Term
| section A, rapid trauma survey..airway module. what is under bullet points a,b and c? |
|
Definition
a. maintain inline cervical stabilization
1. follow spinal precautions per vcems policy 614
b. open airway as needed
2. utilize a trauma jaw thrust to maintain inline cervical stabilization if indicated.
c. suction airway if indicated |
|
|
Term
| moving on to part 2. breathing....what are your 5 things to assess on breathing |
|
Definition
a. assess rate, depth and quality of respirations
b.if respiratory effort inadequate, assist ventilations with bvm
c. insert appropriate airway adjunct if indicated
d. assess lung sounds
e. initiate airway management and oxygen therapy as indicated
1. maintain sp02 greater than 95% |
|
|
Term
| part 3 of your rapid trauma survey. what is the part 3? and what are the four things you are checking for? |
|
Definition
part 3 is circulation.
a. assess skin color, temp, and condition
b. check distal/central pulses and capillary refill time
c. control major bleeding
d. initiate shock management as indicated |
|
|
Term
| part 4 of rapid trauma survey, disability. what 2 things you looking for? |
|
Definition
a. determine loc
b. assess pupils |
|
|
Term
| part 5 of rapid trauma survey, exposure. what 2 things are you performing |
|
Definition
a. if indicated, remove clothing for proper assessment/treatment of injury location. maintain patient dignity.
b. maintain pt. body temperature |
|
|
Term
| detailed physical exam. part 1 head. 2 things |
|
Definition
a. inspect/palpate skull
b. inspect eyes, ears, nose and throat |
|
|
Term
| detailed physical examination. part 2, neck. 3 things to assess for |
|
Definition
a. palpate cervical spine
b. check position of trachea
c. assess for jugular vein distention |
|
|
Term
| part 3 and 4 of detailed physical exam chest and abdomen |
|
Definition
chest -
a. visualize, palpate, and auscultate chest wall
abdomen/pelvis
a. inspect/palpate abdomen
b. assess pelvis, including genitalia/perineum if pertinent |
|
|
Term
| part 5 and 6 of detailed physical exam. extremities and back |
|
Definition
extremities-
a. visualize, inspect, and palpate
b. assess circulation, sensory, motor
back-
a. visualize, inspect, and palpate thoracic and lumbar spine |
|
|
Term
| now on to trauma care guidelines. section one, head injuries. what 4 things must you do/consider |
|
Definition
a. general treatments
1.evaluate head and face - maintain high index of suspicion for injury if significant mechanism of injury is present or physical exam is remarkable for findings
2. if in spinal precautions, elevate backboard 30degrees unless contraindicated
3. do not attmept to intubate head injured patients unless unable to manage with bls airway measures
4. do not delay transport if significant airway compromise. |
|
|
Term
| trauma care guidelines for head injuries...section b penetrating injuries |
|
Definition
1. do not remove impaled object unless airway obstruction is present
2. stabilize object manually or with bulky dressings |
|
|
Term
| trauma care guidelines for head injuries part c...facial injuries. 2 things |
|
Definition
1. assess airway and suction as needed
2. remove loose teeth or dentures if present |
|
|
Term
| trauma care guidelines for head injuries. section d eye injuries. 5 things |
|
Definition
1. remove contact lenses
2. irrigate eye thoroughly with suspected acid/alkali burns
3. avoid direct pressure
4. cover both eyes
5. stabilize any impaled object manually or with bulky dressings |
|
|
Term
| trauma care guidelines for spinal injuries. section a general treatments. (2) |
|
Definition
1. evaluate spinal column - maintain high index of suspicion for injury if significant mechanism of injury is present or physical examination is remarkable for findings
2. place patient in shock position if hypotension is present |
|
|
Term
| trauma care guidelines for section 2, spinal cord injuries, part b penetrating injuries (1 headline, 3 letters a,b,c) |
|
Definition
do not remove impaled object
1. stabilize object manually or with bulky dressings
2. control bleeding if present
3. even in the presence of penetrating injuries, if no neurologic deficit is present upon physical examination, consider withholding spinal immobilization |
|
|
Term
| trauma guidelines for spinal injuries. section c neck injuries (2) |
|
Definition
1. monitor airway
2. control bleeding if present |
|
|
Term
| trauma guidelines section 3 thoracic trauma part a. general treatments (2) |
|
Definition
evaluate chest - maintain high index of suspicion for internal injury if significant mechanism of injury is present or physical examination is remarkable for findings
2. keep patients sitting high fowlers
a. if in spinal precautions, elevate head of backboard 30 degrees unless contraindicated
b. even in the presence of penetrating injuries if no neuro deficit is present upon physical examination, consider withholding spinal immobilization |
|
|
Term
| trauma care guidelines for thoracic trauma part b penetrating injuries - do not remove impaled objects. 3 items |
|
Definition
a. remove object if cpr is interfered
b. stabilize object manually or with bulky dressings
c. control bleeding if present |
|
|
Term
| trauma care guidelines for thoracic trauma (section 3) part c - flail chest/rib injuries. 2 items |
|
Definition
a. immoblize with padding and bulky dressings to affected area
b. assist ventilations if respiratory status deteriorates |
|
|
Term
| trauma care guidelines for thoracic trauma section d. pneumothorax/hemothorax (2 items) |
|
Definition
a. keep patient sitting high fowlers
b. assist ventilations if respiratory status deteriorates
1. suspected tension pneumothorax should be per vcems policy 715 |
|
|
Term
| trauma guidelines for thoracic trauma (section 3) part e. open (sucking) chest wound. 2 items |
|
Definition
a. place an occlusive dressing to wound site. secure on 3 sides only
b. assist ventilations if respiratory status deteriorates |
|
|
Term
| trauma care guidelines for section 3 thoracic trauma part f, cardiac tamponade...if suspected , what? and then 3 criteria of becks triad |
|
Definition
if suspected expedite transport.
a) becks triad
1. muffled heart sounds
2. jvd
3. hypotension |
|
|
Term
| trauma care guidelines for section 3, thoracic trauma part g, traumatic aortic disruption (2items) |
|
Definition
a. assess for quality of radial and femoral pulses
b. if suspected, expedite transport |
|
|
Term
| trauma care guidelines...section 4 is called? |
|
Definition
|
|
Term
| trauma care guidelines section 4 part A, general treatments (2 items) |
|
Definition
1. evaluate abdomen and pelvis - maintain high index of suspicion for internal injury if significant mechanism of injury is present or physical exam is remarkable for findings
2. goal of fluid resuscitation is to maintain sbp greater than 80mmhg. if sbp greater than 80mmhg then set iv to tko |
|
|
Term
| trauma care guidelines for section 4 abdominal/pelvic trauma, part b and c....blunt injuries and penetrating injures - do not remove if impaled object (1 for blunt 2 forr penetrating) |
|
Definition
blunt injuries
1. place patient in shock position if hypotension is present
penetrating injuries - do not remove impaled objects
1. stabilize objects manually or with bulky dressings
2. control bleeding if present |
|
|
Term
| trauma care guidelines for section 4 abdominal/pelvic trauma part d - eviscerations (1) |
|
Definition
1. do not replaced abdominal contents
a. cover wound with saline soaked dressings
2. control bleeding if present |
|
|
Term
| trauma care guidelines for section 4 abdominal/pelvic trauma part e, pregnancy (2 items) |
|
Definition
1. place patient in left lateral position
2. if in spinal immobilization, place padding under backboard to tilt to the left |
|
|
Term
| trauma care guidelines for section 4 abdominal/pelvic trauma part f pelvic injuries (3 items) |
|
Definition
1. DO NOT LOG ROLL PATIENT
a. assessment of pellcis should be only performed once to limit additional injury
2. control bleeding if present
3. consider wrapping a bed sheet tightly around the pelvis and tying it together for use as a sling |
|
|
Term
| trauma care guidelines for section 4 (technically 5, mislabled) extremities. part a, general treatments (5) |
|
Definition
1. evaluate csm distal to injury
a. if decrease or absence in csm is present:
1. manually reposistion extremity into anatomical position
2. re-evaluate csm
b. if no change in csm after reposistion, splint in anatomical position and expedite transport
c. cover open wounds with sterile dressings
d. place ice pack on injure area (if closed wound)
e. splint/elevate extremity with appropriate equipment |
|
|
Term
| trauma guidelines for section 5 (labled as 4) extremity injuries part b, dislocations (1) |
|
Definition
| 1. splint in position found with appropriate equipment |
|
|
Term
| trauma guidelines for section 5 (labled as 4) extremity injuries part c, penetrating injuries (2) - do not remove? |
|
Definition
impaled objects
1. stabilize object manually or with bulky dressings
2. control bleeding if present |
|
|
Term
| trauma guidelines for section 5 (labled as 4) extremity injuries part d femur fractures (2) |
|
Definition
1. utilize traction splint only if isolated mid shaft femur fracture is suspected
2. assess csm before and after traction splint application |
|
|
Term
| trauma guidelines for section 5 (labled as 4) extremity injuries part e amputations |
|
Definition
1. clean the amputated extremity with ns
2. wrap in moist sterile gauze
3. place in plastic bag
4. place bag with amputated extremity into a separate bag containing ice packs
5. prevent direct tissue contact with the ice packs |
|
|
