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Assessment of the Trauma Patient. Focused History and Physical Exam for the Trama Patient.

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Presentation on theme: "Assessment of the Trauma Patient. Focused History and Physical Exam for the Trama Patient."— Presentation transcript:

1 Assessment of the Trauma Patient

2 Focused History and Physical Exam for the Trama Patient

3 No significant mechanism of injury Focus assessment on just the areas of injury or compliant. Includes Physical Exam VS SAMPLE

4 DCAPBTLS e obuueaw fnrnrnce otacndel mustserl isIurai tIorntn ioneeIg enssso sssn s

5 Apply a cervical collar during the rapid trauma assessment

6 Trauma patient with a significant mechanism of injury Remember with children same type of injury may take less force. Continue spinal immobilization Reconsider transport decision Reassess MS

7 Perform a Rapid Trauma Assessment Inspect Palpate Auscultate Smell From head-to-toe

8 Jugular vein distension Paradoxical motion Flail chest Crepitation Subcutaneous Emphysema Pulsating mass Pelvis- Priapism


10 Reconsider mechanism of injury Determine chief complaint Perform a focused physical exam

11 Expose

12 Mechanism of Injury Index of suspicion Law of inertia: A object in motion stays in motion until acted upon by another force Three collisions:First; vehicle strikes something Second; Victim strikes something on impact

13 Third collision; organs strike

14 Examples: Head-on collision: Up and over injury up and over the steering wheel Down and under injury down and under the steering wheel

15 Rear-end collision Head and neck injury Side impact collision Skeletal and internal injuries Rollover Possibility of ejection Rotational Impact Observe damage to the windshield, steering wheel, dash andpedals

16 Motorcycles and ATVs Helmet? Suspect any and all types of injuries

17 Falls Height of fall three times patient height is severe Surface they landed on

18 Penetrating Trauma Shooting; stabbing Velocity: Speed of the object Low velocity Stabbing Injury usually isolated to area penetrated multiple wounds damage to internal organs

19 Medium-velocity Handguns and shotguns Arrows High velocity High powered rifles Assault rifles

20 Bullets cause damage in two ways: Damage directly from the bullet itself Cavitation pressure wave

21 Blunt Force Trauma maintain a high index of suspicion

22 Assessment of the Medical Patient Responsive Four parts History of present illness Focused physical exam OPQRST SAMPLE Baseline VS Prior history DCAPBTLS

23 Unresponsive Patient history from family, bystanders etc. Rapid assessment Abd: distension, firmness, rigidity Pelvis: Incontinence of urine, feces ID bracelets Baseline VS Consider need for ALS History of present illness and SAMPLE

24 Patients name What happened what did family/bystander see Did patient complain of anything prior Know illness Medications

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