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Paramedic Care Volume 5 - Trauma > Chapter 1 - Trauma and Trauma Systems > Flashcards

Chapter 1 - Trauma and Trauma Systems Flashcards

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1
Q

Trauma

A

pg 3

  • a physical injury or wound caused by external force or violence.
  • Can be either blunt or penetrating
  • 3rd leading cause of death in US; 1st for people under 44.
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2
Q

Penetrating Trauma

A

pg3

  • when an object (arrow, knife, bullet, or other object) enters body and exchanges energy with human tissue causing injury.
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3
Q

Blunt Trauma

A

pg 3

  • injury that occurs as energy and collision forces associated with an object - not the object itself - enter the body and damage the tissue
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4
Q

The five steps of the public health care model

A

pg 4

  • Surveillance
  • Risk analysis
  • Intervention Development
  • Implementation
  • Evaluation
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5
Q

Surveillance

A

pg 4

  • collection of data to identify the significance, existance, and characteristics of disease
  • The study of disease based on such surveillance is called epidemiology
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6
Q

Risk Analysis

A

pg 4

  • looks at disease and determines various factors that impact its development, course, and consequences
  • Haddon Matrix - tool used to ID risks associated with trauma
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7
Q

Haddon Matrix

A

pg 4

  • 3x3 matrix - tool used to help ID risk elements associated with trauma
  • when applied to trauma it segregates causative and contributive factors that can be modified to reduce trauma incidence, severity, and outcome.
  • Pre-event - Things that can be mitigated before event or injury takes place ie training, education saftey equiptment, protocols
  • Event - factors that exist during event; occupant health, drugs & alcohol, weather
  • Post-Event - factors that worsen or improve victims outcome; ie access to EMS systems, weather, victims health
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8
Q

Intervention Development

A

pg 5

  • creates or modifies programs to reduce both the incidence and the seriousness of trauma
  • ie. safety developments for vehicles and roadways; ie OnStar, airbags, and barriers that deflect/absorb impact
  • EMS was created as a way to provide better care for injured patients
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9
Q

Implementation

A

pg 6

  • Putting an intervention into practice; ie enforcing traffic laws, reducing speed limits in hazardous areas, education etc.
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10
Q

Evaluation

A

pg 6

  • repeating the surveillance to ensure implemented measures are effective
  • injury prevention is an evolving role of the modern EMS system
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11
Q

Level I Trauma Center

A

pg 7

  • Regional Trauma Center
  • Commits resources to address all types of specialty trauma 24hrs/day x 7
  • usually a medical university teaching center
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12
Q

Level II Trauma Center

A

pg 7

  • Area Trauma Center
  • Commits resources to address the most common trauma emergencies with surgical capability 24/7; will stabilize and transport for speciaty cases to Level I facility
  • some services may be on-call rather than in-house
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13
Q

Level III Trauma Center

A

pg 8

  • Community Trauma Center
  • Commits to special emergency department training and has some surgical capability, but will usually stabilize and transfer seriously inhured trauma patients to a higher level trauma center as needed.
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14
Q

Level IV Trauma Center

A

pg 8

  • Trauma Facility
  • Remote areas, small community hospital or medical facility designated as a trauma recieving facility. Stabilizing and prepare seriously injured for transport, to a higher level facility, often by air.
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15
Q

Specialty Centers

A

pg 8

  • Specialty focus centers
    • neurocenters
    • burn centers
    • pediatric trauma centers
    • hand/limb replantation
    • hyperbaric oxygenation
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16
Q

MOI Analysis & Index of Suspicion

A

pg 9

mentally recreate incident from evidence available at the scene

  • Identify
    • strength of forces involved
    • direction of force
    • areas of pt most likely affected
  • Index of Suspicion - mental summation of anticipated injuries based on analysis of event
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17
Q

Physical Signs that suggest serious trauma include

A

pg 9

  • S&S of Shock
  • Signs of internal Head Injury

If you suspect internal injury, closely monitor vital signs for shock and altered mental status

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18
Q

Environmental Impact

A

pg 9

  • anticipate the impact that environmental extremes may play on your assessment
  • Adverse weather may merit moving patient to ambulance earlier in assesment
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19
Q

Primary Assessment - Trauma

A

pg 10

  • Form General Impression
  • Evaluate need for C-Spine considerations
  • Evaluate A/B/C’s
  • Determine need transport priority

*Evaluation of C-spine depends on whether patient is a reliable reporter of spinal

**If you suspect the patient is in cardiac arrest begin assessment with CAB

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20
Q

Golden Period

A

pg10

  • time from incident to surgery
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21
Q

Trauma Triage Criteria

A

pg 11

  • GCS
  • Vital Signs
  • Anatomy of the injury
  • MOI
  • Special Considerations: age, existing medical conditions
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22
Q

Trauma Registry

A

pg 11

  • a uniform and standard set of data collected by regional trauma centers
  • used to analyze types of patients and injuries responded to and ID factors that +/- survival
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23
Q

CDC Field Triage Guidelines

A
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24
Q

Quality Improvement/Management

A

pg 13

  • examination of performance with the aim of improving patient care
  • indicators are used to determine if selected care modalities are being met
    • application of trauma triage criteria
    • field skill performance
    • time spent in response/assessment/care/transport
    • appropriateness of trauma patient destinations
  • True QI is not punitive and does not look to id fault with indicidual providers
25
Q

The leading killer of persons under age 44 in the US is ________?

A

pg 3

Trauma

26
Q

The best care you, as a paramedic, can offer a trauma patient is to :

A

pg 4

  • immobilize the cervical spine
  • secure the airway
  • ensure adequate respirations
  • control hemorrhage
  • provide rapid transport to definitive care
27
Q

Certain trauma centers located in smaller communities situated in generally rural areas commit to special emergency department training and have a degree of surgical capability but usually stabilize and transfer seriously injured patients are designated as a ___________ facility

A

pg 7/8

Level III

28
Q

One specialty service important in the treatment of carbon monoxide posioning and problems related to sucba diving is the ____________.

A

pg 8

hyperbaric oxygenation center

29
Q

When determining the MOI you will identify the _______?

A

pg 9

forces involved in the collision

30
Q

You will begin your consideration of the mechanism of injury during the ________.

A

pg 9

scene size-up

31
Q

In the ideal scenario, you should provide the primary and rapid trauma assessments, emergency stabilization, patien packaging, and initiation of transport in under __ minutes.

A

pg 10

10

32
Q

In the QI process, comittees look at selected care midalities to determine if the designated standards of care are being met. These modalities are also called ______.

A

pg 13

indicators

33
Q

Auto accidents account for how many deaths each year?

A

pg 3

34,500

34
Q

T/F - Although trauma poses a serious threat to life, its presentation often masks the patient’s true condition.

A

pg 3

True

35
Q

T/F - Some 90% of all trauma pt’s don’t have serious, life-endangering injuries.

A

pg 4

True

36
Q

T/F - Trauma triage criteria are MOI or physical signs exibited by the patient that suggest serious inury.

A

pg 4

True

37
Q

The legislation that helped establis guidlines, funding, and state-level leadership and support for trauma systems was the _________.

A

pg 7

Trauma Systems Act of 1963

38
Q

The trauma system is prediccated on the principle that serious trauma is ________

A

pg 7

a surgical disease.

39
Q

A Level I Trauma Center is usually a

A

pg 7

teaching hospital with resources available full time for emergency cases.

40
Q

The small community hospital or health care facility in a remote area, designated as a receiving facility for trauma is a Level ___.

A

pg 7

Level IV

41
Q

Trauma centers may also be designated for provision of what types of special services?

A

pg 8

Pediatric trauma center

Burn Center

Neurocenter

Hyperbaric Center

42
Q

You arrive onscene to find a 4-yr old child who has fallen out of a second story window. The child responds to verbal stimulus. Respirations and puls are WNL. You note a broken left arm but no other apparent injuries. Your index of suspicion for possible injuries includes:

What is your primary concern?

A

Pg 9

Internal bleeding, head injury, C-Spine Injury

Rapid packaging and transport

43
Q

The period of time between the occurrence of serious injury and surgery as a goal for prehospital care providers is the _______.

A

pg 10

Golden Period

44
Q

TF - In applying trauma triage criteria, it is best to err on the side of precaution

A

pg 11

True

45
Q

T/F - Trauma Triage criteria are designed to over triage trauma patients to ensure those with more serious injuries are not missed.

A

pg 11

True

46
Q

You arrive on scene to find a 26-yr old male pt ejected from motor vehicle. The pt is unconscious but breathing at a rate of 28. He is bleeding profusely from the head. You note an open **femur fx ** on the left leg. The trauma triage criteria that is most indicative of a serious injury is:

A

pg 12

Ejection from the vehicle

47
Q

The reduction in the incidence and seriousness of trauma in recent years can be credited to:

A

pg 11

better highway design

better auto design

use of auto restraint systems

development of injury prevention programs

48
Q

The standardized data retrieval system used to evaluate and improve the reauma system is the ______.

A

pg 11

Trauma Registry

49
Q

T/F - Quality Improvement is a significant method of assessing system quality and providing for its improvement

A

pg 13

True

50
Q

Trauma accounts for about what death toll each year?

A

pg 3

177,000 deaths

51
Q

T/F - Serious life-threatining injury occurs in about 30% of all trauma.

A

pg 4

False - 10%

52
Q

Surgical intervention rates for serious trauma are greatest in what type of trauma?

A

pg 7

Penetrating Trauma

53
Q

A level III trauma center is a

A

pg 8

Community hospital

54
Q

The guidelines that help determine the need of a trauma patient for the services of the trauma center are called the____.

A

pg 8

Trauma Triage Criteria

55
Q

The result of the analysis and the MOI is the _____.

A

pg 9

Index of Suspicion

56
Q

T/F - Because paramedics are usually at the side of seriously injured patients so quickly, the S&S of serious injury and shock will be be apparent.

A

pg 11

False

57
Q

T/F - One of the most effective methods of reducing trauma morbidity and mortality is through injury prevention programs.

A

Pg 11

True

58
Q

Which of the following indicates a trauma pt’s need for immediate transport to a trauma center?

  • Systolic < 90
  • Flail Chest
  • Ejection from a vehicle
  • fall from greater that 3x victims height
  • all of the above
A

pg 12

All of the above

Paramedic Care Volume 5 - Trauma (11 decks)

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