STS 2/18/14 Trauma

Skull fractures Bleeding: – Loosely cover bleeding site with sterile gauze (look for CSF) – DO NOT attempt to stop blood flow DO NOT insert nasopharyngeal airway Suspect C-spine

Eye injuries Foreign objects in eye: – Irrigate with saline/water (flush middle of eye to outside corner) – Never attempt to remove object from cornea (only remove if object is on eyelid) – Impaled stabilize with roller gauze – Chemical in eye flush with saline/water for 20 min – Thermal burn cover with burn dressing

Blowout fracture – Fracture of orbit bone – Googly eyes Check PERL Contacts should be kept in eye – Unless chemical in eye – Notify ALS/Tx if Pt wearing contacts Get to hospital ASAP

Epistaxis Bleeding from nose Tx: 1)Pinch nose 2)Tilt forward -Do not tilt backwards -If Pt swallows blood, may cause Pt to vomit  suction 3) Apply ice

Mouth injuries Teeth dislodged – Save teeth in container mixed with Pt’s saliva/milk If bleeding in mouth is heavy – Check airway – Prepare to suction Never stick your hand into someone’s mouth!

Soft tissue injury Hematoma – Pool of blood collects in an area  compartment syndrome – May be due to blunt injury Tx: splint and CMS

Open injuries Abrasion – Superficial damage no deeper than epidermis – Tx: clean and apply bandaid/dressing Avulsion – Flap ripped away, still attached – Tx: Clean and place flap back in right position Control bleeding Apply dressing

Penetrating wound (impaled) – Tx: Splint and stabilize impaled object DO NOT remove object unless – Interferes with CPR – Obstruction of airway Gunshot wound (GSW) – Look for entry and exit wound (document) – Tx: Control bleeding Provide O 2 accordingly Blanket and shock position if in shock

Pneumothorax Air in pleural space – Lung may collapse within seconds Sucking chest wound – Open chest wound allows air into pleural space – Tx: Occlusive dressing Tape 3 sides down  allow air out when pressure builds Lung sounds every 5 min If lung sounds absent after applying occlusive dressing  ventilate, remove dressing momentarily

Abdominal wounds Evisceration – Organ protruding through abdomen – Tx: Soak big trauma dressing in sterile saline solution, tape over exposed organ DO NOT touch exposed organ (infection)

Amputations Wrap severed body part in sterile gauze Place in plastic bag (zip loc) Chill with ice – DO NOT allow body part to freeze or come into direct contact with ice

Neck Jugular vein injury – Tx: Occlusive dressing Tape down on 4 sides Monitor respirations closely (in case of air embolism)

Thermal Burns 1 st degree superficial 2 nd degree dermis 3 rd degree full thickness Tx: - Stop burning  submerse in cool water/saline - If severe, apply burn dressing (non-adhesive) Treat for shock Pt’s with critical burns lose a lot a fluids

Chemical burns Tx: 1)Remove clothing 2)For powder chemicals: brush off powder first 3) Flush with water for 20 min Electrical burns Look for entry and exit wounds Prepare to perform CPR – Cardiac arrhythmia

Scenario