2. Definition of Trauma
•
A term derived from the Greek for “WOUND”
•
It refers to any bodily injury.
•
It defined as tissue injury due to direct effects of externally
applied energy. Energy may be
mechanical, thermal, electrical, electromagnatic or nuclear.
•
An emotional wound or shock that creates substantial, lasting
damage to the psychological development of a
person, often leading to neurosis.
•
An event or situation that causes great distress and disruption.
•
Included:burns, drowning, smoke, inhalation, slip & fall.
•
Excluded: poisoning/toxic ingestion.
3. Primary Survey (Initial Assessment)
1.
General Impression
2.
Airway with Cervical Spine Stabilization
3.
Breathing
4.
Circulation
5.
Disability or Neurologic Status (Level of
Consciousness)
6.
Expose or Environment
5. Airway with Cervical Spine
Stabilization
•
Protection of the spine & spinal cord is the
important management principle.
•
Neurological exam alone does not exclude a
cervical spine injury.
•
Always assume a cervical spine injury in any
patient with multi-system trauma, especially with
an altered level of consciousness or blunt injury
above the clavicle.
7. 1. Blood Volume & Cardiac
Output
a. level of consciousness
Circulation
b. skin color
c. Pulse
2. Bleeding
•
external bleeding is
identified & controlled in
the
•
primary survey.
8. Disability or Neurologic Status
(Level of Consciousness)
Simple Mnemonic to describe level of
consciousness
A - Alert
V - Responds to Vocal stimuli
P - Responds to Painful stimuli
U - Unresponsive to all stimuli
9. Expose or Environment
•
Remove the patient’s clothes because exposure of the trauma
patient is critical to finding all injuries. Blood can collect in
clothing and go undetected. Although it is important to expose
the patient, hypothermia is a serious problem in the prehospital
setting. Only what is necessary should be exposed to the outside
environment.
•
It is the patient’s body temp that is most important, not he
comfort of the health care provider.
•
Intravenous fluid should be warm.
•
Warm environment (room tem) should be maintained.
•
Early control of hemorrhage.
11. Secondary Survey (Focused History
and Physical Exam)
Rapid Trauma Assessment
• It is a quick method, (60 to 90 seconds), to
identify hidden and obvious injuries in a
trauma victim. The goal is to identify and
treat immediate threats to life that may
not have been obvious during an initial
assessment.
12. DCAP-BTLS
DCAP B T L S -
Deformities
Contusions
Abrasions
Penetrations
Burns
Tenderness
Lacerations
Swelling
13. Focused History Assessment
S - signs and symptoms
A - allergies
M - medications
P - past or pertinent medical history
L - last oral intake
E - events
17. 1.
First Aid
•
2.
Reduce Patient Pain/Discomfort
Protection of wound
•
Function
of
Bandaging
•
Decrease incidence of wound infection
•
3.
Dressing of open wound
Stabilization or compression of tissues
Absorption of Exudates
•
Enhancement of wound healing
4.
Debridement of Wound
5.
Immobilize Body Part
•
Support or protection of body parts
coaptation
prevent
(e.g. splints, casts)
weight bearing
18. •
•
General
Principle
of
Bandaging
Must not be too lose
or too tight
Must not restrict circulation
•
Should be absorptive if
necessary
•
Should avoid distortion of
tissues
•
Never leave foot or toes
outside of bandage
•
Requires serial examination
and changing
19. Reduce inflammation
from trauma
2. Control of pain
3. Prevent further injury
4. Provision of external
support
5. Protection of healing
structures
1.
Principles
of Splinting