Written By: Dr. Jassin Jouria
A 17-year-old female presents to the Emergency Room after getting hit by a golf cart while working at her summer job at the Community Country Club. She describes walking across the green to check on some guests when she heard some shouting. She could not get out of the way fast enough before the runaway golf cart ended up hitting her side and knocking her down. She did not lose consciousness but complains of sharp left sided abdominal pain and difficulty taking a deep breath. In the Emergency Room, the physician orders a bedside ultrasound to look for an intra abdominal injury.
Blunt trauma injuries are one of the most common and severe types of injuries contributing to an occupational fatality. A blunt trauma injury is a non-penetrating injury resulting from a forceful impact on the body. Unlike a penetrating injury, blunt trauma causes damage to internal organs without penetration. Blunt trauma can produce about five different types of injuries. These include:
- Contusions
- Abrasions
- Bone fractures
- Internal hemorrhage/bleeding
- Trauma to internal organs
Blunt Trauma Injuries at Workplace- Some Statistics
According to the WHO, about 2 million people die annually due to occupation-related accidents. Out of these, blunt trauma injury is the third leading cause. Worldwide, blunt trauma is the most significant factor accounting for disability in adults under 35 years.
At-Risk Occupations for Blunt Trauma Injuries
The risk of having a blunt-trauma related accident exists in almost all occupations. However, there are a few industries where the likelihood of such incidents is increased manifold.
These industries include:
- Heavy machinery industry
- Woodwork industry
- Transportation industry
- Metals and mining industry
- Construction industry
Since all of these industries use the operation of heavy machinery and forces, they contribute more to the annual statistics of blunt trauma injuries.
The Risk of Blunt Trauma Injuries at Workplace
The risk of blunt trauma injuries at the workplace varies. From slips, trips and falls to crashes, collisions, and getting struck by parts of heavy machinery, there is a whole spectrum. The severity of these traumatic injuries can range from minor fractures or contusions to severe traumatic brain injuries (TBI) and even death.
The main forces in these injuries are compression of internal organs, acceleration, or rapid deceleration. Forceful impacts in these cases can result in permanent disability. Internal bleeding is the major cause of death in trauma incidents.
What does the Law say about Blunt Trauma Injuries?
The Occupational Safety and Health Administration (OSHA) has appointed a wing for workers’ rights and association. The job is to ensure that workers are aware of their rights and privileges. It also encourages workers to file a complaint without the fear of retaliation whenever they detect a threat in the workplace that can cause blunt trauma injuries. According to OSHA rules and regulations, a worker is entitled to compensation of wages and medical bills in case of an accident.
Types of Blunt Trauma Injuries at Workplace
Though crashes and collisions are the most common types of blunt trauma in the workplace, they are not the only ones. There are numerous other ways in which a non-penetrating injury can occur. This includes:
- Slips, trips, and falls.
- Crashes and collisions
- Overexertion strains due to heavy weight-lifting
- Being struck by a moving vehicle or object/motor vehicle crashes
- Getting caught in machines or parts of heavyweight objects
Blunt trauma injuries are mainly classified into the following three types:
- Blunt Trauma to the Abdomen
The two main forces at play in Blunt Abdomen Trauma (BAT) include compression of the internal organs due to the blunt force. The other one is acceleration or rapid deceleration in motor vehicle accidents.
The most serious and fatal complications of trauma to the abdomen include rupture of arteries and rupture of the liver or spleen.
Management of Blunt Trauma Abdomen
- Wear Blunt Trauma Personal Protective Equipment at all times
- Look for fatal complications such as peritonitis, hemorrhage, or uncontrolled shock.
- Perform resuscitation and transfer to immediate emergency care.
- Establish IV lines for fluid administration.
- Oxygen supply may be required in severe cases.
In all cases, timely decisions need to be made. This can allow for transporting to a health facility and ensuring emergency treatment.
- Traumatic Head Injuries
Trauma brain injury and head injuries result from trauma to the head. Usually, the brain is jostled inside the skull. This leads to cranial and extracranial hematomas, damage to the sensitive nerve fibres, or contusion of brain tissue.
Usually, the only presenting symptom might be bruising over the skin of the scalp or swelling on the head. But this requires immediate treatment. Failure to do so can result in permanent brain damage. This is the main reason management protocols in case of trauma to the head should be well-known.
Management of Traumatic Head Injury
- Prevention should be the priority.
- Workers should wear protective headgear at all times.
- In case of trauma, the foremost priority should be to ensure that the patient has an adequate oxygen supply.
- Maintain blood supply.
- Prevent further injury to the head and neck.
- Perform a neurologic exam of the patient.
Timely and appropriate management of traumatic brain injury can reduce the otherwise drastic consequences.
- Traumatic Eye Injury
The eye is a delicate organ that can get severely damaged in a traumatic injury. Blunt trauma to the eye can result in its dislocation from its socket. It can also cause fracture of the orbit.
Management of Traumatic Eye Injury
- Reduce the fracture.
- Remove the splinters of bone from the socket.
- Realign the broken pieces of bone.
You should also inform your employer and the occupational health department about the injury. The occupational health specialist will perform a thorough assessment to determine the nature and extent of your injuries. This can help your employer enforce policies to prevent such injuries.
Meet the Author Dr. Jassin Jouria
Dr. Jassin Jouria is a practicing Emergency Medicine Physician who specializes in resuscitation of critical patients. The majority of his clinical work is at the Decatur County Memorial Hospital Emergency Department in Greensburg, Indiana. Learn More About the Author.
References:
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- https://www.osmosis.org/answers/blunt-trauma
- https://www.ncbi.nlm.nih.gov/books/NBK470338/
- https://www.sciencedirect.com/topics/nursing-and-health-professions/blunt-trauma
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