Trauma Flashcards
What problem do you address first in a trauma case
greatest threat to life
Age group with highest trauma rate
Young adults in late adolescence/early 20s (Males > females)
Why were trauma teams developed
to address early/immediate deaths as as possible.
When would you activate Full Trauma
- Airway distress or intubated
- RR 20 per min
- Circulation (Pulse > 120, SBP
Full vs Limited trauma
Limited is activating the ER team
Who comes to Full Trauma Team alert
- ED/MD doc at head
- Trauma surgeon
- 2 RNs
- resp therapy (2)
- ED Tech
- Pharmacy (pediatric alerts only, sometimes adults)
- Runners for blood bank
- Fluid RN
- OR Charge nurse
- Recorder- typically ICU nurse
- Charge RN
Primary Survey in Trauma
C-ABCDE
- Catastrophic hemorrhage control
- Airway (and cervical spine control where appropriate)
- Breathing and Ventilation (with O2 where available)
- Circulation and Hemorrhage control
- Disability or Neuro deficit
- Extremity/Environment/Exposure
Meds/Allergies/ Past fam hx not important right now
What happens to everyone with GCS
Put in airway
Glascow Coma Scale
3-5 point scale
Best observed response
Modified for children
= 8 is a “coma” and requires intubation for airway protection
Limitations to GCS
Peds
Motor deficits- well quantified but deficits not given priority
EtOH, Intoxication, language barriers
2 most important vital signs in trauma
HR and BP
How to assess Neuro status
Talk to pt/ask questions and do physical exam
GCS
Adjuncts to primary survey
Chest Xray (tension pneumo, Pelvis Xray (fractures) FAST exam (fluid; can also check for pneumothorax if no chest xray) Diagnostic peritoneal lavage--not really done anymore
Secondary survey
Look at pt head to toe
Adjuncts to secondary survey
CTs
plain radiographs
blood tests
