Trauma/Trauma Systems Flashcards
What is Trauma?
Trauma is a physical injury or wound caused by external force or violence
trauma is the leading killer of persons UNDER what age in Canada?
45
what is serious trauma considered?
Surgical Disease
The trauma center has how many levels and what are they?
1) tertiary
2) District
3) Primary
Tertiary Trauma Centre
Commits resources to address all types of specialty trauma 24 hours a day, 7 days a week
District Trauma Centre
commits the resources to address the most common trauma emergencies with surgical capability available 24 hours a day, 7 days a week; will stabilize and transport specialty cases to the tertiary trauma centre
Primary Trauma Centre
commits to special emergency department training and has some surgical capability but will usually stabilize and transfer seriously injured trauma patients to a higher level trauma centre as needed
trauma triage criteria
guidelines to aid prehospital personnel in determining which trauma patients require urgent transportation to a trauma centre
mechanism of injury
the processes and forces that cause trauma
when does the mechanism of injury start?
consideration of the mechanism of injury begins during the scene assessment. the mechanism of injury should be reconsidered as the first step of the focused history and secondary assessment for trauma pateints
index of suspicion
the anticipation of injury to a body region, organ, or structure based on analysis of the mechanism of injury
What is your role as a PCP when attending a critical trauma patient?
to ensure the ABC’s and prepare the patient for rapid transport
What are the physical signs suggesting serious trauma?
signs and symptoms of shock, and those of internal head injury (which are principal killers in trauma)
Golden Hour
the 60 minute period after a severe injury; it is the maximum acceptable time between the injury and initiation of surgery for the seriously injured patient.
Trauma Triage Criteria indicating Need for Immediate Transport (Mechanism of Injury) please flip to see list
- falls > 6m. (3x the victims height)
- pedestrian/bicyclist versus auto collision (struck by car travelling >10 km/h, thrown or run over by a vehicle)
- motorcycle impact at 30 km/h
- Ejection from a vehicle
- Severe vehicle impact (speed @ impact >60km/h, intrusion of >30cm into occupant compartment, vehicle deformity >50cm)
- rollover with signs of serious impact
- death of another occupant in the vehicle
- extrication time >20 minutes
CHILDREN/INFANTS - a fall >3m (3x victims height)
- a bicycle/vehicle collision
- a vehicle collision at medium speed
- any vehicle collision in which the infant or child was unrestrained
Trauma Triage Criteria indicating Need for Immediate Transport (Physical Findings) please flip to see list
- Revised trauma score < 11
- GCS <14
- SBP <90
- RR <10 or >29
- HR <50 or >120
- 2 or more proximal long-bone fractures
- flail chest
- pelvic fracture
- limb paralysis
- burns to >15% of body surface area
- burns to airway or face
- Complete amputation of limb
- tender, distended abdomen secondary to blunt/penetrating trauma
- head injury with unilaterally dilated pupil. and/or patient unconscious or LOC decreased or decreasing during assessment
In Canada, trauma is the leading killer of persons under the age of
25
Trauma patients that do not have serious, life-threatening injuries is approximately
90%
Trauma care is predicated on the principle that serious trauma is a(n):
Surgical Disease
A Primary Trauma Center is a(n):
community hospital
Teaching hospitals that also provide resource support for other levels of healthcare are
tertiary trauma centers.
A facility with 24 hours a day, 7 days a week surgical capability, that handles most regional seriously injured or multisystem trauma patients, is a(n):
district trauma center
Medical facilities that go beyond and are prepared to provide advanced personnel, equipment, and resources are designated
specialty centres
The guidelines that help determine the need of a trauma patient for the services of the trauma center are called the
trauma triage centre
The result of the analysis of the mechanism of injury is the:
Index of suspicion
Consideration of the mechanism of injury begins:
during the scene-assessment
Trauma triage criteria are guidelines for the paramedic to assess the patient’s mechanism of injury and
any physical assessment findings
Based on analysis of the event the index of suspicion is a(n):
anticipation of possible injuries
In Canada, it is estimated that drunk drivers kill
twice as many Canadians as do murders
In Canada, firearms cause more than:
1300 deaths per year
In most patients with life-threatening injury, the injury is internal and is likely to involve
the head or a body cavity hemorrhage
Studies have shown that victims of vehicle crashes suffered not only from the injuries received in the crashes, but also from the lack of
organization in pre-hospital care
The Trauma Care Systems Planning and Development Act of 1990 helped establish guidelines, funding, and support for the
development of trauma systems.
A well-designed EMS system will allocate resources in a way that provides the most
efficient and effective care for patients.
In the 1960s, studies of motor vehicle crash victims showed that most hospitals were
inadequately equipped and staffed to care for vehicle crash victims.
The processes and forces that cause trauma are the:
mechanism of injury
By evaluating the force of impact and its nature in an accident, you can anticipate the damage and the
degree it has been damaged
The physical signs suggesting serious trauma include the signs and symptoms of shock and those of
internal head injury.
The principle killers in trauma are internal head injuries and
Shock
The maximum acceptable time between the injury and initiation of surgery for the seriously injured trauma patient is the:
Golden Hour
Although there are many factors in an incident the initial and rapid trauma assessments, emergency stabilization, patient packaging, and initiation of transport should be provided in:
Under 10 Minutes
For air medical transport to be appropriate the patient must be
relatively stable
In applying trauma triage criteria, it is best to:
err on the side of caution.