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Basic Trauma Life
Support
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.
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
•

General
Impression

Impression of the
patient's condition
that is formed on first
approach, based on
patient's
environment, chief
complaint, and
appearance.
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.
Breathing
& Ventilation

•

Airway patency
does not assure
adequate
ventilation
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.
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
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.
Transport
If
life-threatening
conditions
are
identified during primary survey, the
patient should be rapidly packaged
after initiating limited field intervention.
Unless
extenuating
circumstances
exist, limit scene time to 10 minutes or
less.
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.
DCAP-BTLS

DCAP B T L S -

Deformities
Contusions
Abrasions
Penetrations
Burns
Tenderness
Lacerations
Swelling
Focused History Assessment
S - signs and symptoms
A - allergies
M - medications
P - past or pertinent medical history
L - last oral intake
E - events
Closed Soft
Tissue Injuries
Management
(RICE)

R
I
C
E

-

rest
ice
compression
elevation
Bleeding Management
D
E
P
T

-

Direct Pressure
Elevation
Pressure
Tourniquets
Bandaging and Splinting
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
•
•

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
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

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Basic trauma life support

  • 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
  • 4. • General Impression Impression of the patient's condition that is formed on first approach, based on patient's environment, chief complaint, and appearance.
  • 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.
  • 6. Breathing & Ventilation • Airway patency does not assure adequate ventilation
  • 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.
  • 10. Transport If life-threatening conditions are identified during primary survey, the patient should be rapidly packaged after initiating limited field intervention. Unless extenuating circumstances exist, limit scene time to 10 minutes or less.
  • 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