ED Care 2 Flashcards
Describe level 1 trauma
Regional resource facility
- highest
- serve dense pop areas
- collaborative care for all aspect of injury
Describe level 2 trauma
- community hospitals
- can provide care for vast majority
Describe level 3 trauma
Stabilize pt with major injuries
Describe level 4 injuries
Rural or remote areas
*lowest
What is the mechanism of injury
Describes the manner in which the traumatic injury occurred
What are the most common producing mechanisms
Blunt trauma
Penetrating trauma
Describe blunt trauma
- Results from impact forces (ie/ car accidents, fall, assault w/ fists, kicks or baseball bat)
- trauma to bones blood vessels and soft tissue
What is blast effect
From exploding bomb
Type of blunt trauma
Describe acceleration deceleration forces
Energy transmuted from blunt forces involved produce injury
*occurs in blunt trauma
What are penetrating traumas
Caused by injury from sharp objects and projectiles
(Is/ knife, ice pick, bullet wounds
When do you not follow ABCDE
Follow primary survey unless clear presence of massive uncontrolled bleeding
*priorities shift to CAB d/t external hemorrhage
When are tourniquets used
Used to manage severe bleeding when direct pressure fails
Hemostatic dressings
Impregnated with substances that speed up clotting
What to do if external hemorrhage
Firm direct pressure on bleeding site with thick dry dressing
Before the cuff is used how do you know the systolic BP
- radial pulse: BP 80
- femoral pulse: BP 70
- carotid pulse: BP 60
Describe primary survey
ABCDE
- the initial assessment of the trauma pt
- organized system to rapidly identify and effectively manage immediate threats to life
What occurs simultaneously with each element of primary survey
Resuscitation efforts
What is A in primary survey
Airway and cervjcal spine
- establish patent airway
- manual align neck into neutral in like positions (jaw thrust maneuver)
- supplemental O2 (nonrebreather mask)
- pt with GSC < 8 requires endotracheal tube and mechanical vent
What is B in primary survey
Breathing
- determine whether bent efforts are effective or not (if pt breathing or not)
- listen to breath sounds, chest expansion, resp effort, chest wall trauma
- ensure effective ventilation
What is c in primary survey
Circulation
- adequacy of HR, BP, and overall perfusion
- restore effective circulation with hemorrhage control, cardiopulmonary resuscitation, IV access with fluid and blood administration, drug therapy
How should fluid and blood he given
Warmed before administered to prevent hypothermia
What is d of ABCDE
Disability
- rapid baseline assessment of neuro status and LOC
- ACPU (alert, responsive to voice, responsive to pain, unresponsive)
- Glasgow Coma Scale
Describe Glasgow coma scale
Scores eye opening, verbal response, monitor response
Lowest is 3 (unresponsive)
Normal is 15
What is e in primary survey
Exposure
- remove all clothing
- prevent hypothermia with blankets l, heating device, warm solutions
- may need evidence collection for rape, elder abuse, domestic violence, home use, suicide, drug overdose, assault
What is hypothermia
< 95 F or 36 C
What is the expected sequence or ED
Treatment, stabilization, discharge home or admission for hospitalization
Older adults that come to the ED…
Often admitted to the hospital for comorbidities
What is a secondary survey
- more comprehensive head to toe
- identify other injuries and medical issues that need to be managed that may affect course of treatment
