Trauma standards Flashcards
What r the 6 Ps and an A
Paresis: muscular weakness
Paraesthesia: pins and needles
Paralysis: inability to move
Pain
Pallor
Pulse
Anaesthesia: loss of sensation
How do we treat first degree burns
Moist sterile dressing and then cover with dry dressing
How do we treat 2nd degree burns <15% BSA
Moist, sterile dressing
How do we treat 2nd degree burns equal to or over 15% BSA
Dry sterile dressing
How do we treat 3rd degree burns
dry sterile dressing
Describe the rule of 9s for BSA burn %
Front of head = 4.5%
Back of head = 4.5%
Chest = 9%
Back = 9%
Abdomen = 9%
Lower back = 9%
Front of one arm = 4.5%
Back of one arm = 4.5%
Genitals = 1%
Front of one leg = 9%
Back of one leg = 9%
Describe the parkland formula
4mL * BSA% * Weight(kg)
Give half over the first 8 hours, give the other half over the next 16 hours.
For abdominal/pelvic injury consider what potential life/limb/function threats
Rupture, perforation, laceration, or hemorrhage of organs or vessels in the abdomen and potentially in the thorax or pelvis
Spinal cord injury
How to do u irrigate bite injuries on a stable patient
up to 5 minutes
What life/limb/function threats do you consider for bite injuries
injuries to underlying organs, vessels and bones
If envenomation (from a bite) is know or suspected you should…?
Position the patient supine
Immobilize the bite area at or slightly below the heart level
Not apply cold packs
For chest injury consider what life/limb/function threats
tension pneumothorax
Hemothorax
Cardiac tamponade
Myocardial contusion
Pulmonary contusion
Spinal cord injury
Flail chest
If the patient has a penetrating chest injury assess for…
Entry and exit wounds
Tracheal deviation
JVD
Airway and/or vascular penetration
For head injury, observe for…
CSF from nose/ears
Mastoid bruising
Abnormal posturing
Agitation or fluctuating behaviour
Incontinence
Emesis
What are some s/s of cerebral herniation
Deteriorating GCS with;
Dilated and unreactive pupils
Asymmetric pupillary response
A motor response that shows either unilateral or bilateral decorticate or decerebrate posturing
How often should u do pulse and respiration check for suspected/known hypothermia
10 seconds
In absence of shivering, and LOC in decreased, what could u assume their body temp is?
below 32
In electrical injury, what life/limb/function threats to consider
Cardiopulmonary arrest
Dysrhythmias
Extremity neurovascular compromise
Multiple/severe trauma
Seizures
Significant internal tissue damage
How do u treat an alkali burn
irrigate for a min. of 20 minutes if pt is stable
How do u treat an acid burn
irrigate for a minimum of 10 minutes if pt is stable
How do u treat unknown chemical exposure
Irrigate for min. 20 minutes if pt is stable
In submersion injury consider what underlying disorders
Drug or alcohol consumption
Hypoglycemia
Cardiac dysrhythmias
Trauma
what are some suctioning complications
Gag reflex
Vagal stimulation / vasovagal response
Bradycardia
Laryngospasm
Soft tissue injury
Induce vomiting
Under the amputation/avulsion standard what potential life/limb/function threats should you consider
Hemorrhagic shock
Loss of limb
Loss of function
How do you take care of an complete amputation
cover the stump with a moist sterile dressing, followed by a dry dressing. Don’t constrict or twist remaining tissue
How do you take care of a partial amputation or avulsion
place the remaining tissue or skin bridge in as near-normal anatomical position as possible
How do you preserve amputated tissue
- If the part is grossly contaminated, gently rinse with saline
- Wrap or cover the exposed end with moist, sterile dressing
- Place the part in a suitable container/plastic (water-tight if possible) bag and immerse in cold water
Under the blunt/penetrating abdominal/pelvic injury standard, what potential life/limb/function threats should you consider
Rupture, perforation, laceration, or hemorrhage of organs and/or vessels in the abdomen and potentially in the thorax or pelvis AND spinal cord injury
Under the blunt/penetrating bite injury standard, what potential life/limb/function threats should you consider?
Injuries to underlying organs, vessels, bone
Specific to snake bite; anaphylaxis, shock, CNS toxicity, local tissue necrosis
Under the blunt/penetrating chest injury standard what potential life/limb/function threats should you consider?
Tension pneumothorax
Hemothorax
Cardiac tamponade
Myocardial contusion
Pulmonary contusion
Spinal cord injury
Flail chest
If a patient has a penetrating chest injury, what should you assess for
Entry and exit wounds
Tracheal deviation
JVD
Airway and/or vascular penetration
If the patient has a chest injury what potential problems should you prepare for
Tension pneumothorax
Cardiac tamponade
Cardiac dysrhythmias
Hemoptysis
How should you transport a patient with a blunt/penetrating eye injury
Supine, with head elevated approx. 30 degrees
Under the blunt/penetrating head injury, what potential life/limb/function threats should you consider
Intercranial and/or intracerebral hemorrhage
Neck/spine injuries
Facial/skull fractures
Concussion
Under the blunt/penetrating head injury what should you observe for?
Fluid from ears/nose
Mastoid bruising
Abnormal posturing
Periorbital ecchymosis
Agitation or fluctuating behaviour
Urinary/fecal incontinence
Emesis
What are the signs of cerebral herniation
- Dilated and unreactive pupils
- Asymmetric pupillary response
- A motor response that shows either unilateral or bilateral decorticate or decerebrate posturing
Under the traumatic head trauma injury standard what potential problems should you prepare for?
Respiratory distress/arrest
Seizures
Decreasing level of consciousness
Agitation or combativeness
Under the traumatic neck/back injury standard injury what should you observe for?
Diaphragmatic breathing
Neurological deficits
Priapism
Urinary/fecal incontinence/retention
For a traumatic neck/back injury, perform at a minimum, a secondary survey to assess what?
Airway and/or vascular penetration
Lungs, for decreased air entry and adventitious sounds through auscultation
Head/neck for JVD, and tracheal shifting
Chest for subcutaneous emphysema
Under the burn standard, what potential life/limb/function threats should you consider?
Airway burns
Asphyxia
Carbon monoxide/cyanide poisoning
Shock
Under the burn standard, perform at a minimum a secondary survey to assess what?
Area burned
Burn depth
Percentage of body surface area burned
And assess for signs of smoke inhalation and upper airway injury
Under the traumatic burn standard, what expected problems should you be prepared for?
Airway obstruction
Airway burns (bronchospasm, orolingual/laryngeal edema)
Respiratory distress/arrest
Agitation or combativeness
Under the cold injury standard, how do you treat mild to moderate hypothermia
Wrap the patients body/affected parts in a blanket or foil rescue blanket
Provide external re-warming to axilla, groin, neck, and head (hot packs, hot water bottles)
Under the cold injury standard, how do you treat severe hypothermia
Wrap the patient’s body/affected parts in a blanket or foil rescue blanket.
When suction is required, do not perform vigorous suctioning or airway manipulation as it may trigger ventricular fibrillation
What are some S/S of severe hypothermia
No shivering present
Unconscious patient with cold, stiff limbs
Slow/absent pulse and respirations
No signs of obvious death
How do you treat frostbite
Wrap the patient’s body/affected parts in a blanket or foil rescue blanket. Cover and protect the part.
Don’t rub or massage skin
Leave blisters intact
If dressing digits, dress digits separately
Under the electrocution/electrical injury standard, what potential life/limb/function threats should you consider?
Cardiopulmonary arrest
Dysrhythmias
Extremity neurovascular compromise
Multiple and/or severe trauma
Seizures
Significant internal tissue damage
What should you attempt to determine for an electrical injury?
Type of current and voltage
Under the electrical injury standard, you should assess for what signs of significant electrical injury?
Burns
Cold/mottled/pulseless extremities
Dysrhythmias
Entry/exit wounds
Muscle spasms
Neurological impairment
Shallow/irregular respirations
If an extremity is affected by electrical trauma, how often should you re-assess distal neurovascular status?
Approx. every 10 minutes
Under the electrical injury standard, what potential problems should you prepare for?
Dysrhythmias
Extremity neurovascular compromise
Under the soft tissue injury standard, what underlying injuries should you consider?
Injury to deep structures (nerves, vessels, bones)
How do you treat a soft tissue extremity wound
- Direct pressure
- Tourniquet
- Second tourniquet
- Pack the wound
How do you treat a soft tissue wound in a junctional location
- Direct pressure
- Pack the wound
How do you treat a soft tissue wound located in the hollow spaces of the skull, chest, or abdomen
- Direct pressure
Do not pack, do not insert finger
Under the submersion injury standard, what potential life/limb/function threats should you consider?
Asphyxia
Aspiration
Hypothermia
Pulmonary edema
Underlying disorders which may have precipitated events (drug or alcohol consumption, hypoglycemia, cardiac dysrhythmias, trauma)
Under the submersion injury standard, what potential life, limb, function threat should you consider specific to scuba-diving related disorders
Barotrauma (ears, sinuses, pneumothorax)
Decompression sickness
Arterial gas embolism
