Tramuatic Injuries Chart Flashcards
SKULL FRACTURE - Critical Interventions
OPEN:
(moderate or major hemorrhage) pressure w/ gloved hand around fracture site to control bleeding
Do NOT apply pressure directly to skull fractures
CLOSED:
No intervention necessary
SKULL FRACTURE - Package for transport
APPLY STERILE DRESSINGS:
- Non-stick (telfa) dressing
- Absorbent dressing (Abdominal-pad)
LIGHTLY secure with bandage
Do NOT apply pressure to fracture/depressed area
SKULL - Impaled Object: Critical Interventions
-(Moderate or major hemorrhage) direct digital (fingers) pressure w/ gloved hand to control bleeding
-Manually stabilize object in place
SKULL - Impaled object: Package for Transport
Apply sterile dressings to open skin
- Non-stick (telfa) dressing
- Absorbent dressing (abdominal-pad)
Use bulky dressings to stabilize impaled object then secure object to limit movement and bleeding
Do not apply pressure to fractures/depressed area
REMOVE OBJECT ONLY IF IT OBSTRUCTS AIRWAY OR PREVENTS CPR
EYE INJURY - Impaled object: Critical interventions
Manually stabilize object
EYE INJURY - Impaled object: Package for Transport
Cover uninjured eye with gauze, apply sterile dressings to open skin:
- Non-stick (telfa) dressing or sterile gauze
- Use bulky dressings to stabilize object
- Secure dressings with bandage to limit movement and bleeding
EYE INJURY - Extruded Eyeball: Critical interventions
Stabilize with sterile gauze
EYE INJURY - Extruded Eyeball: Package for Transport
Cover uninjured eye with gauze, apply sterile moist dressings around the injured eye
- Non-stick (telfa) dressing or sterile gauze
- Use BVM mask or ring pads over moist dressings to keep pressure off eyeball
Secure mask/pads with bandage as to limit movement & pressure on eyeball
NECK LACERATION - Critical interventions
Pressure with gloved hand to control bleeding
NECK LACERATION- Package for transport
Apply 4 sided occlusive dressing
- Abdominal pad over occlusive if major hemorrhage
- Be careful not to occlude other vessels or affect the trachea
CHEST INJURY - Impaled object: Critical interventions
- Cut, expose and examine injury
- Manually stabilize object
CHEST INJURY - Impaled object: Package for Transport
Apply sterile dressings to open skin
- Non-stick (telfa) dressings or sterile gauze
- Use bulky dressings to stabilize the object
- Secure dressings with bandage to limit movement and bleeding
(Do NOT impede breathing when securing dressings)
CHEST INJURY - Open chest wound: Critical interventions
- Cut, expose and examine injury
- Apply pressure with gloved hand (?)
(all the pdf says for the bottom point one is “gloved hand” so I’d assume that means direct pressure but I should probably ask about that)
CHEST INJURY - Open chest wound: Package for Transport
- Apply ONE chest seal OR 3 sided occlusive dressing to open wound per side of chest
- Seal all other open wounds with occlusive dressings closed on all 4 sides
CHEST INJURY - Flail segment: Critical interventions
- Cut, expose and examine injury
- Hard pressure
CHEST INJURY - Flail segment: Package for Transport
- Secure bulky dressing (size to fill space) on inhalation
- Use tape to secure pad in place (flail segment moves as a unit with rest of rib cage)
CHEST INJURY - Rib fracture: Critical interventions
- Cut, expose and examine injury
- No intervention necessary
ABDOMINAL INJURY - Impaled object: Critical interventions
- Cut, expose and examine injury
- Manually stabilize object
ABDOMINAL INJURY - Impaled object: Package for Transport
Apply sterile dressings to skin
- Non-stick (telfa) dressing
- Secure dressings with bandage to limit movement and bleeding
(Do NOT impede breathing when securing dressings)
ABDOMINAL INJURY - Open abdominal wound: Critical interventions
- Cut, expose and examine
- Gloved hand (still dunno what that means, direct pressure with gloved hand maybe)
ABDOMINAL INJURY - Open abdominal wound: Package for Transport
Apply sterile dressings to open skin
- Non-stick (telfa) dressing
- Absorbent dressing (abdominal pad)
- Secure dressings with bandage to limit bleeding
(Do NOT impede breathing when securing dressings)
ABDOMINAL INJURY - Evisceration: Critical interventions
- Cut, expose and examine injury
- Manually corral exposed bowels with gloved hands
ABDOMINAL INJURY - Evisceration: Package for transport
Apply sterile moist dressings to open skin and exposed bowels
- Add dressings
- Cover with occlusive dressing
- Secure dressings with tape or triangular bandage as to limit movement and contain warmth
Position patient supine or semi-Fowlers with knees bent as to decrease pressure on abdomen
HEMORRHAGE - Critical interventions
- Cut, expose and examine injury
MINOR: often capillary bleed, no intervention necessary
MODERATE: often venous bleed: direct pressure in front of gloved hand
MAJOR: often venous/arterial bleed: with gloved hand (probably means direct pressure)
HEMORRHAGE - Package for Transport
3 Stage Approach:
Step 1: Apply direct pressure with sterile dressings
- Non-stick (telfa) dressing
- Absorbent dressing (abdominal-pad)
- Secure with tight bandage (zap strap/tensor)
Step 2: If hemorrhage NOT controlled
- Leave original dressing in place and apply second dressing with direct pressure
- Absorbent dressing (abdominal-pad)
- Secure bandage
Step 3: If hemorrhage NOT controlled, Apply tourniquet 5-10 cm (2-4 in.) above the injury or just above the joint on single long bone if necessary
- Document the time applied
- If not already, the patient becomes RTC when tourniquet is applied
AMPUTATION - Critical interventions
- Cut, expose and examine injury
- Direct pressure with abdominal-pad
AMPUTATION - Package for Transport
Begin staged Hemorrhage control protocol or apply tourniquet 5 - 10 cm above amputation
AMPUTATED BODY PART:
1. Locate body part
2. Rinse with Sterile Saline
3. Wrap in sterile gauze
4. Place inside plastic bag
5. Place all above in larger plastic bag and cool with ice or chemical cold packs BUT ensure parts don’t freeze
6. Label bag with name (yours? Patients? Probably patients) date and time
7. Transport with patient
BURNS - Thermal: Critical interventions
Cool w/ sterile saline for 1-2 mins
BURNS - Radiation: Critical interventions
Cool w/ sterile saline for 1-2 mins
BURNS - Chemical: Critical interventions
Flush/cool with sterile saline for 20 mins
BURNS - Electrical: Critical interventions
Cool local burns w/ sterile saline for 1-2 mins
BURNS - Package for Transport
- Apply dry sterile burn dressings after cooling
- Drape or secure loosely with bandage
- Consider entonox for pain management
FRACTURES IN STABLE PATIENTS - Critical interventions
- Manual stabilization
- Cut and expose
- Control bleed (if necessary)
- Assess CMS (Circulation, motor, sensation (probably))
FRACTURES IN STABLE PATIENTS - Package for Transport
Refer to principles of management: “Injuries to Extremities”
SAGER traction splint = 1/3 femur only
Use STAPLES acronym
- Size
- Thigh strap
- Ankle straps
- Padding
- Lbs ❤️
- Elevate/Elastic Straps ❤️
- Strap ❤️ + Reassess Traction
(I don’t know what the hearts are supposed to represent but they’re in the pdf so…)
FRACTURES IN UNSTABLE PATIENTS - Critical interventions
- Manual stabilization
- Cut and expose
- Control bleeding
- Assess CMS (Circulation, motor, sensation (probably))
If pale cool and pulseless, long bones realign to anatomical
If limb remains pulseless transport patient as RTC (unstable)
FRACTURES IN UNSTABLE PATIENTS - Pelvis: Package for Transport
Use zap straps or triangular bandages
- Rolled blanket between the legs
- 3 sets of straps around pelvis, top of superior strap should be just inferior to iliac crest
- 1 set securing femurs
- 1 set securing tibia/fibulas
FRACTURES IN UNSTABLE PATIENTS - Hip fracture(s)/Dislocation: Package for Transport
Use zap straps or triangular bandages
- Pad in position of comfort
- Secure injured limb to uninjured with zap straps and blankets
- Pad in position of comfort (maybe unintentionally repeated?)
- 2 sets securing femurs
- 1 set securing tibia/fibulas
FRACTURES IN UNSTABLE PATIENTS - Femur Fracture(s): Package for Transport
Use zap straps or triangular bandages
- Rolled blanket between legs
- 1 set of straps securing femurs above fracture
- 1 set of straps securing femurs below fracture
- 1 set securing tibia/fibulas
FRACTURES IN UNSTABLE PATIENTS - Tibia/Fibulas: Package for Transport
Use zap straps or triangular bandages
- Rolled blanket between legs
- 1 set of straps securing femurs
- 1 set of straps securing tibia/fibulas above fracture
- 1 set of straps securing tibia/fibulas below fracture
FRACTURES IN UNSTABLE PATIENTS - Humerus/Radius/Ulna(s): Package for Transport
Secure arms beside body of patient inside clam shell
OR
Sam splint strapped in place with zap straps or triangular bandages
