• Round-the-clock staff trained to care for traumatic injuries; usually larger institutions
• Must be able to provide emergency radiography, fluoro, CT, and MRI 24/7
• Will often be able to receive patients by helicopter and ambulance

• ED physician 24 hours a  day, as well as RNs and radiography staff
• Surgical radiography staff and fluoro must be available as well as angio, CT and MRI

• Smaller, community/rural hospitals that have an ED physician and radiographer on call at night
• Patients may be transferred to a Level I or II hospital if their condition dictates
• Even if you are not a Level I trauma center, you will still need to be prepared to deal with traumatic situation.

• Those with the most unstable vitals, especially when care is dependent on image results.
• In 2 equally urgent cases, the shorter exam should be performed first.
• STAT orders are issued for exams that must have priority; it indicates that the patient's well-being may be seriously jeopardized by any delay

• An essential part of disaster response
• Defined as the process of identifying the victims, performing initial exams, and assigning priorities for further care.
• Set up in a large, central locale

• Nonurgent
• Urgent
• Life-threatening

• For low-flow (1-6L/min) or long term oxygen administration
• Most common used
• 24%-45% oxygen concentration

• For short term use, delivers variable oxygen concentrations based on fit and flow rate
• (1-10L/min)
• Adds humidity
• 40%-60% oxygen concentration

• High flow
• Can deliver an oxygen concentration of 24%-60%
• Recommended for COPD

• Can be inserted down a patient's throat or via tracheostomy for patients who cannot breath on their own.

• Make sure to transition the patient from the portable oxygen tank to oxygen from the wall unit so that the tank air is conserved and the patient receives supplemental oxygen the entire time
• Take not of the flow rate of the portable tank and match it with the wall unit.

• Myocardial infarction (MI)-heart attack, if a patient complains of sudden, intense chest pain, you should assume that the patient is having a heart attack until proven otherwise
• Angina pectoris-pain or discomfort under the sternum due to insufficient flow of oxygen to the heart by the coronary arteries. (Usually relieved by rest or by sublingual administration of nitrogycerin.
• Cardiac arrest-cessation of effectual cardiac activity.  Lack of circulation to the central nervous system can cause irreparable brain damage in 3-5 minutes.

• Delivers an electric shock to correct an ineffective cardiac rhythm.
• Automatic external defibrillator (AED) for the average person to use.

Cross-table lateral c-spine

• Obtain with immobilization in place
• Myst be evaluated by ED physician before patient is moved
• Log-rolling is used to move patients when necessary

• Make sure to move an extremity with a suspected fracture as one unit
• Do not remove any dressings, splints, or impaled objects
• Take 2 radiographs at 90 degree angles
• If the extremity is too long to fit both joints on one image, take another to include the other joint and make sure there is overlap of the images that the the whole extremity is imaged.

• A general term used to describe a failure of circulation which blood pressure is inadequate to support oxygen perfusion of vital tissues and is unable to remove the by-products of metabolism
• A dangerous, potentially fatal condition

• Caused by massive blood or plasma loss, so that an insufficient amount of fluid is available to fill the circulatory system
• Results from internal and external hemorrhage, plasma loss from burns, or severe dehydration

• Occurs when a massive infection, such as one cause by Gram-negative bacteria, produces toxins that increase capillary permeability and vasodilation, causing the blood pressure to drop sharply

• The failure of arterial resistance
• Causes blood to pool in peripheral vessels
• Occurs with nervous-system injuries
• Closely monitor patients with head or spinal trauma for blood-pressure drop

• Occurs from exposure to foregn substances to which they are sensitized.
• Blood pressure falls rapidly, severe dyspnea caused by respiratory edema, and death can result if not recognized and treated rapidly.

• Medical term for fainting
• Mild form of shock
• Treatment: Assist patient into supine position with feet elevated.

• Now known as PTSD; much different from other forms of shock

• Caused by kidney or pituitary disorder
• Characterized by polyuria and thirst
• If untreated, dehydration results

• Insulin-dependent form
• More likely to lapse into diabetic coma

• Related to obesity
• Treated with hyperglycemic drugs

• Low blood sugar
• Occurs in Type I when insulin is taken and a meal is skipped
• Emergency medications include squeeze tubes of glucose gel

• Also called a stroke
• Caused by interruption of blood flow to the brain

-Hemorrhage

-Occlusion

• Slurred or difficult speech
• Extreme dizziness
• Severe headache
• Muscle weakness on one or both sides
• Vision difficulty or deviation in one eye
• Temporary loss of consciousness

• May have trembling, shaking, or violent spasms
• Absent seizures-brief loss of consciousness
• Keep patient as safe as possible
• Call for assistance

• Turn patient to lateral recumbent to prevent aspiration of secretions
• Provide reassurance and assistance
• Patient may be irritable and confused
• Often wishes to sleep