The Multiple Injured Patient Flashcards
Why is trauma important?
Leading cause for first 4 decades of life
For every death, there is 2 survivors with significant disability
Not always high energy mechanism
What is involved in good quality trauma care?
Prevention, pre-hospital care, acute trauma care, specialist definitive care and rehabilitation
Describe a pre-alert
Trauma call pre-alerts the trauma team of patient
Team is made up of ED, anaesthetics, radiology and surgical specialists
Assign roles
Equipment and drugs set up for arrival
What is involved in paramedic handover?
Time of injury, mechanism of injury, suspected serious injury, vital signs and interventions carried out
What is involved in trauma assessment?
Primary survey - ABC defects and treats immediate threats to life
Secondary survey - identification of all injuries and more detailed history
What is included in the primary survey?
ATLS and BATLS
ABC approach
Catastrophic haemorrhage control
Why is catastrophic haemorrhage control important?
Haemorrhage is leading cause of death in military trauma
Delays in treating haemorrhage while treating A and B will lead to deterioration
Pelvic binders and Thomas splint used
What is assessed in airway control?
Noises - speech, gurgling and stridor
Visual - swelling/ deformity and vomit/ blood/ debris
Airway management - manoeuvres, suction, adjuncts and advanced procedures
When is C-spine used if cervical injury assumed?
Dangerous mechanism
Reduced conscious level
Injury above clavicles
Neurological signs
Then add neck brace and stability
How is breathing and oxygen assessed?
Expose the chest
Look for visible injuries, RR and effort/ expansion
Feel - palpate and percuss
Listen
Oxygen, analgesia and drain
How is circulation assessed?
HR, palpation of radial pulse, CRT, BP, pulse pressure narrows, urine output and confusion
Blood tests - HB and lactate
Imaging - US and CT
What are the 5 main sites of blood loss?
Floor, chest, abdomen, pelvis and long bones
What is included in volume replacement?
IV access, IO access, type of fluid, amount of fluid and massive transfusion protocols
How is volume replacement monitored?
Vital signs, urine output and lactate
Lethal triad - coagulopathy, acidosis and hypothermia
What is included in neurological examination of disability?
AVPU, GCS, pupils, tone + reflexes and log roll
