Trauma Flashcards
Level 1 MCI
5-10 patients
Level 2 MCI
11-20 patients
Level 3 MCI
21-100 patients
Level 4 MCI
101-1000 patients
Level 5 MCI
1000+ patients
TXA indications
~hemorrhagic shock
~TBI
~pt on anticoag meds
~traumatic hemorrhagic shock
~TBI with GCS < 13
~blunt/penetrating trauma
TXA contraindications
~injuries > 3 hrs
~ age < 5 yrs
TXA adult dose
2 g in 100 mL D5W or NS
TXA pedi dose
age 5-11
~15 mg/kg
START Triage:
Pt able to walk
green
START Triage:
Pt able to walk but has massive bleeding requiring bleeding control
yellow
START Triage:
Not able to walk
not breathing –> pt breathes after readjusting airway
red
START Triage:
Not able to walk
not breathing –> pt apneic after readjusting airway
black
START Triage:
Not able to walk
Breathing, RR > 30
red
START Triage:
Not able to walk
Breathing, RR < 30
radial pulse absent
red
START Triage:
Not able to walk
Breathing, RR < 30
capillary refill > 2 sec
red
START Triage:
Not able to walk
Breathing, RR < 30
capillary refill < 2 sec
obeys commands
yellow
START Triage:
Not able to walk
Breathing, RR < 30
radial pulse present
obeys commands
yellow
START Triage:
Not able to walk
Breathing, RR < 30
capillary refill < 2 sec
doesn’t obey commands
red
START Triage:
Not able to walk
Breathing, RR < 30
radial pulse present
doesn’t obey commands
red
JUMPSTART Triage:
Able to walk
green
JUMPSTART Triage:
Able to walk but has bleeding needing control
yellow
JUMPSTART Triage:
Not able to walk
not breathing –> breathes after adjusting airway
red
JUMPSTART Triage:
Not able to walk
not breathing –> apneic after adjusting airway
no palpable pulse
black
JUMPSTART Triage:
~Not able to walk
~not breathing –> apneic after adjusting airway
~palpable pulse
~begins breathing after 5 rescue breaths
red
JUMPSTART Triage:
~Not able to walk
~not breathing –> apneic after adjusting airway
~palpable pulse
~still apneic after 5 rescue breaths
black
JUMPSTART Triage:
~Not able to walk
~breathing
~ RR> 45 or RR<15
red
JUMPSTART Triage:
~Not able to walk
~breathing
~ RR = 15 - 45
~no palpable pulse
red
JUMPSTART Triage:
~Not able to walk
~breathing
~ RR = 15 - 45
~palpable pulse
~”A”, “V”, “P” response appropriate
yellow
JUMPSTART Triage:
~Not able to walk
~breathing
~ RR = 15 - 45
~palpable pulse
~”A”, “V”, “P” response inappropriate
red
Adult Trauma Alert Red Criteria (1 needed)
~Active airway assistance required
~no radial pulse with sustained HR > 120 or SBP < 90
~multiple long bone fracture sites
~2nd/3rd deg burns > 15% BSA
~electrical burns (high voltage/direct lightning) regardless of BSA
~amputation proximal to wrist or ankle
~penetrating injury to head/neck/torso
~BMR < 4 or exists presence of paralysis/ suspicion of spinal cord injury
~loss of sensation
~GCS < 12
~paramedic judgment
Adult Trauma Alert Blue Criteria (2 needed)
~sustained RR > 30
~sustained HR > 120
~single long bone Fx site due to MVA
~single long bone Fx site due to fall > 10 feet
~major degloving
~flap avulsion > 5 inches
~GSW to extremities
~BMR = 5
~ejection from vehicle (excluding open vehicles)
~deformed steering wheel
~older pt > 55 yrs on anticoags
~blunt abdominal injury
Pedi Trauma Alert Red Criteria (1 needed)
~assisted or intubated airway
~AMS
~paralysis
~suspected spinal cord injury
~loss of sensation
~faint or nonpalpable carotid or femoral pulses
~SBP < 50
~any open long bone fx
~multiple Fx sites
~multiple dislocations
~major soft tissue disruption (i.e. major degloving, major flap avulsion)
~amputation proximal to wrist or ankle
~2nd/3rd deg burns to 10% BSA
~electrical burns (high voltage, direct lightning) regardless of BSA
~penetrating injury to head/neck/torso
~paramedic judgment
Adult Trauma Alert Blue Criteria (2 needed)
~amnesia
~reliable HX of loss of consciousness
~carotid or femoral pulses palpable
~no pedal pulses
~SBP < 90
~single closed long bone fx site
~blunt abdominal injury
~red, purple < 11 kg (<24 lbs)
Level 2 Adult/Pedi criteria
~falls > 12 feet (adult)
~falls > 6 feet (pedi)
~extrication time > 15 min
~rollover MVC
~burns involving face/eyes/ears/hands/feet/ perineum that may result in functional or cosmetic impairment
~death of occupant in same passenger compartment
~major intrusion into passenger compartment
~separation from bicycle
~pedestrian struck by vehicle not meeting preceding automatic criteria (i.e. adults < 15 mph and pedi < 5 mph)
~fall from any height if pt > 55 yrs & on anticoags
~paramedic judgment
Cardiac (Trauma) arrest resulting from electrocution or lightning injury
immediate defibrillation
4 presumptive signs of death not needing to be resuscitated
apneic
pulseless/agonal
fixed/dilated pupils
injury incompatible with life
Tx if patient has sustained penetrating or blunt chest trauma & are in cardiac arrest
bilateral needle decompression
tx for penetrating junctional trauma (neck, axillary, thoracic, abdominal, pelvis, groin) not easily controlled using direct pressure or tourniquet
clotting agent
tx - burn injuries
~stop burn process by irrigating using room temp water or NS
~don’t attempt to remove tar, clothing, etc if stuck to skin
~monitor airway, consider intubation if respiratory involvement
~remove jewelry/watches from burned area
Tx :
1st/2nd deg burns < 15% BSA
3rd deg burns < 5% BSA
dry sterile dressing
OR
Burn gel/burn sheet
Tx :
2nd deg burns > 15% BSA
3rd deg burns > 5% BSA
dry sterile dressing
OR
Burn gel/burn sheet
1 L NS, assess LS (adult)
20 mL/kg NS (pedi)
TX:
Electrical burns
treat associated burns as indicated
TX:
chemical burns
~irrigate liquid chemical burns with copious amounts of water or sterile solution
~brush off dry chemicals prior to irrigation
~remove patient’s clothing & ensure pt is decontaminated prior to transport (personnel shall wear protective clothing and/or respiratory protection as needed)
TX:
Crush injury/compartment syndrome
1 L NS
pain management
Definition of crush syndrome
~entrapment with compression lasting longer than 4 hours
OR
~compression on thorax for 20 min
