Module 1 Flashcards
Acceleration and Deceleration Injuries
Shearing
Compression
Rebound
Shearing Injuries
Shearing forces cause liver heart and other organs to pull away or fold around ligaments or muscle
Compression Injuries
ie: head hits dash board
Rebound Injuries
Occur due to recoil following deceleration
Includes spinal # and contra coup injuries to the brain
What must you always ask about with any injury/ Trauma
Pre incident
Incident
Post incident
Targeted history taking
ie. were you dizzy before you fell
Cauitation
When the body is hit by something there is a transfer of energy that knocks the organs out of place
Can be permanent or temporary (depending on the amount of force and elasticity of tissues involved)
Permanent Cauitation
tract or hole through tissue that remains after the energy is removed
Exit wounds
larger then entry wounds
The structures and debris that the bullet collects as it passes through are forced out the exit wound
Trauma assessment (C)
CPR
Hemorrhage
Trauma assessment A
Look -swelling -facial trauma -look in the mouth (broken teeth etc.) -chest rise and fall -LOC Listen -air movement -Stridor Feel -air movement
clarity of speech
signs of obstruction
AVPU
CSpine
Trauma assessment B
Look
- WOB
- Symetry (flail segment?)
- Rise and fall
- Skin colour
- Tracheal deviation
- Depth
- Quality
- Rate
Listen
-Lungs to bases
Feel
-SubQ emphysema
Trauma assessment C
Skin: colour, temp, moisture cap refill pulses:quality ,rate, rhythm chest pain? signs of bleed FAST POCUS pelvic stability
Trauma assessment D
Gluc Barriers (pain and nausea) Doctor/specialists AVPU Pupils GCS cincinnati stroke scale
Trauma assessment E
Assess for further injuries
Silver half hour
Used for infants/Peds
Silver half hour
Used for infants/Peds
Trauma triad of death (list the 3 parts)
Coagulopathy
Acidosis
Hypothermia
Trauma
Injury to tissues resulting from the transfer of energy
Blunt trauma
Skin remains intact
more serious -extent of injury is hard to see
more wide spread injury
Penetrating trauma
skin surface is broken
List the accelerating and decelerating forces
Shearing injuries
Compression injuries
Rebound injuries
Essential information to gather from scene/paramedics
speed seatbelt airbags LOC Intrusion Deaths at scene EBL (arterial vs Venous) MOI
Trauma interventions A
Intubate early BVM suction Jaw thrust (or chin lift for C-Spine) C-spine/SMR Sx airways- needle cric, sx cric, tracheostomy's
Trauma interventions B
Oxygen Assist with breaths (BVM)/vent pulse oximeter Resposition if safe BiPAP or CPAP Chest tube needle thoracostomy
Trauma interventions C
Pericardial needle aspiration cardiac monitor Pelvic binder IV fluids RL/Plasmalyte (avoid NS) 1-2L Blood 1:1:1 TXA IV/IO 12 lead ECG
Trauma interventions D
CT scan
Decrease ICP
control pain and nausea
Trauma interventions E/F
Family presence rewarm cut off wet clothes behr hugger blankets etc.
Trauma triad of death HYPOTHERMIA
Core Temp <35
vasoconstriction causes a lack of perfusion to cells (blood is shunted to core organs)- leads to acidosis
The clotting cascade is temperature-dependent
Oxygen dissociation curve shifts left (LOVE oxygen)
Trauma triad of death ACIDOSIS
Build up of lactic acid d/t poor perfusion (anaerobic metabolism)
Trauma triad of death HYPOTHERMIA INTERVENTIONS
Active rewarming warm fluids warm blankets warm CBI warm thoracic lavage
Trauma triad of death COAGULOPATHY
bleeding out loosing clotting factors
INR >1.5
Inability to clot
Inflamatory response causes us to lose clotting factors which causes DIC
Hypothermia inhibits ability to clot
Acidosis (<7.3) inhibits ability to clot
Trauma triad of death ACIDOSIS INTERVENTIONS
Improve oxygenation and perfusion
give oxygen
Give fluids (RL or blood)
find cause of acidosis
Complications with CSpine collars
Impaired venous drainage from head
pain
skin breakdown
Airway compromise (SUCTION)
Flail Chest
3 or more ribs broken in 2 or more places (segments)
Flail Chest Interventions
Immediate intubation
Saline bags on injury
Tension Pneumo Signs and symptoms
Early signs
- SOB
- Decreased sats
- Decreased TV
Late signs
- Altered LOC
- Tracheal deviation
- hypoxic arrest
Tension Pneumo Signs and symptoms
Early signs
- SOB
- Decreased sats
- Decreased TV
Late signs
- Altered LOC
- Tracheal deviation
- hypoxic arrest
Fluid resuscitation in trauma
RL or plasmalyte not NS because it can lead to acidosis
Blood products 1:1:1 FFP, Platlets and PRB then 1g calcium gluconate
Chest drainage systems should be clamped when?
to much blood loss- clamping it can cause a tamponade which will apply pressure and slow bleed
Worst type of brain bleed
epidural (arterial bleed)
Signs of Increased ICP
Uneven pupils
Cushings triad
Cushings triad
Widening pulse pressure
irregular resps
bradycardia
Cushings triad
Widening pulse pressure
irregular resps
bradycardia
Cushings triad
Widening pulse pressure
irregular resps
bradycardia
Secondary assessment LMNOP
Labs Monitor Nasogastric tube Oxygen Pain
Trauma triad of death COAGULOPATHY INTERVENTIONS
Blood products 1:1:1
WARM pt
