1. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Chapter 17 Overview of Trauma and Trauma Systems Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer

2. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer OBJECTIVES DIRECTORY 1.Define key terms introduced in this chapter. 2525 2.Outline key historical events that contributed to the development of EMS systems as we know them today. 10-11 10-11 3.Describe how trauma centers contribute to the survival of trauma patients. 1212 4.Compare and contrast assessment of trauma patients with assessment of medical patients. 13-1513-15

3. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer OBJECTIVES DIRECTORY 5.Given a scenario of a trauma call, perform each of the following components of the scene size-up: 1616 a.Scene safety b.Standard Precautions c.Mechanism of injury d.Number of patients e.Resource determination 6.Given a scenario of a trauma call, perform a primary assessment. 1717 7.Identify trauma patients for whom cervical spine stabilization is needed during airway maneuvers. 1717

4. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer OBJECTIVES DIRECTORY 8.Describe how the head-to-toe exam of a trauma patient will vary according to the patient’s condition and mechanism of injury. 1818 9.Inspect and palpate each of the following body areas to assess for indications of injury: 1818 a.Head b.Neck c.Chest d.Abdomen e.Pelvis f.Extremities g.Back

5. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer OBJECTIVES DIRECTORY 10.Determine a patient’s level of responsiveness according to the Glasgow Coma Scale score. 2020 11.Discuss the importance of each of the following concepts in the care of trauma patients: 16-1716-17 a.Priority of the ABCs b.Avoiding unnecessary movement c.Keeping the scene time short d.Determining patient criticality

6. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer MULTIMEDIA DIRECTORY Slide 21Entrance and Exit Wounds Animation Slide 22Mechanisms of Injury in Vehicle Collisions Animation

7. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer TOPICS The History of Trauma Care EMR Assessment and Care: Identification and Categorization of Trauma Patients

8. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer INTRODUCTION Trauma—A force that has caused injury to the patient Trauma care

9. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Case Study: The Call Dispatch –You are called to a MVC in the business district –Waved over by bystanders –Scene is safe as traffic has stopped –A bystander tells you that she witnessed the patient being hit by a car and “thrown into the air” –You see a dent in the bumper of the car that struck the patient

10. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer The History of Trauma Care Back to Topics

11. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Back to Objectives

12. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Trauma Centers Capable of advanced care 24 hours a day Provide the best chance of survival Photo: © Ray Kemp / 911 Imaging Back to Objectives

13. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer EMR Assessment and Care: Identification and Categorization of Trauma Patients Back to Topics

14. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Photo: © Jacksonville Journal Courier/ The Image Works

15. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer A hands-on process –Observation Palpation Trauma Assessment Photo: © Mark C. Ide Back to Objectives

16. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Trauma Assessment Scene size-up –Five decisions Scene safety Standard Precautions Mechanism of injury (MOI) Number of patients Resource determination Photo: © Mark C. Ide Back to Objectives

17. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Trauma Assessment Primary assessment –Airway –Breathing –Circulation Back to Objectives

18. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Trauma Assessment Head-to-toe exam –Head –Neck –Chest –Abdomen –Pelvis –Extremities Back to Objectives

19. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Case Study: The Response You arrive at the patient’s side Her eyes are closed She is bleeding from a wound on her forehead She has an obviously deformed right leg

20. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Trauma Assessment Glasgow Coma Scale -Eye opening -Verbal response -Motor response Back to Objectives

21. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Entrance and Exit Wounds Click on the screenshot to view an animation on entrance and exit wounds. Back to Directory

22. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Mechanisms of Injury in Vehicle Collisions Click on the screenshot to view an animation on mechanisms of injury in vehicle collisions. Back to Directory

23. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Case Study: Transition You hold manual stabilization of the head and neck Your partner applies oxygen The patient opens her eyes to verbal stimuli and mumbles incoherently Rapid radial pulse and cool, moist skin EMS arrives quickly, and this is all you have completed

24. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer

25. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer REVIEW Define the following terms –Trauma center –Index of suspicion –Glasgow Coma Scale Back to Objectives

26. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer STOP, REVIEW, REMEMBER Hospitals that maintain high standards set forth by the American College of Surgeons, including having certain services available 24 hours a day, are said to be a)surgery centers. b)trauma centers. c)emergency departments. d)stroke centers. CONTINUED

27. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer STOP, REVIEW, REMEMBER In a trauma assessment, the majority of your relevant information will come from a)the patient’s medical history. b)the patient’s story about their symptoms. c)your physical assessment. d)your medical equipment. CONTINUED

28. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer STOP, REVIEW, REMEMBER A patient who is in shock will often present with a ________ pulse and cool, clammy skin. a)weak b)slow c)rapid d)strong

29. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer REVIEW Discussion 1.Discuss how trauma centers improve survivability of trauma patients. 2.Discuss the importance of the scene size-up on a trauma call. 3.Identify patients requiring manual stabilization of the head and neck. 4.Demonstrate the ability to calculate level of consciousness using the GCS.

30. Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Please visit www.bradybooks.com www.bradybooks.com and click on the mykit links to access content for this text. REINFORCE AND REVIEW