HEMS Team/MOI Flashcards
How can the HEMS team improve team function
introduce yourself
find out who the “attending” is
don’t take over - give the team tasks to suit their skill level
ask the odd question rather than coming across as interrogating
Why are prehospital histories often unreliable
catecholamine surge
drugs and alcohol
What is the new A-E (sorry to Joe who is emotionally attached to the old one)
360 degree access
analgesia
CNVF…..
Cardiovascular (pulse, skin colour and temp, venous guttering, cap refil)
Ventilation (symmetry, rate, volume, type of breathing)
Neurology (GCS, pupils, cord function, autonomic dysfunction)
Full extent of injuries
What injury pattern would you expect with a fall from height?
calcaneous fracture tibial plateau VS pelvic fracture lumbar spine burst fracture BOS (very bad if they have this!)
What injury pattern would you expect if a child wearing a lapbelt were involved in an accident
lumbar spine chance fracture
duodenal injury
mesenteric tears
What injury pattern would you expect with a lateral impact to a car (for the driver)
liver and kidney injury
head injury (hits the B pillar of the car)
LC pelvic fracture
what injury pattern would you expect with a frontal impact to a car
hip dislocations and NOFF (dashboard injury)
foot dislocations and fractures (especially if intrusion into passenger compartment)
head/face (bullseye is impossible if driver is restrained)
How does delta-V impact our thoughts on the severity of an injury
it’s the rate of change of speed that determines injury pattern i.e. a motorcyclist found thrown far away from the car/bike wreckage is probably better off than one on the floor at the incident scene
What are the benefits of giving analgesia to patients early
assess physiology humanitarian packaging the patient is easier reduces scene time reduces sympathetic activation so reduced vasoconstriction and tissue hypoxia exacerbation
