IECP Trauma Algorithm

Question 1

S.A.F.E approacht

Answer 1

-Shout/send for help

-Assess scene for Hazards - Self
- Scene
- Survivors

-Find and Free casualties

-Evaluate Casualties - Are there any Catastrophic bleeds

Question 2

<C> Catastrophic Haemorrhage
</C>

Answer 2

• Bystander - Direct/indirect pressure

Limb wounds
- CAT Tourniquet, assess and apply another if ineffective

Junctional wounds
- Celox rapid - Two person technique
- Bystander direct pressure with bandage
- communicate with bystander

            - Direct pressure removed and cellox packed into wound using two digit technique

             - bystander reapply new bandage and hold pressure over site with two hands for one minute. 

             - After one minute ask bystander to spread hands and look for strike through . 

                    - ?Strike through - communicate with bystander to remove pressure and pack more cellox into wound. Repeat above for a further minute. 

                   -No strike through. Apply emergency care bandage tightly and assess distal to bandage for pulse and cap refil.

Question 3

Response

Answer 3

Check response

-Alert

• Alert to voice
• Unresponsive

(NO PAIN RESPONSE ASSESSMENT AT THIS TIME)

Question 4

C- Spine

Answer 4

Consider mechanism for possible C-spine injuries.

Quick check of C- spine

Get bystanders to apply MILS

Question 5

Airway

Answer 5

-Check

• Clear (if required)

-Maintain (Head tilt chin lift, Jaw thrust if C-Spine concern, OPA or NPA)

Question 6

Breathing

Answer 6

-Rate , Apply O2 if needed (RR <10 / >20)
-Injuries (Anterior chest, Find and treat)
-Symmetry
-Effort (?accessory muscles, ?Sternal tug, ?intercostal recession, Tripoding etc)

Neck (12)

-Trachea
-Wounds
-Emphysema
-Larynx
-Veinous distension
-Every time before a collar

-Feel (Sternum, Clavicles, Ribs)
-Assess, Percuss 2nd, 4th MC and 5th Ax IC space)
-Listen 2nd, 4th MC and 5th Ax IC Space)
-Look for undiscovered wounds to back using the gloved Union Jack method.

Question 7

Circulation

Answer 7

-Pulse check, Bilateral radial - if no pulse move proximal (brachial, Carotid)

-BOTF+4 -Chest
- Abdomen
- Pelvis (if mechanism suggests injury apply pelvic binder)
-Long bones (Femur/Humorous)
Administer analgesia before using KTD (discuss time to Peak Plasma concentration and reassess pain score)

Question 8

Disability

Answer 8

-Alert
-Voice
-Pain
-Unresponsive

    - PEARRL (Sz 2 - 4)

Question 9

Consider Pain Relief

Answer 9

Alert or Alert to Voice

With a Pain score of 2 or 3

ONLY

Question 10

Environment

Answer 10

-Self

• Scene

-Survivors

Question 11

Secondary Survey

Answer 11

Zone 1 - Head, Ears (?CSF) Neck (12) apply collar, and shoulders

Zone 2 - Chest, front and back

Zone 3 - Abdomen and Pelvis

Zone 4 - Full arm and legs, ankles, wrists and digits

Question 12

Packaging

Answer 12

-Zone 1 - Head, Neck and Shoulders (Dress any wounds)

-Zone 2 - Chest (Check any chest seals and occlusive dressings, dress any other wounds)

-Zone 3 - Abdomen and Pelvis (Apply moist dressing, bind legs if pelvic injury suspected )

-Zone 4 - full leg and Arms (Dress any wounds and splint ?Fractures)

Question 13

Handover

Answer 13

-Mechanism
-Injuries
-Signs and Symptoms
-Treatment given
-Age of casualty (Adult/Child)
-Time of wounding