4302 Traumatic Injuries Flashcards
Pertinent Environmental Findings
PENMAN
Pertinent Hx
MOI Time of event Speed and details Damage to vehicle/structure Location in vehicle/structure Ejection Seatbelt, air bag, car seat, helmet, other protective equipment Others injured or dead SAMPLE
Pertinent Physical Findings
DCAPBTLSTIC
Pertinent Differential Diagnoses
Head injury Spinal Cord injury/ neuro inury Spinal fracture Airway obstruction and hypoxia Tension pneumo pneumo/hemothorax Flail chest Bleeding/hypovolemia Pericardial Tamponade Pelvic or femur fracture Dislocation
TBI
Increase ventilatory rate for unequal/ fixed and dilated pupils and extensor (decerebrate) posturing/ no motor response
Adults: 20Breaths/min
Peds: 25 Breaths/min
Infants: 30 Breaths /min
Impaled Object
Stabilize and support object
Only removing if interfering with airway or chest compressions
Flail Chest
Assist ventilations if needed
Do not stabilize the segment
Eye injury
Irrigate with saline
Apply bilateral protective rigid shields
Position appropriately
Avulsed tooth
Handle tooth by crown
Do not touch any part of tooth that exists below gum line
In alert and cooperative pt, attempt to replace tooth in socket
if unable wrap in milk or NS soaked gauze
Wound Care
Dress and bandage lacerations, abrasions, avulsions, punctures, and penetrations
Dress open pneumo with occlusive dressing, briefly remove to release pressure with signs of tension pneumo
Dress evisceration with saline soaked gauze
Rinse exposed bone with saline and dress with saline soaked gauze, do not intentionally allow bone to retract
Dress injured genitalia with saline soaked gauze, apply direct pressure to control bleeding, rinse amputation in saline, wrap in saline soaked dressing, bag, and indirectly place on ice
Fracture or dislocation
Assess PMSC Manually stabilize and splint as found Reduce grossly angulated fractures to anatomic position with gentle traction Midshaft femur fracture traction splint BHC for neuro or vascular compromise
Pain Management
Fentanyl slow IV/IO push or IM/IN for pain associated with isolated traumatic injury to an extremity or the appendicular skeleton.
May repeat once
Further repetition requires BHO
Administration of more than one opioid requires BHPO
Crush Injuries
NS for suspected hyperkalemia associated with crush injury
Use buretrol for peds
BHO for traumatic injuries
Nebulized Albuterol for suspected hyperkalemia associated with crush injuries
Calcium Chloride for suspected hyperkalemia associated with crush injuries
Midazolam for anxiety associated with traumatic injuries
Morphine/Fentanyl for pain other than isolated extremity
Bicarb for suspected hyperkalemia associated with crush injuries
