Blunt trauma

Last updated: March 24, 2022

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Blunt force trauma (BFT) is any injury resulting from the impact of an accelerated blunt object (e.g., a baseball bat) against the body or of the accelerated body against a surface or object (e.g., propulsion against the floor in a fall). Common causes include motor vehicle collisions, falls, and sports injuries. Low-impact BFT can result in dermal contusions, lacerations, and/or abrasions that require supportive treatment only, whereas high-impact BFT, especially of the abdomen, head, and thorax, can cause severe internal organ injury in addition to dermal manifestations and represents a major cause of morbidity and mortality in all age groups. The most common symptoms of severe abdominal trauma are pain, hypovolemia, and peritoneal irritation.First response in severe BFT focuses on airway and circulation management. FAST and CT imaging are used to detect intraabdominal bleeding and organ damage, while chest x-ray is the most important initial diagnostic tool in the assessment of blunt chest trauma.Treatment depends on hemodynamic status of the patient as well as type and severity of injury, which may require emergency surgery. Conservative management with close monitoring is indicated for hemodynamically stable patients.

For information on prehospital care and general principles of trauma management, see “Prehospital trauma care.” Penetrating trauma is discussed in a separate article.

  • Etiology
    • Motor vehicle crashes (50–75%)
    • Falls
  • Mechanism of injury
    • Rapid deceleration of organs/structures results in shear forces that cause vascular tears, as well as hollow and solid organ contusions and ruptures
    • External compression and crushing

Common severe complications

Abdominal bleeding

Approach to blunt abdominal trauma

Imaging should be performed even if there is no pain if significant intraabdominal injury is suspected.

If FAST exam is not available, a hemodynamically unstable patient should be taken to the operating room immediately.

Possible injuries

Clinical features

Approach to blunt chest trauma

Rib fracture

Phrenic nerve paralysis

Cardiac injury

Aortic injury and traumatic rupture of the aorta (aortic rupture)

Pulmonary contusion

Tracheobronchial injury (TBI)

Pneumomediastinum [1]

Diaphragmatic rupture

See “Diaphragmatic rupture.”

  1. Kouritas VK, Papagiannopoulos K, Lazaridis G, et al. Pneumomediastinum. J Thorac Dis. 2015; 7 (Suppl 1): p.S44-49. doi: 10.3978/j.issn.2072-1439.2015.01.11 . | Open in Read by QxMD

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