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Trauma Patient Assessment

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

1 Trauma Patient Assessment

2 Trauma Assessment

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

4 Safety Traffic Smoke Electricity Haz-Mat

5 Safety Hostile Persons Weapons Drugs Silence

6 BSI Gloves Goggles Mask Gown

7 BSI Gloves for minimal fluids
Add eye protection if there’s any chance of splatter Add gown and mask for gross contamination

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

10 Number of Patients Call for additional resources ASAP

11 Additional resources Extrication Traffic control Utilities

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

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

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

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

19 Assess Circulation - Skin
Color Temperature Moisture

20 Assess Circulation - Bleeding
Direct pressure Pressure dressing

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

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

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

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

28 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 Head to Toe

30 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 Head to Toe

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

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

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