Scribd Logo
Upload

Welcome to Scribd!

  • 15 views

    Trauma: HX and PE (Adults) : For The EMS Providers, (Prior To Patient's

    Uploaded by

    Justine Castillo
    The document provides guidance on trauma assessment and management for EMS providers and in the emergency department. It outlines the primary and secondary surveys which involve evaluating the patient's airway, breathing, circulation, disability, and exposure (ABCDE). The primary survey focuses on life threats while the secondary survey involves a more detailed head-to-toe examination, imaging, and labs. Extremity injuries should be evaluated for fractures, vascular injury, and foreign bodies with imaging and treatment involving bleeding control, antibiotics, and surgery if needed.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Trauma: HX and PE (Adults) : For The EMS Providers, (Prior To Patient's

    Uploaded by

    Justine Castillo
    15 views3 pages
    The document provides guidance on trauma assessment and management for EMS providers and in the emergency department. It outlines the primary and secondary surveys which involve evaluating the patient's airway, breathing, circulation, disability, and exposure (ABCDE). The primary survey focuses on life threats while the secondary survey involves a more detailed head-to-toe examination, imaging, and labs. Extremity injuries should be evaluated for fractures, vascular injury, and foreign bodies with imaging and treatment involving bleeding control, antibiotics, and surgery if needed.

    Original Title

    Untitled

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    The document provides guidance on trauma assessment and management for EMS providers and in the emergency department. It outlines the primary and secondary surveys which involve evaluating the patient's airway, breathing, circulation, disability, and exposure (ABCDE). The primary survey focuses on life threats while the secondary survey involves a more detailed head-to-toe examination, imaging, and labs. Extremity injuries should be evaluated for fractures, vascular injury, and foreign bodies with imaging and treatment involving bleeding control, antibiotics, and surgery if needed.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    15 views3 pages

    Trauma: HX and PE (Adults) : For The EMS Providers, (Prior To Patient's

    Uploaded by

    Justine Castillo
    The document provides guidance on trauma assessment and management for EMS providers and in the emergency department. It outlines the primary and secondary surveys which involve evaluating the patient's airway, breathing, circulation, disability, and exposure (ABCDE). The primary survey focuses on life threats while the secondary survey involves a more detailed head-to-toe examination, imaging, and labs. Extremity injuries should be evaluated for fractures, vascular injury, and foreign bodies with imaging and treatment involving bleeding control, antibiotics, and surgery if needed.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    You are on page 1of 3

    Trauma: Hx and PE (Adults)

    In accordance with the principles of advanced For the EMS providers, (prior to patient’s A focused history should provide
    trauma life support, injured patients are assessed arrival in hospital), they should provide the important information such as:
    and treated based on three concepts: following to the receiving ED:
    -Circumstances of injury
    1) Treat the greatest threat to life first. 1) mechanism of trauma -Ingestion of intoxicants
    2) The lack of definitive diagnosis 2) suspected injuries -Pre-existing medical conditions
    3) vital signs -Medications
    should never impede the application
    of an indicated treatment. 4) clinical sx It may be obtained from the:
    3) A detailed history is not essential to 5) examination findings  Patient or Family members
    begin the evaluation of a patient 6) treatments provided  Witnesses or Prehospital
    with acute injuries. providers

    PRIMARY SURVEY

    A
    1. Determine airway patency:
    Airway a. Foreign bodies
    b. Maxillofacial fractures
    2. Jaw thrust/chin lift
    3. Endotracheal intubation, if:
    a. Depressed LOC
    b. Inability to protect airway
    4. If the patient is obtunded, assume a
    cervical spine injury until proven
    otherwise.
    a. Maintain spinal immobilization
    during resuscitation.

    B
    Breathing Inspection of thorax and neck: Consider immediate needle thoracostomy for
     Open chest wounds suspected tension pneumothorax.
     Abnormal chest wall motion (flail chest)
    Consider tube thoracostomy for suspected
    Palpate:
    hemopneumothorax.
     Deviated trachea (tension
    pneumothorax)
     Crepitus (pneumothorax)
    Auscultate:
     Absence/asymmetric of breath sounds
    on either side of chest

    C
    Circulation Assess for blood volume status: Skin color,
    capillary refill, central/peripheral pulses, & BP.

    IVF for initial resuscitation: LR (crystalloid)

    IV placement:
     2 large bore IV catheters
    Blood transfusion (if indicated):
     type O blood: after rapid infusion with
    no marked improvement
     PRBC/Plasma: clotting and platelet
    function
    Perform screening neurologic and

    D
    Disability mental status examination, assessing:
     Pupil size and reactivity
     Limb strength & movement,
    grip strength
     Orientation, GCS score
    Consider measurement of capillary
    blood glucose level in patients with
    altered mental status

    E
    Exposure Completely disrobe patient and inspect
    for burns and toxic exposures.

    Logroll patient, maintaining neutral


    position and in-line neck stabilization, to
    inspect and palpate…
     Thoracic spine
     Flank
     Back
     buttocks

    SECONDARY SURVEY IMAGING AND LABORATORY


    TESTING
    Standard radiographic imaging:
    - cervical spine
    - chest, and pelvic radiographs
    Extended FAST examination

    In obtunded patients or those with multisystem


    trauma, consider imaging of the entire spine if the
    mechanism of injury warrants it.

    Routine laboratory studies often include:


    - blood type and screen; hgb level
    - urine dipstick testing for blood
    - blood ethanol level
    - pregnancy test for women of childbearing
    age
    - capillary blood glucose level in pts with
    altered mental status
    - >55 y/o: ECG, markers for cardiac ischemia
    TRAUMA TO EXTREMITIES
    Note:

    In the absence of hard signs, determine the ankle-brachial


    index for any injured extremity along with the nonaffected
    extremity for comparison.

    RADIOLOGIC EXAMINATIONS:

    1) Plain Radiographs
     anteroposterior and lateral radiographs of extremities
    with suspected injury/fracture
     Oblique views for suspected retained foreign body
     For shotgun or blast injuries, obtain radiographs of the
    extremity and joint distal to the injury
    2) CT angiography
     Primary diagnostic study for the evaluation of vascular
    injuries to the extremities
     Also assists in the evaluation of extravascular injuries
    such as fractures, foreign objects, or joint involvement
     Noninvasive; less expensive compared to catheter
    angiography
    3) Ultrasonography
     To identify vascular injury

    TREATMENT:

    1) Control of bleeding
    - direct pressure, pressure dressing, or a tourniquet
    2) Arterial injury
    - CT angiography
    - Positive >>> immediate vascular surgery consult
    3) Fractures and joint injuries
    - Surgical debridement
    - IV antibiotics
    4) Wound management
    5) Wound closure
    6) Soft tissue foreign bodies
    - Detection using plain radiographs
    7) Follow-up

    You might also like