Mod 5 Multisystem Trauma Flashcards
Multiple trauma
-More than one serious injury
Multisystem trauma
-One or more injuries that affect more than one body system
The 3 most critical decisions to be made for any trauma patient
- Patient priority/severity
- Whether to limit scene time or not
- Which hospital or transport method is best for your patient
Valuable findings during an assessment of patient (physiologic conditions)
-Altered mental status (GCS 28) usually indicates shock. Slow respiratory rate (
Determining severity anatomic criteria
- All penetrating injuries head, neck, torso, and extremities proximal to elbow and knee
- Chest wall instability or deformity (flail chest)
- Two or more proximal long bone fractures.
- Crushed, degloved, mangled, or pulseless extremity
- Amputation proximal to wrist or ankle
- Pelvic fractures
- Open or depressed skull fracture
- Paralysis
Determining severity mechanism of injury criteria
- Adults fall >20 feet (One story is equal to 20 feet)
- Children fall >10 feet or two or three times the height of the child
- High risk auto crash intusion (including roof) >12 in occupant site > 18 in any site
- Ejection (partial or complete) from auto mobile
- Death in same passenger compartment
- Vehicle telemetry data consistent with high risk of injury
What to limit scene treatment to for a critical patient
- Stabilizing the cervical spine during all interventions
- Suctioning the airway
- Inserting an oral or nasal airway
- Restoring a patent airway by sealing a sucking chest wound
- Ventilating with a BVM
- Administer O2
- Control bleeding
- Immobilize patient with cervical collar and a long backboard
Principles of multisystem trauma management
- Scene safety is paramount
- Ensure an open airway
- Perform urgent or emergency moves as necessary
- Adapt to the situation
- Overall goal is to treat immediate life threats
- Do not spend to much time at a scene treating patient injuries
Trauma score
-A system of evaluating trauma patients according to a numerical rating system to determine the severity of the patients trauma
Revised trauma score
- Glasgow coma scale 13-15 (4 points), 9-12 (3 points), 6-8 (2 points), 4-5 (1 point), 3 (0 points)
- Systolic blood pressure >89 mmHg (4 points), 76-89 mmHg (3 points), 50-75 mmHg (2 points), 1-49 mmHg (1 point), 0 (0 points)
- Respiratory rate 10-29/min (4 points), >29/min (3 points), 6-9/min (2 points), 1-5/min (1 point), 0 (0 point)