FTT, Sepsis, Stroke

Question 1

What are the physiological criteria for the field trauma triage

Answer 1

• Patient does not follow commands
• Systolic BP <90 mmHg
• Respiratory rate <10 or ≥30 breaths per minute or need for ventilatory support (<20 in infants under 1 y/o)

Question 2

What are the anatomical criteria for the field trauma triage

Answer 2

• Any penetrating injuries to the head, neck, torso, and extremities proximal to elbow or knee
• Chest wall instability or deformity
• Two or more proximal long-bone fractures
• Crushed, de-gloved, mangled, or pulseless extremity
• Amputation proximal to wrist or ankle
• Pelvis fractures
• Open or depressed skull fracture
• Paralysis

Question 3

What are the mechanism of injury criteria for the field trauma triage

Answer 3

Falls
* Adults: fall ≥6 metres (1 story = 3m)
* Children (<15yrs): fall ≥ 3 metres or 2-3 times the height of the child

High risk auto crash
* Intrusion ≥0.3 metres occupant site, ≥0.5 metres any site, including the roof
* Ejection (partial or complete) from automobile
* Death in the same passenger compartement
* Vehicle telemetry data is consistent with high risk injury

Pedestrian or bycyclist thrown, run over or struck with significant impact (≥30km/hr) by an automobile.

Motorcycle crash ≥30km/hr.

Question 4

What are the special criteria for the field trauma triage

Answer 4

Age
* Risk of injury/death increases after age 55
* SBP <110 may represent shock after age 65

Anticoagulantion and bleeding disorder

Burns
* With trauma mechanism

Pregnancy ≥ 20 weeks

Question 5

What should you assess in a patient for a stroke

Answer 5

• Inappropriate words or mute
• Slurred speech
• Umnilateral arm weakness or drift
• Unilateral facial droop
• Unilateral leg weakness or drift

Question 6

What are the contraindications to the stroke protocol (7)

Answer 6

• CTAS 1 and/or an uncorrected airway, breathing, or circulation issue
• Stroke symptoms resolved prior to paramedic arrival or assessment
• Blood glucose <3 mmol/L (if the symptoms persist after BGL is normal, then the patient is not contraindicated)
• Seizure at the onset of symptoms or that is observed by the paramedics
• GCS <10
• Terminally ill or is in palliative care
• Duration of transport to the Designated stroke center will exceed 2 hours

Question 7

How much time do you have to bring the pt to the stroke center since their symptoms started

Answer 7

6 hours

Question 8

What are the criteria of the LAMS score

Answer 8

Facial droop
* Absent: 0
* Present: 1

Arm drift
* Absent: 0
* Drifts down: 1
* Falls rapidly: 2

Grip strenght
* Normal: 0
* Weak: 1
* No grip: 2

Question 9

What does LAMS score stand for

Answer 9

Los Angeles Motor Scale

Question 10

What is the first criteria of the sepsis notification

Answer 10

Current infection OR suspicion of infection and known immunocompromised

Question 11

What is the second criteria of the sepsis notification

Answer 11

History of fever or present temperature >38.3C

Question 12

What is the 3rd criteria of the sepsis notification

Answer 12

2 or more signs of hypoperfusion
* SBP <90 mmHg
* HR ≥ 100 bpm
* RR ≥ 24
* Altered LOC/LOA
* Etc.