Trauma Assessment & Mass Casualty Incidents and Triage

Question 1

Three conditions that often compromise ventilation

Answer 1

Tension pneumothorax

Open pneumothorax

Large flail section with pulmonary contusion

Question 2

3 Key Factors of Rapid Assessment

Answer 2

State of consciousness: perfusion to brain (<50% blood loss)

Skin color: pink skin of face and extremities = no significant hypovolemia

Pulse: Carotid or femoral pulse present = <50% blood loss

->50% loss means death is imminent

Question 3

Brief Neuro Exam

Answer 3

AVPU

Check pupillary size and reaction

Decrease in LOC during exam may indicated decreased cerebral perfusion

• check oxygenation, perfusion, and ventilation status

Glasgow coma scale is for secondary assessment

Question 4

Blunt Trauma

Answer 4

MC caused by auto accidents

Direction of impact determines injury pattern - talk to EMS

Patient’s injuries often mirror the car damage

Question 5

Frontal Impact with bent steering column and star-pattern on windshield

Answer 5

C-spine injuries

Central flail chest

Myocardial contusion

Fractured spleen/liver

Question 6

Side Impact Injury Pattern

Answer 6

Contralateral neck sprain or cervical fracture

Lateral flail chest

Pneumothorax

Acceleration injury to aorta

Fractured pelvis or acetabulum

Question 7

The 5 S’s

Answer 7

Safety Assessment

Scene Safety

Send Information

Setup

START

Question 8

START

Answer 8

Simple Triage And Rapid Treatment

Based on RPM - respirations, perfusion, mental status

Allows rapid assessment of victims

Do not take more than 15 sec/patient

Question 9

Virginia Triage Tag Concept

Answer 9

Red: highest priority - immediate

Yellow: second priority - delayed

Green: third priority - minor

Black: lowest priority - dead

Question 10

Red and Yellow Parameters

Answer 10

Red: Poor respirations, perfusion, mental status, and severe burns (life-threatening injuries)

• May survive with immediate life-saving measures
• Imminent risk asphyxiation or shock but can be stabilized

Yellow: Burns, major or multiple bone/back injuries (potentially life-threatening)

• Should survive if given care w/in a few hours
• Severely debilitating injury

Question 11

Green and Black Parameters

Answer 11

Green: Minor painful, swollen deformities, minor soft tissue injuries

-Walking wounded: minor injuries that do not require rapid care

Black: Deceased or non-salvageable

• Deceased or severely injured patients unlikely to survive
• Unresponsive with no circulation

Question 12

Respiration Assessment

Answer 12

Not breathing? - open airway

• Still not breathing = Black
• Starts to breath = Red

Respiratory Rate

• >30 bpm = Red
• <30 bpm = Check perfusion

Question 13

Perfusion Assessment

Answer 13

Radial pulse absent OR Cap refill >2 seconds = Red

Radial pulse present OR Cap refill <2 seconds = Move to Mental Status Assessment

Stop any gross hemorrhage along the way

Question 14

Mental Status Assessment

Answer 14

Give patient simple command - squeeze finger, blink eyes

• Doesn’t follow command = Red
• Able to follow command = Yellow

Question 15

Reverse Triage

Answer 15

Used for mass-casualty lightning injuries

Treat dead first - high potential for resuscitative success from respiratory arrest