Overview

Question 1

Intro

Answer 1

Excellence in major trauma care is a hallmark of a world class Paramedic system

Recognition of the potential existence of occult injuries and the rapid stabilization and transport of critically injured pts are two critical functions of pre-hospital trauma care

MOI plays an important role in raising the suspicion of type and seriousness of injury
Paramedics should maintain a high index of suspicion and never be complacent when confronted w/ what appear to be minor injuries associated w/ a significant mechanism

Follow trauma preferred destination guidelines which apply in your are

Question 2

Guiding Principles

Answer 2

In cases of both obvious and potentially subtle injuries, the importance of short scene times and immediate transport cannot be understated

Paramedics must ensure that any delay in transport is warranted. The only interventions that should be carried out prior to transport are:

• SMR, when required
• Airway management and ventilatory support of pts w/ increasing airway obstruction or failing resps
• Relief of tension pneumothorax
• Simple stabilization of long bone and pelvic fractures

**Except for very long transports the value of an IV and fluids, even for a pt in moderate shock is controversial and certainly does not warrant any delay

Question 3

Major Trauma Criteria

Answer 3

Defines pts who clearly have a high risk of death - include but are not limited to:

• ALOC w/ GCS =<13
• Resp distress - rate <10 or >30
• Signs of hypoperfusion - BP <90
• Penetrating injs - head, neck, chest, abdomen or proximal extremity
• Long bone fractures - 2 or more
• Flail chest
• Major amputation of extremity
• Airway compromise w/ 2nd or 3rd degree burns