Trauma Critical Guidelines

Question 1

What are the three different types of time critical emergencies?

Answer 1

• Actual
• Emergent
• Potential

Question 2

What is actual time critical?

Answer 2

• at the time the vital signs survey is taken, the patient is in actual physiological distress

Question 3

What is Emergent time critical?

Answer 3

• At the time of the vital signs survey is taken,** the patient is not physiologically distressed** but does have a pattern of injury or significant medical condition which is known to have a high probability of deteriorating to actual physiological distress

Question 4

What is potential time critical?

Answer 4

• at the time the vital signs survey is taken, the patient is not physiologically distressed and there is no significant pattern of actual injury/illness, but there is a mechism of injury/illness known to have the potential to deteriorate to actual physiological distress

Question 5

What is the triad of death?

Answer 5

• hypothermia, acidosis and coagulopathy
• increases mortality in trauma
• we only really have control of hypothermia as paramedics

Question 6

What is the time critical CRITERIA for an adult?

Answer 6

• HR <60 or >120
• RR <10 or >30
• SBP <90
• Sats <90%
• If > 16 years - GCS <13
• if <15 years GCS <15

Question 7

In a trauma, if the abnormal vital sign is an isolated reduction in GCS in a patient age >65 years who suffered a fall <1m in the metripolitan region?

Answer 7

• transport to the nearest Metropolitan Neurosurgical facility

Question 8

What are the injuries meeting POTENTIAL major trauma criteria?

Answer 8

All penetrating injuries (except isolated superficial injuries)

Blunt injuries
- serious injury
to a single body region such that specialised care of intervention may be required or such that life, limb or long term quality of life, limb or long term quality of life may be at risk
- significant injuries involving more than one body region

Specific injuries
- limb amputation or limb threatening injury
- suspected SCI or spinal fracture
- Burns >20% TBSA or >10% on <15 year olds
- Respiratory Tract Burns
- High Voltage (>1000 volts) burn injury
- Serious crush injury
- Major compound fracture or open dislocation
- Fracture to 2 or more of femur/tibia/humerus
- Fractures pelvis

If the pt hits any of this criteria, transport to highest level of trauma service within 60 mins

Question 9

What is the high risk criteria for major trauma?

Answer 9

(PEEP MH FS)

Assess for mechanism of injury:
- pedestrian impact
- ejection from vehicle
- explosion
- prolonged extrication

• motor/cyclist impact >30km/hr
• high speed MVA >60km/hr
• fall from height >3m
• struck on head by object falling >3m

AND CO-MORBIDITIES
- Age <12 or >55
OR
- Pregnant
OR
- Significant underlying medical condition

If they meet any of this criteria -> t/f to trauma service in less than 60 minutes