Trauma

Question 0

What 3 criteria need to be in place in order to perform a needle decompression.

Answer 0

1) Severe respiratory distress
2) SBP less than 90 or loss of radial pulse due to shock
3) Unilateral decreased breath sounds with hx of chest trauma

Question 1

What to titrate BP in a trauma pt?

Answer 1

90-100 for pt meeting trauma triage protocol….for pt meeting physiological criteria start a second line.

Question 2

Where to perform a needle decompression?

Answer 2

On the affected side @ 2nd intercostal space- mid clavicular line

Question 3

What gauge needle is used for a needle decompression ? What length?

Answer 3

14g

3.25” long

Question 4

Optional site for needle decompression.

Answer 4

3rd or 4th intercostal space, anterior axillary line

Question 5

Amputation Treatment
Dressing?
What to do with amputated part?

Answer 5

Dress stump with dry sterile dressing.
Place amputation in sterile, dry container or bag and close.
Place first container in second container or bag and tie it closed.
Place on ice-amputated part should not directly contact ice or water.

Question 6

How to dress Evisceration of Abdomen?

Answer 6

Cover with large saline soaked dressing. Do not replace abdominal contents.

Question 7

How to treat a flail chest?

Answer 7

Stabilize injured side with pillow or hand. Remove if Respiration deteriorate or pressure does not help with the pain.

Question 8

How to treat impaled object?

Answer 8

Only remove when interferes with CPR. Or if impaled object interferes with airway.

Question 9

How to treat open chest wound?

Answer 9

Cover with an occlusive dressing and tape on 3 sides loosely.

Question 10

If open chest wound and occlusive placed…then S/S develop of decreased breath sounds, distended neck veins, dyspnea, failing BP….what do you do?

Answer 10

Remove dressing and allow air to escape.

Question 11

If you have a angulated Fx with no pulse what do you do?

Answer 11

Attempt to gently straighten, unless pain or resistance is met, and splint

Question 12

If fx is angulated and good pulse…how to treat

Answer 12

Splint in position unless transport would be compromised

Question 13

Open fx treatment.

Answer 13

Moist sterile dressing….only exception is open femur fx.

Question 14

Treatment of chemicals-acid or alkali

Answer 14

Irrigate profusely

Question 15

What happens if you go over 10 minutes of scene time.

Answer 15

You must document why.

Question 16

When to start a second IV on a trauma pt.

Answer 16

If pt meets physiological criteria start a second large bore IV

Question 17

Hemorrhage Control in trauma pt

Answer 17

first method of control is direct pressure. If unable to control, see hemorrhage policy.

Question 18

If you have a occlusive dressing taped down and you start getting signs of tension pneumo (name 6) you should do what?

Answer 18

Remove the dressing allow air to escape and reapply dressing.

Question 19

If severely angulated fx what do you do_____

Answer 19

May gently straighten. Check pulse before and after positioning.

Question 20

Open fractures should be treated with ___________ and not reduced. The exception would be a ______________ to an ___________. in this case, it is essential to notify hospital staff of the presence of an _____ ________

Answer 20

moist sterile dressing
traction splint
open femur fracture
open fracture

Question 21

Eye injuries- Chemical : acid or alkali

Answer 21

irrigate with water or normal saline on all chemical injuries. Irrigate profusely until the pt reaches the hospital.

Remove contact lens

Question 22

Eye injuries - trauma -

Answer 22

Cover both eyes loosely with protective dressing and avoid pressure to globe.

Spinal immobilization when indicated.

Position pt, sitting upright if comfortable.

Note: impaled object should be stabilized, not removed. Embedded foreign bodies in eye- cover both eyes.

Question 23

Head Trauma

Answer 23

Oxygen
Airway adjunct
Spinal immobilization- tx while immobilized with backboard on side if airway problems occur.

If in shock, treat according to shock protocol.

Scalp hemorrhage can be life threatening - dress with a pressure dressing.

Further assessment - check for : AVPU

Question 24

Trauma - supplemental oxygen

Answer 24

Use lowest concentration greater than 94%