, <A=20
    =
href=3D"mailto:Greg.Benton@wdbh.hume.org.au">Greg.Benton@wdbh.hume.org.au=
</A>=20
    writes:<BR><BR></FONT><FONT lang=3D0 style=3D"BACKGROUND-COLOR: =
#ffffff"=20
    face=3DArial color=3D#000000 size=3D2 FAMILY=3D"SANSSERIF"></B><BR>
    <BLOCKQUOTE=20
    style=3D"PADDING-LEFT: 5px; MARGIN-LEFT: 5px; BORDER-LEFT: #0000ff =
2px solid; MARGIN-RIGHT: 0px"=20
    TYPE=3D"CITE">Trauma Caused by force distributed over a small area =
of the=20
      body surface<BR>causing an object or projectile to enter a body=20
    cavity"<BR></BLOCKQUOTE><BR></FONT><FONT lang=3D0=20
    style=3D"BACKGROUND-COLOR: #ffffff" face=3D"Comic Sans MS" =
color=3D#0000ff size=3D2=20
    FAMILY=3D"SCRIPT"><B><BR>N0--entering a body cavity is certainly too =

    restrictive--a plate glass window shattering and lacerating the =
volar elbow=20
    down thru the brachial artery is clearly a penetrating injury--as is =
a GSW=20
    or strab in same area--yet not violating any body =
cavity.&nbsp;&nbsp; By=20
    your definition, a laceration of the scalp would not be a =
penetrating=20
    injury--which of course it is.<BR>ERF</B></FONT>=20
</FONT></BLOCKQUOTE></BLOCKQUOTE></BODY></HTML>

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