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Trauma Patient Assessment. Home Trauma Assessment.

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Presentation on theme: "Trauma Patient Assessment. Home Trauma Assessment."— Presentation transcript:

1 Trauma Patient Assessment

2 Home Trauma Assessment

3 Home Size-Up Safety BSI MOI Number of Patients Additional Resources

4 Home Safety Traffic Smoke Electricity Haz-Mat

5 Home Safety Hostile Persons Weapons Drugs Silence

6 Home BSI Gloves Goggles Mask Gown

7 Home BSI Gloves for minimal fluids Add eye protection if theres any chance of splatter Add gown and mask for gross contamination

8 Home Mechanism of Injury Ejection Death of another passenger in the same vehicle Falls >15 or 3X patients height (child = >10) Roll-over High speed collision (child = moderate speed)

9 Home Mechanism of Injury (cont.) Pedestrian Involvement Motorcycle (child = bicycle) Altered mental status Penetrating wounds to head, chest, abdomen)

10 Home Number of Patients Call for additional resources ASAP

11 Home Additional resources Extrication Traffic control Utilities

12 Home Initial Assessment General Impression Mental Status Airway Breathing Circulation Determine priority

13 Home General Impression Age, Weight, Gender Position (relative to posture and surroundings) Activity Obvious Injuries/Bleeding

14 Home Assess Mental Status Take C-Spine control A – Alert and immediately responsive V – Responsive to verbal stimuli P – Responsive to painful stimuli U – Unresponsive

15 Home Assess Airway Open if necessary using jaw-thrust maneuver Consider oro- or naso-pharyngeal airway Note unusual sounds and correct cause –Snoring – oro-/naso-pharyngeal airway –Gurgling – suction –Stridor – consider intubation –Silence

16 Home Correcting silence Attempt ventilation Reposition Heimlich Visualize and remove Intubate Trans-laryngeal jet insuflation

17 Home Assess Breathing Look, Listen, Feel Rate, Rhythm, Depth (tidal volume) Use of accessory muscles/retractions Treat –Absent – ventilate x2, check pulse –< 12/min – assist ventilation –Decreased tidal volume – assist ventilation –Labored – oxygen 10 liters NRB –Normal or rapid – consider oxygen

18 Home Assess Circulation - Pulses Compare radial and corotid Rate –Normal –Fast –Slow Rhythm –Regular –Irregular Quality –Weak –Thready –Bounding

19 Home Assess Circulation - Skin Color Temperature Moisture

20 Home Assess Circulation - Bleeding Direct pressure Pressure dressing

21 Home Determine priority –Poor general impression –Mental status changes –Difficulty breathing –Shock –Chest pain –Severe bleeding –Severe pain

22 Home Rapid Trauma Assessment Head to toe Rapid sweep to identify major injuries which could prove life threatening DCAP-BTLS

23 Home Rapid Trauma Assessment (cont.) DCAP/BTLS D - deformities C - contusions/ crepitation A - abrasions P - penetrations/ paradoxical movement B - burns T - tenderness L - lacerations S - swelling

24 Home Package and begin transport Immediate – immobilize, load, go Delayed – immobilize, treat as necessary, transport

25 Home Focused History and Physical Baseline vital signs SAMPLE History Focus on and treat injuries found during initial assessment and rapid trauma assessment as appropriate considering priority

26 Home Focused History and Physical SAMPLE History S – signs/symptoms A – allergies M – medications P – past medical history L – last oral intake E – events leading up to the incident

27 Home Detailed Physical Exam As appropriate, considering priority Repeat initial assessment Complete critical interventions Careful head to toe survey (DCAP/BTLS)

28 Home Detailed Physical Exam Head to Toe Head – DCAP/BTLS and creptiation Ears – DCAP/BTLS and blood/fluid Face – DCAP/BTLS and blood/fluid Eyes – DCAP/BTLS and discoloration, pupils, foreign bodies, blood Nose – DCAP/BTLS and blood/fluid Mouth – DCAP/BTLS and teeth, foreign bodies, swelling, lacerations, odor

29 Home Head to Toe

30 Home Detailed Physical Exam Head to Toe Neck – DCAP/BTLS and JVD, crepitation Chest – DCAP/BTLS and palpate for paradoxical motion, symmetry, crepitation, and auscultate breath sounds Abdomen – DCAP/BTLS and tenderness, rigidity, distention Pelvis – DCAP/BTLS and pain, tenderness, motion, crepitation

31 Home Head to Toe

32 Home Detailed Physical Exam Head to Toe Upper extremities – DCAP/BTLS and PMS Lower extremities – DCAP/BTLS and PMS Posterior – DCAP/BTLS

33 Home On-Going Assessment Reassess vital signs Reassess injuries Reassess interventions

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