1. TRAUMA STS 2/9/2015

2. SKULL FRACTURES Bleeding: Loosely cover bleeding site with sterile gauze Check for CSF Do NOT try to stop blood flow. Why? Do NOT insert NPA C-spine precautions But keep in mind…THEIR SKULL IS FRACTURED…so be careful of how you hold their head

3. EYE INJURIES Foreign objects in eye: Irrigate with saline/water (flush medial to lateral) Never attempt to remove object from cornea (only remove if object is on eyelid) If impaled: stabilize with roller gauze If chemical: flush for 20 min If thermal burn: cover with burn dressing Blowout fracture: fracture of orbital bone; googly eyes Check PERRL Contacts should be kept in eye unless chemical present Notify ALS if pt wearing contacts TRANSPORT

4. EPISTAXIS Bleeding from nose 1.Pinch nose 2.Tilt forward Do not tilt backwards; if pt swallows blood, may cause pt to vomit  suction 3.Apply ice

5. MOUTH INJURIES Save loose teeth in container mixed with Pt’s saliva/milk If bleeding in mouth is heavy Check airway Turn left-lateral Prepare to suction Never stick your hand into someone’s mouth!!

6. SOFT TISSUE INJURY Hematoma: pool of blood collects in an area, leading to compartment syndrome may be due to blunt injury Treatment: splint and CMS

7. OPEN INJURIES Abrasion: clean and apply bandaid/dressing Avulsion: clean and place flap back in right position control bleeding apply dressing

8. OPEN INJURIES (CONT.) Impaled object: splint and stabilize When do you remove an impaled object? If it interferes with CPR/obstructs airway Gunshot wound: look for entry and exit wound control bleeding provide O2 blanket and shock position if in shock

9. PNEUMOTHORAX Air in pleural space Sucking chest wound: open chest wound allows air into pleural space Occlusive dressing Tape 3 sides down Auscultate every 5 min If lung sounds are absent after applying occlusive dressing, ventilate and remove dressing momentarily to relieve pressure

10. TENSION PNEUMOTHORAX What’s the difference between this and a sucking chest wound? This is caused by a collapsed lung (genetic defect, trauma, etc) You cannot ventilate a tension pneumo because it’ll add more air and exacerbate the problem What is the biggest indicator of a tension pneumo? Tracheal deviation Treatment: TRANSPORT

11. ABDOMINAL WOUNDS Evisceration: organ protruding through abdomen Soak big trauma dressing in sterile saline solution Tape over exposed organ DO NOT touch exposed organ DO NOT try to pack organs back

12. AMPUTATIONS Wrap severed body part in sterile gauze Place in plastic bag Chill on ice Do NOT allow body part to freeze or come into direct contact with ice

13. NECK Jugular vein laceration Apply occlusive dressing Tape down on 4 sides Monitor respirations closely (in case of air embolism)

14. THERMAL BURNS 1 st degree: superficial 2 nd degree: dermis 3 rd degree: full thickness Treatment: Stop burning  submerse in cool water/saline If severe, apply burn dressing (non- adhesive) Treat for shock Patients with critical burns lose a lot of fluids Rule of Nines

15. CHEMICAL/ELECTRICA L BURNS Chemical burn treatment: Remove clothing For powder chemicals: brush off powder first Flush with water for 20 min Electrical burn treatment: Look for entry and exit wounds Prepare to perform CPR in case of cardiac arrhythmia

16. SCENARIO You get a dispatch call for a 20 y/o male at Doheny Fountain with suspected trauma.