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I'm reading Overview of pediatric injury prevention: Epidemiology; history; application on UpToDate. It says:

The Haddon Injury Control Model, proposes that all injuries are attributable to five forms of energy (kinetic, chemical, thermal, electrical, and radiation).

A knife wound, or a puncture from an ingested foreign body, doesn't have much mass or velocity, which means it has a very low kinetic energy. But they are even worse fits for the other four forms of energy!

Similarly, drowning, strangulation, smothering, and suffocation also do not seem to fit.

How should I classify these low-energy types of injury?

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The key, I think, is the relationship between energy transferred and the ability of the receiving tissue to tolerate it. For example, although the overall kinetic energy of a knife is relatively low the tip/blade pressure is extremely high, more than high enough to part tissues and, critically, cut through arterial walls causing fatal bleeding.

Drowning is more complex. The pathophysiology that leads to tissue damage and thus death is hypoxia so I would class this as a chemical injury. However, this is a bit of a cop-out. Arguably, what kills in the case of the knife wound is not the wound itself but the resulting tissue hypoxia from bleeding so should we not count that as "chemical" as well?

Overall, this is probably best used as a guide to "injury" in the sense of "external factor causing direct tissue damage". It is definitely not all encompassing. Finally, I think there could be a good argument made for "hypoxic" as a 6th category of injury.

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  • Great answer, thanks! You could take out the bits about death, as this question is about the Haddon Injury Control Model, rather than the processes that follow from injury. – Jacob Krall Jun 24 '18 at 15:30

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