1) Intro Flashcards
Trauma def:
Trauma’s 2 categories:
= Physical injury or wound caused by external force or forces
= Penetrating & Blunt
Penetrating:
(under penetrating) Perforating:
= object enters body & exchanges energy directly w/ human tissue causing damage or injury (goes in w/o exit)
= goes in & exits of body
What concept is to remind prehospital providers to hasten care and delivery to a trauma center.
Platinum Period
A helpful tool to identify risk elements associated with trauma is the
Haddon Matrix.
Standards established by your system’s medical direction to assist you in determining which PTs require urgent transportation to a trauma center:
Trauma Triage Criteria
The most cost-effective, and best way to reduce trauma morbidity is
Prevention
The collection of data to identify the existence, significance, and characteristics of a disease or disease process is called
Surveillance.
A medical facility that commits resources to address the most common trauma emergencies w/ surgical capability available 24 hours a day, 7 days a week, is classified as a Level
Level II trauma center.
Definitive trauma care is only available at facilities w/ rapid access to
Surgery.
The health care surveillance process, put in place for trauma systems, is called
the Registry.
Blunt trauma:
= Injury caused by the collision of an object with the body in which the object does not enter the body
Any eye trauma PT:
Zofran contra=
= vomiting &/ B/c +ocular pressure
= prolonged QT
Subdural venous nature hematoma shows symptoms:
Epidural bleed arterial nature hematoma shows symptoms:
= 2-3 or 3-6hrs for symptoms
= immediately
Pressure injury can:
= explode skin off (usually jumpers)
Morphine & fent drop BP by:
= body releasing Histamines
Life threatening injuries %:
Most-life threatning trauma occurs to:
Vol per lung & body:
lethal blood loss:
= <10% traumas
= head and/or chest
= 3L per lung & 5L per body
= >40% or ~2L
1st doc to classify trauma as a disease was:
1st EMT orange book
= the “white paper 1966”
1st EMT orange book
Public health care model:
= Surveillance, Risk identification, intervention dev, implement, Eval/
Implementation:
= putting effective safety measures EX roads,
Surveillance:
= collection of data Epidemiology=study of disease based on med survey
Risk analysis:
= Examines & determines factors that impact dev
Intervention dev:
= dev/mod of programs to reduce both incidence & seriousness of trauma
Evaluation:
= Repeat surveillance “good on paper but what about practice”
(Trauma centers) Lvl 1:
Lvl 2:
Lvl 3:
Lvl 4:
= 1 (18tx) med-uni teaching, best care, everything to Neurovascular
= 2 (23 tx) everything BUT neuro, area trauma, surgical care capable all times, typically not teaching
= 3 general hospital w/ some special staff, TIB-FIB, try avoid w/ severe
= 4 basic ER, can stable but bandage, foot ran over
Specialty Centers:
= Neuro, Burn, Pedi trauma, Hand & limb replant microsurgery, Hyperbaric oxygen
Triaging:
Jump start triage, NO IVs, “Bright lights & cold steel”
CUPS:
C:
U:
P:
S:
= Categories of PT severity
= Critical: ABCs FUCKed
= Unstable: hypotension, comp to decomp
= Potentially unstable: pelvic fracture, stable can unstable
= Stable: stable ex toenail fracture
Golden Period “hour”:
Platinum 10:
= incident to surgery time 1 Hr from Crash to EMS to PT to surgery
= no more than 10 mins on scene
QA QI should NEVER be
punitive
mechanism of injury (MOI):
the circumstances and events by which an injury occurs.
index of suspicion:
Info gathered regarding the scene & MOI for mental summation of suspected injuries based on your event analysis
Scene Oversight:
If 1st on the scene, estab/ scene oversight (command) & report your scene findings to dispatch. When additional resources arrive, transfer command & begin PT care. If the incident command system is already in place and operating, report to the incident commander & begin your assignment (usually PT care).
(2021,National Guide for Field Triage Guide criteria’s) Red Criteria:
Red injury pattern:
Red: PTs at high risk for serious injury.
(2021,National Guide for Field Triage Guide criteria’s) Red Criteria:
Red Vitals & Mental:
Red: PTs at high risk for serious injury.
(2021,National Guide for Field Triage Guide criteria’s) Yellow Criteria:
Yellow Judgement:
Yellow: PTs at moderate risk for serious injury.
(2021,National Guide for Field Triage Guide criteria’s) Yellow Criteria:
Yellow MOI:
Yellow: PTs at moderate risk for serious injury.
!Haldon Mix
.
Dr. R. Adams Cowley & founder of:
Dr. Cowley 2 concepts that helped drive modern trauma care:
= Trauma DR/Flight-medic & Shock Trauma Center in Baltimore
= 1 “Golden Hour” & 2 Trauma Medi-Evac establishment of a network of helicopters operated by the Maryland State Police that would transport trauma patients from the scene directly to the Shock Trauma Center in Baltimore
EMS trauma care began & classified trauma as disease w/:
Modern-med dev/ed & applied model & its 5-steps to reduce trauma:
= White paper “Accidental Death & Disability: The Neglected Disease of Modern Society.” followed by Highway Safety Act of 1966.
= “public health care model,” & 5 steps: surveillance, risk ID, intervention development, implementation, & evaluation.
Founded Shock Trauma Center & Trauma Medivac systemin Baltimore:
Established Trauma Medi-vac system initially by :
= Dr. R. Adams Cowley
= network of helicopters op/ed by Maryland State Police to transport trauma PT from scene directly to Shock Trauma Center in Baltimore
