Universal Patient Care Guidelines - Trauma

Question 1

Scene Size-up.
A. Scene safety
B. Consult/follow dept IMS as needed.
C. Consider _____, number of _________, and special equipment/extrication needs.

Answer 1

MOI, number of patients

Question 2

General. True/False. Do not prolong scene times and/or delay transport time in order to perform procedures for non-immediately life-threatening injuries.

Answer 2

True.

Question 3

General. The survival of trauma patients is dependent upon _____ _________ for surgical intervention.

Answer 3

rapid transport

Question 4

Patients should be approached and assessed utilizing Primary, _______, and ___________ surveys.

Answer 4

Secondary, and reassessment

Question 5

Primary Survey is designed to rapidly identify ____-___________ or potentially ____-___________ injuries.

Answer 5

life-threatening
life-threatening

Question 6

Primary Survey should be completed within __ __________ of patient contact.

Answer 6

2 minutes

Question 7

The primary survey is only interrupted for ______ __________ or Respiratory/Cardiac arrest.

Answer 7

airway obstruction

Question 8

Steps of the Primary Survey include:

Answer 8

i. Manually control C-Spine
ii. Assess airway, breathing and circulation and intervene as necessary.
iii. Control external hemorrhage.
iv. Assess mental status using AVPU scale.

Question 9

Use the ____ scale to assess mental status in the primary survey of a trauma patient.

Answer 9

AVPU

Question 10

Primary survey. Ture/False. Perform procedures to seal an open chest wound, treat a tension pneumothorax, oxygen administration, and provide fluid resuscitation to counter hypo-perfusion.

Answer 10

True

Question 11

Where should the Secondary survey of a critical trauma patient take place?

Answer 11

Should be completed enroute to the ER.

Question 12

When and where can the Secondary survey of a non-critical trauma patient take place?

Answer 12

On scene and should be completed within 5 minutes of the primary survey.

Question 13

Steps of Secondary survey for trauma patient.

Answer 13

i. Obtain full set of vitals (HR, RR, BP, SPO2) Initial BP manually.

ii. SAMPLE history

iii. Perform head-to-toe exam looking for DCAP-BLS in every body area.

iv. Determine GCS and RTS scores.

v. Perform bandaging and splinting. Assess PMS before and after.

vi. Obtain IV access as indicated.

Question 14

An abbreviated exam performed after interventions and done at least every 5 minutes for critical patients is a ____________ Survey.

Answer 14

Reassessment

Question 15

Steps of the Reassessment survey include:

Answer 15

i. Repeat the Primary Survey

ii. Repeat vital signs and GCS

iii. Reassess all injuries and interventions. Look for improvement or deterioration.

Question 16

General management of the trauma patient includes the following:

Answer 16

1. Oxygen/Fluid Therapy/Pain Management
2. OLMCP
3. Pedi Dosing Guidelines

Question 17

Administer O2 to ease pain and/or respiratory distress. Titrate to SPO2 reading of ____% as appropriate.

Answer 17

94%

Question 18

Fluid administration is guided by the pt’s ____

Answer 18

SBP

Question 19

i. All patients with significant or multi-system trauma should have what initiated?

Answer 19

2 large-bore IV’s.

Question 20

ii. Patients with minor trauma should have what started?

Answer 20

1 large-bore IV.

Question 21

iii. IV’s should be TKO unless SBP is less than ?

Answer 21

less than 90 in adult or less than 70 + (2 x age in years) for pedi

Question 22

Fluid bolus in mL for adult trauma patient if SBP < 90.

Answer 22

500 mL. Can repeat once if SBP remains below 90.

Question 23

If pt is hypotensive/hypoperfused and IV access can not be obtained after 2 attempts in 90 seconds, consider ____ for fluid administration.

Answer 23

IO

Question 24

For hypotension refractory to fluid administration, do what?

Answer 24

Contact OLMCP