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. D C A P B T L S
e o b u u e a w
f n r n r n c e
o t a c n d e l
m u s t s e r l
i s I u r a i
t I o r n t n
i o n e e I g
e n s s s o
s s s n 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

9. PMS PMS
PMS
PMS PMS PMS
PMS PMS PMS
PMS PMS

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. up and over the steering wheel Down and under injury
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 and pedals

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. History of present illness and SAMPLE
Patient’s name
What happened
what did family/bystander see
Did patient complain of anything prior
Know illness
Medications