Week 6- Advanced Wound Care & Pedimate Flashcards
Trauma- section 3 - trauma standards from the BLS
What are some findings that the medic will immediately manage during the primary?
- Airway obstruction
- Cardiac arrest/ resp arrest or decrease LOA w inadequate resp
- Sucking chest wounds
- Impaled objects
- External hemorrhage “shock”
- Unstable pelvis
How do we manage critical findings?
We need to delegate tasks!!
- Partner: “stabilize C-spine & preform a modified jaw thrust”
- Fire” “put pressure on this gross bleed
- Bystanders: do they know CPR?
YOU are cont with your primary
What do we do for stay & play pt’s?
- Isolate C/C
-Stabilize & initiate basic treatment plans- Dressings, bandaging, splinting, immobilizations, other non critical interventions either at scene or enroute
What do we do if pt’s condition changes?q
- Repeat the primary: reassess ABC’s
-Find problem and fix problem
What are some types of wounds?
- Amputations
- Penetration- chest, abdo
- Eviscerations
- Burns
- Avulsions
- Flail chest
Make sure all injuries are fully exposed
What equipment can we use?
- Tourniquet
- Hemostatic gauze
- Chest seals
Arterial tourniquets shall…
- be constructed of lightweight/ durable materials
- be single use; disposable
- provide circumferential pressure to any extremity with complete occlusion of arterial blood flow
- allow for incremental increases in tension
- provide a lock or securing mechanism to ensure maintenance of desired tension
- allow for rapid release of tension when necessary
When do we use a tourniquet?
- For uncontrollable bleeds
What are the rules when applying a tourniquet?
- Apply approx 5cm above injury
- if applied not removed in prehospital setting
- application time documented & included in patch to hospital
- MCI: time noted on pt & device
- Do not cover once applied
- Do not cut
What do we do with amputations?
- If located prior to transport the medic should:
- cleanse/ wrap & put into plastic bag/ container
- put “water tight” container/ bag into cool water
Do not pack on ice and do not delay transport to find amputation
When we have amputations, when can we radio for air transport?
- If the amputation is proximal wrist/ ankle
Hemostatic dressing shall be:
- able to accelerate the clotting process of blood
- single use, disposable
- sterile
- approved for this indication by Health Canada, Therapeutic Products Directorate. Make sure to apply hemostatic dressing as per BLS standard
How does Celox Gauze work?
Absorbs blood fluid and forms a gel like plug that covers the wound and stops the bleeding
What is the procedure when using hemostatic dressing?
- Place the dressing over the wound & use it to apply direct pressure (Make sure you try to locate the source of the bleed)
- Pack the wound until there is no additional room. Can use up to 2 packages
- Continue to apply pressure for 1-3 min to activate the product
- Once bleeding is controlled, wrap the injury site to maintain pressure
- Bring packaging along to the hospital and report the use if the product
What wounds do we NOT pack?
- Abdomen
- Chest
- Open skull fractures
What causes sucking chest wounds?
- Penetrations
- Guns, knives
- Shrapnel
When do these injuries get addressed?
- Immediately
How to identify open chest wounds?
- You may hear a “sucking” sound during resp
- Hemoptysis
- Decreased/ absent breath sounds
- SOB
- Anxiety
- Bubbling at site
- Unequal chest movement
- Cyanosis
- Tachycardia
- Tachypnea
What is the treatment plan for sucking chest wounds?
- Initial hand placed during primary to stop air movement
- 3 sided occlusive dressing/ asherman seal type dressing with 1 way valve
* ensure the dressing is large enough to cover the sntire wound
*Monitor for development of tension pneumo
*One dressing per lung
Field Trauma Traige standard pg. 24 BLS
How to treat severe injuries?
- Pack the junctions
- Seal the chest
- Tourniquet the limbs
How do we treat an eviscerated bowel?
- moist sterile dressing
- wrap dressing in plastic
- treat for shock
How to treat burns?
- Dress digits individually
- Remove jewelry if possible
- If wrapping toes/hands leave ends exposed
- keep an eye on neurovascular status
- elevate extremity if possible
- use wet dressing of abrasions oozing, you want to prevent sticking
How to treat eye injuries?
- Assume threat to vision/ other facial & possible head injuries based on incident
- Leave eyelid shut if swollen
- Assess the vision ability if applicable
- Don’t manipulate/ irrigate/ palpate or apply cold packs to ruptured or punctured globes
- Don’t try to replace extruded/ avulsed globes back into socket
How to treat ear and nose bleeding?
- Ear: worry about perforated eardrum
- Nose: worry about airway
- Do not pack or stop fluid from leaving
- Cover loosely to protect from contamination
What is a flail chest?
- Fracture of 3 or more consecutive ribs in at least 2 different places
- Causes paradoxical motions in chest
- Typically caused by blunt force trauma
What are the s/s of a flail chest?
- Paradoxical breathing
- Pain in affected area that increases with movement
What do we do with soft tissue injuries?
- Estimate amount of blood/ or other injuries
- Irrigate as needed/ control bleeding as needed
