Critical Patients

Question 1

What indicates a major trauma in an adult?

Answer 1

GCS less than or equal to 13
Respiratory rate less than 10 or more than 29
Pulse rate less than 50 or more than 120
Systolic blood pressure less than 90
Penetrating injuries to head, neck, torso, or proximal extremities
Two or more suspected proximal long bone fractures
Suspected flail chest
Suspected spinal cord injury or limb paralysis
Amputation (except digits)
Suspected pelvic fracture
Open or depressed skull fracture

Question 2

What indicates a major trauma in a pediatric?

Answer 2

Pulse greater than normal range for patient’s age
Systolic blood pressure below normal range
Respiratory status inadequate
GCS less than 14
Penetrating injuries of trunk, head, neck, chest, abdomen, or groin
Two or more proximal long bone fractures
Flail chest
Combined system trauma that involves two or more body systems, injuries or major blunt trauma to the chest or abdomen
Spinal cord injury or limb paralysis
Amputation (except digits)

Question 3

What are the signs inadequate respiratory status for a pediatric?

Answer 3

Central cyanosis, low respiratory rate, capillary refill time greater than 2 seconds

Question 4

What are critical burns?

Answer 4

Greater than 20% body surface area second or third degree burns
Evidence of airway/facial burns
Circumferential extremity burns
Trauma care before burn care

Question 5

What are critical medical conditions?

Answer 5

Suspected acute stroke
- positive Cincinnati pre-hospital stroke scale
- total prehospital time (symptoms began to expected arrival at stroke center) less than two hours
Suspected AMI
- Chest pain, shortness of breath or other symptoms typical of a cardiac event
-EKG findings of -ST elevation 1mm or more in 2 or more contiguous leads or - LBBB (QRS duration > 12msec, and Q wave in V1 or V2)