Trauma 3 Flashcards
What are the indications for TXA?
Trauma with signs of shock/hypoperfusion in association with injury suggestive of occult or ongoing bleeding.
>16 years
Systolic BP <90mmHg
HR > 110 bpm
Within 3 hours from time of injury and on route to receiving hospital.
What must you do before administering TXA?
Complete primary
Begin transport
Obtained base set of vitals
Initiated hypovolemia protocol
What is TXA not indicated for?
isolated head trauma
significant external hemorrhage
trauma with a low risk of serious hemorrhage
When should you consider pelvic binding?
Any blunt trauma pt if: pelvic instability hypotensive (<90) tachycardia (>100) GCS <14
How does a concussion present?
mild ALOC (13/14)
N/V
repetitive
MVA, sports, falls
How does an epidural hematoma present?
brain bleed
MVI, assaults, falls
lucid period can be seen (about 50%), followed by progressive deterioration.
Declines as the bleed causes more pressure.
How does a subdural hematoma present?
usually results from ruptured veins between the dura and arachnoid layers.
changes to your mood, concentration or memory problems, fits (seizures), speech problems, and weakness in your limbs.
risk factors: alcohol abuse and old age.
How does a subarachnoid hemorrhage present?
with CVAs, SAH comes from ruptured arteries.
with trauma, can occur in different locations.
at risk for increased ICP
What is an intracerebral hemorrhage?
increased ICP
similar to a stroke
What is a diffuse axonal injury?
primary injury (little can be done to reverse it) the shearing (tearing) of the brain's long connecting nerve fibers (axons) that happens when the brain is injured as it shifts and rotates inside the bony skull.
How do you decrease pressure in a TBI?
head of bed above 30 degrees
ensure hard collars aren’t on too tight
don’t ventilate a TBI patient too quickly or with huge volumes.
What are the TBI VS guidelines?
SpO2 >95%
Systolic BP > 120mmHg
What should trigger your suspicions about the potential for child abuse or neglect when you are responding to a call?
injury doesn’t coincide with the child’s developmental stage.
changing stories
child’s interaction with the parents
What should you try to document and how should you document it when responding to potential child abuse?
bruising and marks location healed injuries claimed injury who says what-direct quotes how the child reacts
Bruising and marks: what is important to know about bruising and marks?
various stages of healing circumferential pattern makrs patchy hair bruises on the upper arms, upper legs, trunk, side of face, ears bruising on both sides of the body any bruising under 6 months
What makes burns suspicious on children?
encircling no splash marks a clear line genital burns pattern burns
How do patients present who may be the victim of Abusive Head Trauma?
there may be no external marks seizures drowsiness apnea accidental falls
How does violent shaking injure babies?
subdural hematoma
irreversible brain damage
What makes fractures suspicious?
young age (< 18 months)
multiple healed fractures
rib fractures
more than one broken bone
How is neglect defined?
A child’s baseline needs are not being met
How does a child with failure to thrive present?
they haven’t grown adequately
medical neglect
starvation
being left alone
What should you report when you call the Ministry Reporting Line?
name of the child
where they live
objective details
What are the 5 major functional areas of the ICS?
Command Operations Planning Logistics Finance/Administration
What are the responsibilities of the Incident Commander?
Develops incident objectives and approved resource orders and demobilization