Introduction to Trauma Flashcards
1
Q
Societal impacts of trauma
A
- Worldwide, injury has a profound effect on society.
- Over 5 million people die annually as a result of injury, accounting for 9% of deaths.
- Motor vehicle collisions (MVCs) and drowning are substantial causes of death in early life.
- # 1 cause of nonfatal injuries in the United States during 2015 was unintentional falls.
- More than 3 million patients hospitalized, 27 million treated in emergency departments and released
- Review these sobering statistics.
- CDC lists the top 10 causes of traumatic death by age group.
- MVCs are among the top causes of death for any age group.
- Inattentiveness to driving is a major cause of motor vehicle fatalities and injuries in the United States.
- At an individual level, injuries can have a devastating impact on the quality of life. As participants if they can think of any examples they have witnessed.
2
Q
trauma death
A
- Unintentional injury is leading cause of death between ages of 1 and 45.
- Results in 14,000 deaths each day worldwide due to an injury
- Combined total deaths from diseases such as malaria, tuberculosis, and HIV/AIDS amount to around half as many deaths as those resulting from injury.
3
Q
trauma centers
A
-patient can go to the wrong level of trauma care center
4
Q
economic impact
A
-Financial burdens are incurred to care for those who survive traumatic events.
-National Safety Council estimated a financial impact of approximately $886.4 billion in 2015 from both fatal and nonfatal trauma in the United States.
-Wages and productivity lost was approximately $458 billion annually due to trauma, more than twice as much as the costs associated with injuries resulting in fatalities.
-To compare, costs associated for cancer and heart diseases per patient are much less.
Impact of prehospital care providers
Prehospital care providers can reduce the costs of trauma in society by using their skills and equipment properly.
-ex. protecting a fractured cervical spine properly may make a difference between quadriplegia and productive, healthy life with unrestricted activity.
5
Q
PHTLS philosophy
A
- research
- interventions
- patient care delivery
6
Q
goals of trauma care
A
- reduce mortality and injury from trauma
- Prehospital care providers must have a good foundation of knowledge, be critical thinkers, and have the appropriate technical skills necessary to provide patient care to trauma patients in less-than-optimal circumstances.
- PHTLS supplies the knowledge and skills to enable the use of critical thinking by prehospital care providers in achieving the best care possible for the trauma patient.
7
Q
research
A
- foundation for the best practices for trauma care
- research validates or contests current practices and determines future practices
- Must be critically evaluated if findings apply to EMS systems and patient populations before a practice can be changed
- The PHTLS textbook and program are based on current research.
- Prehospital care providers should continue to be involved with research in prehospital care.
- Direct participants to Lesson 1: Introduction and Overview of Trauma Care and PHTLS in the PHTLS 9e Course Manual.
8
Q
intervention
A
- Appropriate interventions are based on the assessment of each patient.
- Knowing when not to do something is more important than knowing when to do something.
- Therefore, prehospital care providers shall provide the most appropriate interventions for each patient.
9
Q
patient care delivery
A
- Prehospital care providers must deliver the trauma patient:
- To the right facility
- Utilizing the right mode of transport
- In the right amount of time
- As safely as possible
- stop the bleeding campaign
10
Q
golden peroid/hour
A
- from time to injury to the time you get to a place within 1 hour
- want the person off the scene in about 10 minutes
11
Q
team approach
A
- PHTLS stresses utilizing a team approach between people with various levels of knowledge and skills.
- Discuss various members of a trauma team.
- Trauma is a global problem, where prevention is a vital part of our job.
- Working together provides trauma patients with the highest chance of survival.
12
Q
assessment and treatment of trauma patients
A
- PHTLS now uses the XABCDE approach to assessment and in providing lifesaving care in a trauma patient.
- eXsanguination
- X is added to the ABCDE approach in trauma care to correct immediate life-threatening bleeding.
- Locating the source of bleeding
- Applying pressure to the source until bleeding stops
- Using hemostatic dressings or tourniquets to stop bleeding
- Avoid popping the clot and further diluting the blood through fluid resuscitation.
- ALL RBCs COUNT!!
- Airway
- Breathing
- Circulation
- Disability
- Expose/environment
13
Q
MARCH and CABCDE
A
- massive bleeding, airway, respirations, circulation, head
- catastrophic hemorrhage control, airway, breathing, circulation, disability, expose/environment
14
Q
past of PHTLS
A
- Based on the Advanced Trauma Life Support (ATLS) course started in 1978
- 2 years after a plane crash involving the pilot (orthopedic surgeon), wife, and four children in a rural area of Nebraska
- Norman McSwain, known as the father of PHTLS, established a draft curriculum of what became Prehospital Trauma Life Support (PHTLS).
- PHTLS committee established in 1983.
- Brings work of practitioners and researchers around the globe together to determine standards of trauma care for the new millennium
- Support of the PHTLS family worldwide enables PHTLS leadership to keep PHTLS growing.
- Builds upon each participant’s current knowledge base and skills to enrich critical thinking and problem-solving abilities
- Stresses importance of teamwork between providers with various levels of knowledge, skills, and resources
- Provides environment conducive to learning to practice trauma assessment and treatment skills
15
Q
principles versus preferences
A
- principle- based on patient needs
- preference- how the principle is accomplished
- preferences may change depending on:
- situation at scene
- patient severity
- prehospital care provider knowledge and skills
- resources available
- PHTLS teaches the principles of care rather than focusing on preferences
- principle is what needs to be done for apt based on the pt assessment
- preference is how the principle is accomplished
