SMOs- Trauma (Adult and Pediatric) Flashcards
Field Triage (19)
Look at protocol
Revised Trauma Score/GCS (20)
Medical Control calculates this score by you giving:
1. RR
2. SBP
3. GCS
Routine Trauma Care (21)
Primary Assessment
1. LOC/AVPU
2. Immobilize C-Spine
3. Circulation
-Stop life threatening bleeding
-Check pulses
4. Check the neck
-Pulse (none= CPR)
-Tracheal deviation
-JVD
5. Airway
-Open and secure
6. Breathing
7. Neurologic deficit
Secondary Assessment
1. Vital signs
2. GCS
3. Systematic head to toe assessment
4. Medications
5. Allergies
6. Reassure pt
7. Evaluate cardiac rhythm if needed
8. Reassess and radio
Adult Hemorrhagic Shock (22)
OCC IT (AT)
1. Oxygen 100%
2. Circulatory assessment
-control bleeding
3. Cardiac monitor
4. IV with fluids (enroute)
-2 large bore
-SBP >90 (Max 1L)
5. SBP <70 = TXA 1g IVPB over 10 minutes
*Accelerated transport
Spine Injury (23)
Spinal motion restriction
*If patient has no complaints and is well headed, he can refuse
Head Trauma / Unconscious Patient (24)
O AV I checked >8? IN!
Everyone:
1. 100% Oxygen
2. Assist ventilations as needed
3. Vomiting precautions
4. Immobilize C-spine
Alert = Transport
Unresponsive to voice and pain:
-Pupils dilated
-GCS <8
1. Intubate (P85 and P84)
-keep spine in line
-Do not delay transport time with multiple intubation attempts
2. SBP <90= NS bolus up to 1L
3. Accelerated Transport
Traumatic Cardiopulmonary Arrest (25)
CIA
Confirm
1. CPR
-maintain C-spine
-secure airway
-Ventilate w/ 100% O2
2. IV, 2 large bore to keep SBP >90
-max 1L
-attempt enroute
3. Accelerated transport
consider bilateral chest decompression in Blunt Trauma
Accelerated Transport “CODE 26” (26)
Certain situations require treatment within minutes.
These situations occur when a problem is discovered in the primary survey that cannot be rapidly resolved by field intervention.
Only airway and cervical spinal immobilization should be managed prior to transport.
Further efforts at stabilization should be performed enroute and should not delay transport.
If circumstances demand hospital care for patient stability, rapid transport is indicated.
Each case will be unique and compelling reasons must be documented.
Notify the receiving hospital of the situation so that preparations can be made.
Primary resuscitative measures must be initiated.
Establish contact with Medical Control as soon as possible.
Adult Isolated Extremity Injury and/or Amputated and Avulsed Parts (27)
CC FW :(
1. CABs
2. Control bleeding with direct pressure and elevation
-Use tourniquet or hemostatic dressing if needed
3. Adult pain control protocol
4. Wrap body part in sterile gauze and place in waterproof bag, then place bag in cold water
5. Transport part to hospital with patient
Adult Crush Injury (28)
Adult Suspension Trauma (29)
O…CTE FIN ASC
*oxygen
1. Assess for signs of crush syndrome
-pain -paresthesia -paralysis -pallor -pulselessness
2. Assess need for torniquet
3. EKG/cardiac monitor
4. (consider) Fentanyl 50mcg IV
5. IV 1L NS prior to release
6. Albuterol 5mg prior to release
-neb
If hyperkalemia suspected: peaked T-waves or widened QRS
7. Sodium Bicarbonate 50mEq IV with 20ml flush
8. Calcium Gluconate 1g slow IV with 20ml flush
9. Transport
Adult Burns (30)
SACO PIFFT
1. Stop the burning process
2. Assess and treat associated trauma
3. Cover wound with dry, sterile dressing
4. O2 100%
5. Pain management with IV and fluids @ max 1L (fentanyl 50mcg IV/IO/IM/IN)
6. Transport
*Spinal precautions with electrical burns
*Check distal pulse on affected side
Chest Trauma (31) Sucking Chest Wound
Partially occlusive dressing
Chest Trauma (31) Flail Chest
Assure adequate ventilation (avoid CPAP)
Chest Trauma (31) Tension Pneumothorax
Perform needle decompression
Chest Trauma (31) Massive Hemothorax
- Accelerated transport
- Refer to adult hemorrhagic shock protocol (P22)
