Blunt Trauma · What Is It, Diagnosis, Outcomes, and More

Blunt trauma, also known as non-penetrating trauma or blunt force trauma, refers to injury of the body by forceful impact, falls, or physical attack with a dull object. Penetrating trauma, by contrast, involves an object or surface piercing the skin, causing an open wound. Blunt trauma can be caused by a combination of forces, including acceleration and deceleration (the increase and decrease in speed of a moving object), shearing (the slipping and stretching of organs and tissue in relation to each other), and crushing pressure.

Blunt trauma death refers to physical trauma to the body by way of fall, impact, or attack, that results in death. Head trauma and severe loss of blood are the most common causes of death due to blunt traumatic injury. Severity of the injury depends on the mechanism and extent of injury. Typically, a large force applied to a sizable area over several minutes will result in vast tissue damage, which increases the chance of death. Whereas a smaller force applied to a smaller area will result in less tissue damage. 

Severity of injury also depends on the underlying age and health of the individual. For example, elderly patients have been identified as having some of the highest injury-related mortality rates. This has been attributed to several factors including reduced cardiopulmonary reserve, which is a measure of heart and lung function, as well as poor nutritional status, and propensity for bleeding after fractures.

The majority of blunt trauma cases are from motor vehicle crashes and pedestrian injuries often resulting in abdominal injuries. These injuries are typically attributed to collisions between the individual and the external environment, or to acceleration and deceleration forces acting on the individual’s internal organs. 

When assessing possible abdominal trauma, physicians look for abdominal pain, tenderness, nausea, and vomiting. In cases of motor vehicle crashes, the presence of a positive ‘seatbelt sign’, appearing as bruising in a horizontal or diagonal band that corresponds to a seatbelt across the abdomen, chest, or neck, indicates an increased likelihood that the individual has an intra-abdominal injury. If serious trauma is suspected, imaging techniques, such as X-rays, CT scans, and ultrasound imaging, can also be used to detect fractures and internal injury.

Blunt force trauma can often lead to bruising and blood clots. Bruising occurs when the blood vessels on the surface of the soft tissue of skin are broken, typically resulting in a temporary discoloration of the skin. Subsequently, the body forms clots, or semi-solid masses of blood, as a natural reaction to prevent an excess loss of blood from injured vessels or tissues. 

A specific type of blood clot that may be cause for larger concern is a deep vein thrombosis (DVT), which can occur after there has been damage to the inner lining of a vein. This damage can occur as a result of blunt trauma. Deep vein thrombosis typically forms deep in the legs, but can occur in other parts of the body, such as the arm. The most serious complication of DVT occurs when a part of the clot breaks off and travels through the bloodstream to the lungs, causing a blockage known as a pulmonary embolism. A pulmonary embolism is considered a medical emergency and requires immediate medical attention. Additionally, DVT can lead to long-term complications caused by the damage the clot does to the valves in the vein—this is known as post-thrombotic syndrome (PTS). Individuals with PTS often have symptoms such as swelling, pain, discoloration, and in severe cases, scaling or ulcers in the affected part of the body.