SOG 430 Flashcards
Suspicion of Abuse
When suspected that abuse or neglect to a child or vulnerable adult has taken place, the following shall be initiated:
- Treat all related injuries
- Transport all suspected cases
- If transport is refused:
- Request law enforcement
- Stay with Pt until enforcement arrival
- Notify Rescue District/Battalion Chief
Fracture - The evidence of an open long bone fracture, or there are multiple fracture sites or multiple dislocations.
Pediatric Trauma Alert “Any One Condition”
SOG 5030 Allergic Reaction/Anaphylaxis
TX Airway/Breathing - Monitor Spo2 - Admin O2 via proper adjunct >95% - Assist with pt auto-injector epi pen if present -Determine BGL - Assess Temp
Florida Statute 401.445
Emergency examination and treatment of incapacitated persons
Airway - The patient receives active airway assistance beyond the administration of O2
Trauma Alert “Any one condition”
Circulation - The patient lacks a radial pulse with a sustained heart rate greater than 120 or a systolic blood pressure less than 90 mmHg
Trauma Alert “Any One Condition”
BMR - The patient has a BMR of 5 on the motor component of the GCS
Trauma Alert “Any Two Components”
Cutaneous - The pt has a major soft tissue disruption including major degloving injury or major flap avulsion; or 2nd or 3rd degree burns to 10% or more of TBS; or amputation proximal to the ankle or wrist; or any penetrating injury to the head, neck, or torso.
Pediatric Trauma Alert “Any One Condition”
Treatment for Spinal Trauma ? SOG 2060
- Maintain body warmth
- Monitor and record vitals signs every 5 minute
- Provide spinal immobilization
- Airway/breathing; monitor spo2; administer O2 via proper adjunct and maintain 95% or greater; high cervical injury may cause apnea
- Consider SAM pelvic splint
- Control bleeding
- Determine BGL
- Look for underlaying causes
Florida Statute 766.103
Florida Medical Consent Law
Treatment for Trauma Pregnancy ? SOG 2090
- Maintain body warmth
- Provide spinal immobilization if indicated
- Immobilizing a pregnant PT greater than 20 weeks
may cause supine hypotension syndrome- After immobilizing the PT, elevate the PT’s right
side of the LSB 6”; this will displace the uterus and
fetus to the left side and off the inferior vena cava
- After immobilizing the PT, elevate the PT’s right
- Immobilizing a pregnant PT greater than 20 weeks
- Airway/breathing; monitor SPo2 and administer O2 via proper adjunct; maintain 95% saturation or greater
- Immobilize impaled object
- Control Bleeding
- Determine BGL
SOG 5070 Headache
- If sudden severe headache or sudden decrease on LOC, refer to Acute Stroke Protocol
- Headaches with elevated temp, nausea/vomiting and/or altered mental status may be meningitis or neurological
TX
Airway/Breathing - Monitor Spo2
- Admin O2 proper adjunct >95%
- Determine BGL (<60mg/dl)
- Assess Temp
- Look for underlying causes
Cutaneous - The patient has 2nd or 3rd degree burns to 15% or more of TBSA; or amputation proximal to the wrist or ankle; or any penetrating injury to the head, neck, torso.
Trauma Alert “Any One Condition”
Circulation - The patient has sustained heart rate of 120 beats per minute or greater
Trauma Alert “Any Two Components”
What two considerations must be meet, for an Adult to be considered a “Trauma Alert”, IAW Trauma Scorecard Methodology?
Airway - PT respiratory rate of 30 or greater
Circulation - PT has a sustained HR greater than 120 BPM
BMR - PT exhibits a 5 on motor assessment on GCS
Cutaneous - PT has a soft tissue injury from either a major degloving or major flap avulsion greater than 5”; or has gunshot to extremities of the body
LBF - PT reveals signs or symptoms of a single long bone fracture resulting from a MVC or a fall greater than 10’
Age - PT is 55 or older
MOI - PT has been ejected from a motor vehicle or the driver has impacted the steering wheel causing steering wheel deformity (excluding motorcycles, mopeds, ATV, bikes, or open bed of a pick up)
If the patient exhibits a GCS of 12 or less the patient should be consider a ______ _____. (excluding pt’s who’s normal GCS is a 12 or less, as established by the pt’s PMHx or preexisting medical condition when known)
Trauma Alert
Medical Asystole:
Apneic, Pulseless, and Systolic that do not meet the unquestionable death criteria.
Resus efforts may be terminated only when all of the following criteria exist:
- Arrest was not witness
- No shocks provided prior to JFRD arrival
- PT is 18 or older
Rhythm remains in systole after providing 20 minutes of ACLS
Treatment for Chest Trauma ? SOG 2070
- Maintain body warmth
- Provide spinal immobilization
- Airway/breathing; monitor Spo2, maintain oxygen saturation of 95% or greater via proper adjunct
- Immobilize impaled object
- Control bleeding
- Flail Chest; CPAP contraindicated
- Sucking Chest Wound; Apply Vaseline-type occlusive dressing; cover dressing with sterile 4x4; Tape 3 of four sides
Consciousness - The pt exhibits an altered mental status that includes drowsiness, lethargy, inability to follow commands, unresponsiveness to voice, totally unresponsive, or in a coma; or there is a presence of paralysis, suspicion of a spinal cord injury, or loss of sensation.
Pediatric Trauma Alert “Any One Condition”
Airway - The patient has a respiratory rate of 30 or greater.
Trauma Alert “Any Two Components”
What one consideration must be meet, for an Adult to be concidered a “Trauma Alert”, IAW Trauma Scorecard Methodology?
Airway - PT receiving active assistance beyond administration of O2
Circulation - PT lacks a radial pulse, sustained HR greater than 120 BPM or has a systolic of 90 or less
BMR - PT exhibits a 4 or less motor assessment on GCS; or exhibits the presence of paralysis; suspicion of spinal cord injury or loss of sensation
Cutaneous - PT has 2nd/3rd burns to 15% of total body surface are; amputation proximal of wrist or ankle; or penetrating injury to head, neck, or torso
LBF - PT reveals signs or symptoms of 2 or more long bone fracture sites
Treatment for Extremity Trauma? SOG 2100
- Maintain body warmth
- Provide spinal immobilization
- Airway/breathing; monitor Spo2, maintain oxygen saturation of 95% or greater via proper adjunct
- Immobilize impaled object
- Control bleeding
- Splint all areas of tenderness or deformity; splint dislocations and joints injuries on the position found; consider ice packs to reduce swelling and pain; reduce fractures by axial traction if distal pulses are absent; elevate the extremity when practical; locate, mark and monitor distal pulses; record sensation and motor function before and after splinting
- Amputation; place part in sterile gauze, moisten with NS; keep part cool; dress and splint partial amputations in alignment with extremity, avoid torsion
- Do not clamp vessels
- Alert hospital
Treatment for Crush Injuries? SOG 2110
- Maintain body warmth
- Provide spinal immobilization
- Airway/breathing; monitor SPo2 and administer O2 via proper adjunct; maintain 95% saturation or greater
- Control bleeding
A patient shall be defined as:
A person who presents with subjective and/or objective signs and/or symptoms or a complaint which results in evaluation and/or treatment.
Treatment for Head Trauma ? SOG 2040
- Maintain body warmth
- Provide spinal immobilization (All helmets other than football should be removed)
- Airway/breathing; monitor spo2; administer O2 via proper adjunct and maintain 95% or greater
- Consider SAM pelvic splint
- Control bleeding
- Determine BGL
- Look for underlaying causes
- Control Bleeding
- Determine BGL
SOG 5090 Seizures
TX
- Maintain aspiration prophylaxis by placing pt in recovery position
- If trauma suspected, immobilize using proper technique
- If the Pt is actively seizing, protect the Pt from further injury
Airway/Breathing
- Monitor Spo2
- Admin O2 proper adjunct >95%
- Determine BGL
SOG 5040 Altered Consciousness
TX
- Maintain aspiration prophylaxis by placing pt in recovery position
- If trauma suspected, immobilize using proper technique
- Airway/Breathing - Monitor Spo2
- Admin O2 proper adjunct >95% - Determine BGL
- Assess Temp
- Look for underlying cause
An agent with power of attorney may ______ revoke a ___ and request that JFRD _____ or _____ CPR on the patient, even if a _______ exists.
verbally DNRO initiate continue DNRO
Size - Pediatric trauma pt weighing 11 kg or less; or the body length is = to this weight on a pediatric length and weight emergency tape (the equivalent to 33” in measurement or less).
Trauma Alert “Any Two Components”
SOG 5080 Nausea/Vomiting
TX Airway/Breathing - Monitor Spo2 - Admin O2 proper adjunct >95% - Determine BGL (<60mg/dl) - Assess Temp
Circulation - The carotid or femoral pulse is palpable, but the radial or pedal pulse are not; or the systolic is less than 90 mmHg
Trauma Alert “Any Two Components”
Airway - In order to maintain optimal ventilation, the pt is intubated; or breathing is assisted through such measures as a manual jaw thrust, continuous suction, or through the use of other adjuncts to assist ventilation.
Pediatric Trauma Alert “Any One Condition”
Florida Statute 743.064
Emergency medical care or treatment to minors without parental consent
Resuscitation may only be withheld or withdrawn upon presentation of a valid _____ as described in JFRD Resuscitation Protocols ______.
DNRO
1130
Baker Act is an _______ mental health commitment by __ ______ if the patient meets any of the following criteria:
Mentally _______, danger to ____ or others;
_________ or ________.
involuntary Law Enforcement incompetent self Suicidal Homicidal
SOG 5010 Abdominal Pain/Flank Pain
TX
- Place pt in position of comfort
- Airway/Breathing - Monitor Spo2
- Admin O2 proper adjunct >95% - Determine BGL
- Assess Temp
