Trauma Overview Flashcards
- What is shock?
Inadequate tissue perfusion
Inadequate amounts of O2 and glucose are delivered to cell
Impairing amount of waste products in body
- What is aerobic vs. anaerobic metabolism?
Aerobic metabolism is metabolism (production of energy) using oxygen
Anaerobic metabolism is metabolism in the absence of oxygen
Not sustainable as it causes decrease in ATP and increase in acid; induces sodium/potassium pumps to fail which brings sodium and water into the cell causing it swell and burst
- What are the 3 basic etiologies of shock?
1) Inadequate volume (hypovolemia): decreased blood volume = decrease in preload, which causes stroke volume and cardiac output to fall. Decr. in cardiac output drops systolic blood pressure (which is responsible for transporting the oxygenated blood throughout the systemic circulation). Decr. in systolic BP=inadequate tissue perfusion.
a. Hemorrhage=Loss of blood. Needs increase in blood volume to restore adequate perfusion. Losing whole blood= Needs administration of packed red blood cells and plasma to incr. oxygen-carrying capability of blood and improve pressure and perfusion.
b. Non-hemorrhage or hypovolemic=Loss of plasma/fluids. Resulting from excessive urination/diarrhea/burns/vomiting. Needs to have the fluid or water portion of his blood restored.
2) Inadequate pump function: if the pump fails, regardless of blood volume, delivery of oxygen and glucose to cells will decr.
Pump function failure results from injury to the heart that reduces its ability to generate contractions strong enough to push the blood forward throughout the body. Ex. heart attack. Can also be caused by mechanical obstruction of movement of blood. Pt requires improvement of pump function to eliminate shock state.
3) Inadequate vessel tone: tone is related to the size of the vessel and the resistance created within it and is referred to as systemic vascular resistance/peripheral vascular resistance. As vessel size decr., resistance incr. result is an increase in BP, which is governed by both CO and SVR. Incr. vessel size=reduced pressure and reduced preload and cardiac ouput, decr. in BP and diminished tissue perfusion.
- What are the 5 categories of shock? Pathophysiology of each? Examples of each?
- Hypovolemic shock=shock caused from a low blood volume. The most common form of shock. Can be due to blood loss or loss of some other body fluid. Basically any condition or injury that results in a reduction in fluid decreases blood content or fluid portion.
a. Most common=hemorrhage=loss of whole blood (ex. laceration, bleeding from gastrointestinal tract)
b. Non-hemorrhagic=hypovolemia associated w/ fluid loss from burns and dehydration - Distributive shock = associated with a decrease in intravascular volume caused by massive systemic vasodilation and an increase in capillary permeability. No fluid loss or blood loss but rather a relative reduction in volume because vessels incr. in size. Decr. in tissue perfusion.
- Cardiogenic shock = ineffective pump function of the heart. Adequate blood volume and vessel tone, but hypoperfusion because the heart cannot contract effectively.
a. Left ventricle fails to generate enough force to eject sufficient blood from the chamber into the system circulation, reduction in stroke volume, cardiac output, and systolic blood pressure; poor tissue perfusion - Obstructive shock = condition that obstructs forward blood flow. Volume is adequate, heart is not damaged, and vessels are of a normal size with adequate resistance. An obstruction is not allowing the blood to move forward. Large clot that will prevent adequate amount of blood from getting to lungs (pulmonary embolism) will prevent an adequate amount of blood from getting to left atrium and left ventricle, reducing preload and stroke volume, cardiac output, systolic BP, and tissue perfusion.
- Metabolic or respiratory shock: dysfunction in ability of oxygen to diffuse into blood, be carried by hemoglobin, off-load at the cell, or be used effectively by the cell for metabolism.
a. Ex. poison like cyanide, CO poisoning, etc.
- What is MODS? When does it occur? How might it be related to disseminated intravascular coagulation (DIC)?
MODS - Multiple organ dysfunction syndrome
Occurs - When multiple organs begin to fail throughout the body from extreme and prolonged hypoxia, altered metabolism, and evaluated carbon dioxide and acid levels.
Relation between MODS & DIC - MODS is not a single event but a continuous process. One such event that might occur is the production of microemboli that begin to block capillaries throughout the body, leading to lung failure, kidney failure, and multiple organ failures. Clotting factors are used in the formation of the microemboli in the blood. The body responds to the clots by releasing substances to attempt to break them up. Because the clotting factors were used up in the formation of the microemboli, the substances that are released to break down the clots are unopposed in the body and lead to widespread uncontrolled bleeding from any wound that was previously clotted, from intravenous catheter sites, from mucus membranes, and from the skin.
- Name three examples of obstructive shock, and explain the etiology of each.
Tension Pneumothorax - same as Pericardial tamponade → see below
Pulmonary embolism - A large clot that obstructs blood flow in the lungs will prevent an adequate amount of blood from getting to the left atrium and, subsequently, the left ventricle. This reduces the preload and decreases the stroke volume, cardiac output, systolic bp, and tissue perfusion.
Pericardial tamponade/Tension Pneumothorax - Prevent adequate ventricular filling and compress the heart. This reduces the preload, stroke volume, cardiac output, systolic BP, and tissue perfusion. Once the pressure is relieved, the heart regains its normal function. Although the pump function of the heart is disturbed, once the condition is reversed and the pressure on the heart is relieved, it functions normally.
- What are the s/s of the following types of shock: hemorrhagic hypovolemic vs. burn vs. anaphylactic vs. septic vs. neurogenic vs. cardiogenic?
Hemorrhagic hypovolemic: low blood pressure, cool/pale/clammy skin, increased HR
Burn: increased HR, cool/pale/clammy skin, (similar to hypovolemic)
Anaphylactic: altered mentation, low blood pressure, airway concerns, swelling, angioedema (lips, tongue, epiglottis, bronchioles swelling)
Septic: low blood pressure
Neurogenic: loss of consciousness, low blood pressure, lowered HR
Cardiogenic: rapid HR, low BP, pale/cool/clammy skin
- What are the 2 stages of shock? Signs/symptoms of each?
Compensatory: pale/cool/clammy skin, elevated HR and RR, slightly dilated pupils, narrow pulse pressure, anxious/restlessness, normal SBP
Decompensatory: BP dropping, altered mentation/unresponsive
IMPORTANT: the two s/s that indicate a shift from compensatory to decompensatory is altered mentation and decline in SBP
- What 2 body systems play the biggest roles in the body’s response to shock? What does each do?
The nervous and endocrine system
Nervous: Sympathetic nerve stimulation; vasoconstriction
Endocrine: Releases Hormones; norepinephrine and epinephrine stimulate alpha-1 receptors on arterioles that cause vasoconstriction and regulate blood pressure
- What are EMT treatments for shock?
- O2
- Stop any external bleeding
- Splint any fractures
- Supine position
- Blanket
6.Rapid Transport
- What is the formula for determining the lower limit of the SBP for a child less than 10 yoa?
Low SBP = 70 + 2(age in years)
- How does IV fluid replacement help hemorrhagic shock? What are its limitations?
IV fluid is a volume expander -> it takes the place of missing blood in vessels. The limitations are that it can’t carry oxygen to cells.
- How do geriatric patients differ in their response to shock?
Geriatric patients have a slower compensatory period, but a faster decompensatory period
- How do pediatric patients differ in their response to shock?
Pediatric patients have a faster everything (compensatory period, decompensatory period)
What is meant by “mechanism of injury” and “index of suspicion”?
Mechanism of injury - Is the force or forces that cause injury when applied to the human body.
Index of suspicion - is defined in medicine as the level of suspicion that a disease or condition is the underlying diagnosis based on the available findings in the patient.
What is the most significant factor in the transference of kinetic energy?
Rapid acceleration and deceleration
How many collisions are there in a typical MVC? What occurs with each one?
First, the vehicle is suddenly stopped and gets bent out of shape. This is called the vehicle collision.
Next, the patient comes to a quick stop on some part or parts of the inside of the vehicle, such as the steering wheel, causing injury to the chest. This is called the body collision.
Finally, there is the organ collision in which the patient’s internal organs, which are all suspended in their places by tissue, come to a quick stop, sometimes striking an inside surface of the body (e.g., the inner chest wall or the inner skull).
What are 2 pathways that might result from a frontal collision? What injuries are associated with each?
Abdomen: As abdomen strikes the dashboard or steering wheel, the liver, spleen, and hollow organs of the abdomen are compressed between the front and back abdominal walls and spine. The hollow organs are more easily displaced, leaving the solid liver and spleen to bear the brunt of the compression.
Chest: As the chest hosts the dashboard or the steering wheel, bones and soft tissues are both affected. The ribs and sternum can break, and the cartilage connecting the ribs to the sternum may separate. A torn intercostal artery can bleed 50 mL per minute into the chest cavity with no blood seen externally.
What injury patterns might you expect with rear and lateral impact MVCs? With rollover?
Rear:
Whiplash (injury to the neck and spine) (Hyperextension: head is pushed back all the way or Hyperflexion: Head is pushed forward, nearly touches your dashboard) which can shift the brain vertebrate and can potentially break the neck and spinal chord (if there is no headrest).
Coup-contrecoup injury (Anterior and posterior bruise on the brain. Happens when head hits headrest so fast; the brain pushes against occipital and then the frontal bone, causing the bruises)
Lateral:
Can be deadly because of the extreme impact on the side of the car (less protection). Spinal injury, broken bones, blunt-force trauma. Neck, head, chest, pelvis injuries
Rollover:
Many injuries, Both head on and lateral injury patterns, Multiple system injuries, Ejection (death 25x more likely), Crushing injuries, injuries to head, neck, spine, face, eye, arms from airbags
In a vehicle vs. pedestrian collision, what injury differences might you expect between child vs. adult?
Adults turn away from vehicle (side impact, thrown onto hood): leg, back, torso, shoulders, arms, abdomen, head, and neck injuries
Children turn toward vehicle (front impact and are so small they’re thrown forward and ran over) and tend to have Waddell’s Triad: femur, chest/abdomen head injuries
The extent of injury pedestrians experience depends on how fast the car is going, what part of the pedestrian’s body was hit, how far they were thrown, what surface they landed on, and the body part that first hit the ground
What is the proper position for a car seat?
Secured rear facing in the back seat
Reclined 45 degree angle
What injuries might you expect from seatbelts? From airbags?
Head, neck, spine, face, eye, arms
What are some limitations of airbags?
Airbags only work once.
The driver may still hit steering wheel after deflation.
Front airbags don’t protect from side impact.
- What are 3 questions you need to ask regarding any fall?
Distance, surface, and body part impacted first
What constitutes a severe fall for an adult vs. child?
Adult - A fall of 20 feet onto an unyielding surface is considered severe for an adult.
Child - A fall of 10 feet, or 2-3 times the height of the child, can cause severe injuries to a child.
What injuries might you suspect with feet-first falls? With head-first falls?
Feet first: fractures of the heels, ankles, tibia/fibula, femur, knee dislocations, hip injury, and spine compressions.
Head first: colle’s or smith’s fracture, elbow injury, shoulder dislocation, clavicle fractures, and damage to the cervical spine.
What MOI details are important to gather regarding a knife injury?
How far into the body it penetrates
The angle of penetration
Slice vs. stab
Underlying organs
The cone of damage
What is cavitation? How does this relate to the entrance vs. exit wounds of a bullet?
When a bullet travels through tissue, it creates a cavity, but there is also air pressure that is moving perpendicular to the bullet that is about 4x the width of the bullet. This creates a temporary cavity. This cavity then recedes and leaves a cavity that is about twice the size of the bullet.
This means the trauma caused by the bullet will be about 4 widths of the bullet
Because of cavitation, the exit hole of a bullet is larger than the entrance wound. The skin is pushed outwards and oftentimes we see tearing or splitting.
- What are the 5 phases of a blast? What injuries occur in each?
Primary - Due to pressure wave of the blast, it affects gas containing organs such as lungs, stomachs, inner ears, sinuses. Severe damage and death can occur without signs of external injury.
Secondary - Flying debris propelled by force of blast. Obvious injurys like lacerations, impaled objects, fractures, and burns
Tertiary - When a patient is thrown away from a blast. Injuries are similar to ejection from a vehicle. The pattern depends on distance thrown and the point of impact
Quaternary - Result from structural collapse; something landing on top of someone
Quinary - Result of chemicals/toxins/bacteria/radiation; something comes upon one after landing
What is the meaning of the “golden period”? “Platinum 10”?
The “golden period” has been established as a parameter for emergency care because severely injured patients have the best chance for survival if intervention takes place as quickly as possible from the time of injury
Some EMS systems refer to the “platinum 10 minutes.” This means that in cases of severe trauma, 10 minutes is the maximum time the EMS team should devote to on-scene activities—with patient assessment, emergency care for life threats, and preparation for transport all being accomplished within 10 minutes of arriving on the scene. The patient should be loaded into the ambulance and transport should begin within 10 minutes after arriving on the scene of a severely injured or multisystem trauma patient.
How much blood volume does an average size adult have?
5 liters
What difference in bleeding does it make when a vessel is cut at 90 degrees vs. lengthwise?
90 degrees will bleed less because vessels will contract and dilate better
. What are the differences between these bleeds: arterial vs. venous vs. capillary? Which are major bleeds?
Arteries: Spurting blood, pulsating flow, bright red color
Oxygen rich
Pulsating - Coincides with force of contraction of the heart
Most difficulty to control from high pressure in arteries
Veins: Steady/slow flow, dark red color
Dark red - Deoxygenation
Steady.slow flow - Veins under less pressure
More profuse, but easier to control
Capillaries: Slow, even flow
Dark red
Slowly comes up
Easily controlled with pressure
Clots spontaneously
- How do you control an arterial bleed? What is the first thing an EMT should do?
This bleeding is identified as bright red, spurting blood from a wound usually indicates a severed or damaged artery. The blood is bright red because it is rich in oxygen. Spurting generally coincides with the pulse or contraction of the heart.
Controlling this can be difficult because of the higher pressure in the arteries; although the muscular walls can assist in hemostasis. Constant, hard, direct pressure of 20 minutes or more can be required to stop the arterial bleeding.
When is a tourniquet indicated? How do you apply it?
Indication - When external bleeding to an extremity is not controlled with direct pressure the immediate next step is to apply a tourniquet.
Application - Steps below
1. Wrap the tourniquet around the extremity at a point just proximal to the bleeding.
2.Tighten the tourniquet until the hemorrhage ceases and secure the device in place.
3.Write the time of the tourniquet application on tape and secure it to the tourniquet.
4. If bleeding continues, tighten the tourniquet
5. Notify the receiving medical facility that a tourniquet has been applied.
What is a hemostatic agent? How is it administered/applied?
Hemostatic agents are designed to improve clotting and control life-threatening hemorrhage that can’t be controlled with direct pressure. These agents come in two form: (1) a dressing, gauze, or sponge that is impregnated with the hemostatic agent and (2) a powder or substance that is poured directly into the wound.
Powder type hemostatic agents are no longer recommended for prehospital use
After the wound is packed with the hemostatic gauze, sponge, or dressing, it is recommended that a minimum of 3 minutes of direct pressure be applied.
Where on the body might a hemostatic dressing be used to pack a wound?
The hemostatic agents are used for bleeding that can’t be controlled with direct pressure in wounds to areas of the body where a tourniquet can’t be applied.
When/where do you use an occlusive dressing?
Occlusive dressings create an air tight seal for an open abdominal or chest wound (3 sided dressing) or large neck wound. Petroleum occlusive dressing prevents adhering to open wound. Dressing (should be sterile) covers an open wound to control/aid the bleeding and prevent further damage and contamination
How can a splint help with internal bleeding?
Splinting the extremity can assist with control of bleeding associated with a possible fracture because the splint can decrease movement at the site of the bleeding wound
What are the s/s of blood loss? What is the earliest sign?
Pale/cool/clammy skin, rapid heart rate (first sign) , weak/thready pulse, narrow pulse pressure, lightheadedness/dizziness/confusion, rapid shallow breathing
Always suspect internal bleeding when penetrating wounds to skull, chest, abdomen, or pelvis; unexplained signs of shock
. What is a contusion vs. hematoma vs. abrasion vs. avulsion vs. laceration vs. crush vs. amputation?
Abrasion: scraping of epidermis, usually just capillary bleeding, extremely painful due to exposed nerve endings
Laceration: cut/incision in skin, may be deep
Avulsion: torn flap of skin hanging loose, bleeding may or may not be severe, prolonged healing
Amputation: body part completely removed/body part is “discontinued” (can still be partially attached still, but do not complete amputation)
Crush: usually result of blunt trauma or crushing forces, consider underlying organs and internal bleeding, open or closed
Contusion: bruise (black and blue discoloration is called ecchymosis), injury to tissue/vessels in dermis
Hematoma: similar to bruise but damage to larger vessel and larger amount of tissue, large lump with bluish coloration due to pooling of blood
What is a linear vs. stellate laceration? What type of trauma most often causes each?
Linear: smooth and regular, caused by knives, razors, broken glass
Stellate: jagged and irregular, caused by blunt objects. Edges of wound will be jagged. Healing process will be prolonged.
What is the treatment for an avulsion?
Rinse off wound to clear surrounding debris
Apply dressing and bandages to keep the avulsed tissue in place.
Splint the extremity to limit movement.
What is epistaxis? How do you control it?
Definition - epistaxis is a nosebleed
Treatment - consider the MOI, consider the airway. Make the patient lean forward, and apply pressure, pinch the nostrils, and use a cold pack for the nose. Make sure the patient does not blow their nose during/after the injury for at least 12 hours.
What is a clamping injury? How do you treat it? Why is it important to try to remove the clamping object?
Clamping injury - A clamping injury is defined when a body part is caught or strangled by some piece of machinery, a tool, or other object, or equipment.
Treatment - In general, if a body part is trapped in a clamping object and the patient is stable, apply a lubricant and slowly attempt to wiggle the part loose. If possible, evaluate the body part above the level of the patient’s head to decrease circulation pressure as you attempt to remove the part.
Importance of removal-
Timing is an important factor because the longer a part remains clamped, the more damage there can be. Also, edema makes removal more difficult over time.
How do you treat/bandage an evisceration?
Do NOT touch the organs
Cover the wound with sterile dressing moistened with water or saline. The dressing needs to be large enough to cover all of the organs
Use sterile gauze to cover the moistened dressing with occlusive dressing taped on all four sides
Maintain the temperature with bulky dressing
Use fiber-free abdominal dressing
Flex the patients hips and knees
What is the major risk of an open neck wound? What specific condition might this cause?
A major risk of an open neck wound is air embolism which can lead to pulmonary embolism.
How should you treat an open neck wound? What is the first thing you should do?
Place a gloved hand over the wound to control bleeding. (First thing you should do)
Apply an occlusive dressing, which should extend beyond all wound edges to avoid air or part of the dressing being sucked into the wound. Tape the dressing on all four sides.
Cover the occlusive dressing with a regular dressing.
Apply only enough pressure to control the bleeding. Compress the carotid artery only if it is severed and it is necessary to control bleeding.
After bleeding is controlled, apply a pressure dressing, taking care not to restrict airflow or compress the major blood vessels in the neck. Such a dressing should not be applied circumferentially around the neck. (Direct pressure is preferred.)
If there is a suspected spinal injury, provide appropriate spine motion restriction. Spinal injury should always be suspected with any significant injury or MOI to the neck.
How do you treat/bandage an amputated digit? What do you do with the amputated part?
Remove any gross contamination by flushing with sterile water or saline. Never immerse the part in water or sterile saline because this can damage it.
Apply direct pressure to the stump to control bleeding. Apply sterile dressings and bandages
Wrap the part in a dry sterile gauze dressing. (Check with local medical direction, which can dictate the use of moist dressings instead.)
Wrap or bag the amputated part in plastic. Place it in a watertight plastic bag or plastic wrap in accordance with local protocol. Do not allow the amputated part to be immersed in the water. Label the bag with the patient’s name, date, and time the part was wrapped and bagged.
Keep the amputated part cool. Place the wrapped and bagged part in a cooler or other suitable container with an ice pack or ice on the bottom to keep the part cool. Do not place the part directly on the ice pack or ice to avoid any possibility of freezing the part. The container should also be marked with the patient’s name, date, and body part.
Transport the part with the patient, if possible. In some cases, however, this might not be possible, especially when the part has not been located. In this instance, arrange for immediate transport of the body part, after it is found, to the same facility to which the patient has been transported.
Note: If an amputation is incomplete and the body part is still partially attached, do not complete the amputation. Care for the wound as previously described, but also make sure that the partially amputated part is not twisted or constricted. Immobilize the injured area to prevent further injury.
What special considerations should you have for a dog bite?
Infections -> Wash/dress/bandage
Even if not transported, many patients with bites and other open soft tissue injuries should receive tetanus prophylaxis within 72 hours of injury
When can you remove an impaled object?
Only if it is obstructing airway
What is the difference between dressing vs. bandage?
Dressing is completely sterile, goes on wound for bleeding control/prevention of contamination
Banading; non-sterile (yet clean), holds dressing in place
What are some factors that may increase bleeding?
Some of these factors include: movement, coldness, anticoagulant meds, & removal of bandage
What are the 3 layers of the skin? What layer contains most nerve receptors?
Layers of skin: Listed below
Epidermis - Outermost layer
Dermis - middle layer
Hypodermis (also called the subcutaneous layer) - the innermost layer of the skin
Most nerve receptors - The dermis
What kills most burn patients in the prehospital setting? What kills them later?
Pre-hospital setting - In burns with over 40% of the total body surface area, 75% of all deaths are currently related to sepsis from burn wound infection or other infection complications and/or inhalation injury.
Death at hospital setting - Sepsis infection from the burn.
Why is a patient with a significant burn susceptible to hypothermia?
Patients with significant burns are prone to hypothermia due to the loss and degradation of skin–a large component of thermoregulation in the body
What is “burn shock”? What is its pathophysiology? When does it occur?
A condition that can occur with moderate to major burns that cover sufficient body surface area (BSA) is called burn shock. Burn shock, which develops only after the first few hours, results from extensive vascular bed damage that allows both fluid and protein molecules in the plasma to leak into surrounding tissues.
The loss of plasma proteins causes the normal fluid balance of the rest of the vascular system to become disturbed and, as a result, blood plasma starts to seep from all capillary beds (even those not involved in the burn itself). The result is a large fluid shift out of the vessels and into the spaces surrounding the cells to a point where the total vascular volume is insufficient to meet the body’s needs. This also explains the extensive swelling seen in the burn patient.
In the first 24 hours after a burn injury, because of the fluid loss from the vessels into the tissues, the edema can cause the body to swell to double its normal size.
What are the classifications of burns by depth? What are the s/s of each?
Superficial (1st degree burn): Injury involves only epidermis, skin appears red, pink and dry, some swelling may occur, no blisters, skin is soft and tender to the touch. May be very painful because pain receptors in underlying dermis to the skin is still intact. Examples: sun burn, minor skulled injury
Partial thickness (2nd degree burn): Involves epidermis and portion of the dermis, damage to small blood vessels cause plasma and tissue fluid to collect in between the layers of the skin and form blisters, patient may still complain of burns because pain receptors are still intact. May be further classified as superficial partial thickness and deep partial thickness
Full thickness (3rd degree burn): Involves all of the layers of the skin. Skin becomes dry, hard, tough, and leathery, and may appear white and waxy to even dark brown to black and chard (the tough and leathery dead soft tissue formed in a full thickness burn: called eschar)
Why is there no pain at the site of a full-thickness burn?
Because nerve endings have been destroyed. Second degree burn around them, however, can be extremely painful
What is a “critical” burn?
A critical burn requires immediate medical attention and are potentially life threatening, disfiguring, and disabling
Burns to face, eyes, ears
Hands and feet
Genital or groin
Major joint function like hips or shoulders
Why are circumferential burns critical?
Encircle a body area
Circulatory compromise (decreased or complete lack of consciousness) and nerve damage due to swelling of tissue
What is the “rule of nines”? For adults vs. children?
Body part
adult
child
Head and neck
9%
18%
Posterior trunk
18%
18%
Anterior trunk
18%
18%
Each upper extremity
9%
9%
Each lower extremity
18%
14%
External genitalia
1%
n/a
What is the “rule of palms”?
Rule of palms - An alternative way to determine the BSA estimate is to compare it to the patient’s palm surface area with the fingers closed, which equals approximately 1% of the BSA. Also known as the rules of ones.
What needs to be done for a burn victim during the primary assessment and within 10 minutes of a burn?
Removing the patient from the burn source does not completely stop the burning process. Both injuries need to be “cooled down” within approximately the first 10 minutes of injury. Stop the burning process initially by using water or saline. As you work to stop burning, attempt to remove any smoldering clothing and any constricting jewelry, which produce heat and might constrict swollen extremities. Cure around clothing still adhering to the patient. Do not attempt to remove the adhered portion, b/c can cause further damage to soft tissues.
Afterwards: continue primary assessment and patient’s airway, breathing, oxygenation, and circulation. Look for indication that airway might be compromised (sooty deposits in mouth or nose, singed facial or nose hairs, signs of smoke inhalation, facial burns). SpO2 might give false high reading b/c of CO in blood.
How long should you cool a burn before dressing/bandaging it? Should you use water or ice?
Cool a burn for 60-120 seconds only using water
What are the s/s of inhalation injury on a burn victim?
Singed nasal hairs, possible colored/swollen tongue, hoarse voice, specks in the sputum, edema/swelling
How might a partial or full-thickness burn lead to compartment syndrome?
Partial thickness circumferential burns or full-thickness burns can lead to compartment syndrome from the edema collecting beneath the burn area
