Trauma - Unstable Patient

Question 1

Primary Survey

Answer 1

• Stabilize head & neck if necessary
• Assess lvl of consciousness (AVPU scale)
• Assess & manage ABC’s as required
• Expose & examine injuries - visualize, palpate, where appropriate
• Complete RBS
• Intervene at each injury as per traumatic injuries list
• Apply O2 (standard face mask or non-rebreather mask)
• Consider the PT’s position based on findings and S/S

Question 2

Decision Point

Answer 2

Findings in an unstable PT include:
- Altered LOC
- Difficulty maintaining airway
- Signs of ineffective breathing (e.g. accessory muscle use)
- Weak, rapid, or absent radial pulse
- Life or limb threatening injuries

Question 3

Load & Transport

Answer 3

Transport he unstable PT following the Primary Survey
- Immobilize spine
- Use minimize stabilization only for emergency extrication
- To facilitate transport, stabilize fractures with straps and blankets (see injury chart for packing)
- Continue with further assessment and treatment enroute, if head injury is suspected, elevate the head to 30 degrees

Question 4

Secondary Survey

Answer 4

• Critical History
• PT history (SAMPLE & OPQRRRST)
• Vital Signs
• Notification (ISBAR)
• Head to toe and functional inquiry

Question 5

Protocol(s)

Answer 5

Pain management protocol (if indicated)

Question 6

Treatment (enroute)

Answer 6

• Monitor PT q5 for unstable PT