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Flashcards in Multisystem Trauma Deck (16)
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Multisystem Trauma

• Patient with one or more injuries serious enough to affect more than one body system


Factors in Determining Patient Severity Multisystem Trauma

• Physiologic criteria
• Anatomic criteria
• Mechanism of injury


Physiologic criteria - Determining Patient Severity Multisystem Trauma

• Physiologic criteria
– Altered mental status (GCS <90mmHg): shock, internal bleeding
– Abnormally slow respiratory rate: head injury, later stages of shock
– Abnormally high respiratory rate: shock


Anatomic criteria - Determining Patient Severity Multisystem Trauma

• Injury to specific a body part/area requiring immediate surgical intervention
• Injuries to the head and chest
• Multiple musculoskeletal injuries
• Amputations
• Severely mangled extremities
• Pelvic injuries


MOI - Determining Patient Severity Multisystem Trauma

• In absence of anatomic or physiologic signs, MOI is considered if severe
• Fall
• High-risk auto crash
• Automobile-pedestrian crash
• Motorcycle crash


Preparing for Multisystem Trauma Patients

• Practice with crew: determine roles
• En route to call, review roles each member of the crew will have


Scene Safety for Multisystem Trauma Patients

• Scene safety is paramount
• Different trauma is associated with different dangers
• Auto crash will have passing traffic
• Penetrating trauma—assailant may still be on the scene


Treating Multisystem Trauma Patients

• Follow priorities determined by primary assessment
• Attend to threats to life
• Reassess what to treat on scene and what needs definitive care
• Call hospital so they can prepare
• Postpone vital - Alert Hospital


Treating Multisystem Trauma Patients

• Limit scene treatment
– Suction airway
– Insert oral or nasal airway
– Restore patent airway
– Ventilate with bag-valve mask
– Administer oxygen
– Control bleeding
– Immobilize patient


Managing Multisystem Trauma Patients

• Adapt to situation
• Do what is necessary to ensure an open airway
• Perform urgent or emergency moves as necessary
• If part of patient’s body is not accessible, assess part of the body you can reach


Trauma Scoring

• Numerical rating system for trauma
• Assigns number to certain patient characteristics to create a score
• Objectively describes severity
• Helps determine transport to a trauma center or local hospital
• Helps trauma centers evaluate the care of similar patients


Revised Trauma Score (RTS)

• Components
– Glasgow Coma Scale (GCS)
– Systolic blood pressure
– Respiratory rate
• Follow local protocol for use of the trauma scoring system
• Do not let it interfere with patient care


Chapter Review: Multisystem Trauma

• Multisystem trauma is a serious condition in which two or more major body systems are injured or affected.
• Recognizing multisystem trauma, triaging properly, transporting promptly, and choosing the correct destination are vital for the survival of your patient.
• The CDC has issued guidelines for trauma triage and transport. These are a guide and should be used in conjunction with your protocols.
• The revised trauma score (RTS) is one method of classifying trauma patients by severity and includes the Glasgow Coma Score (GCS), systolic blood pressure, and respiratory rate.


Remember: Multisystem Trauma

• Your primary assessment should determine whether your patient is seriously injured or potentially seriously injured.
• Limit scene treatment to life-threatening conditions.
• The “golden hour” begins from the time of trauma.
• Use patient severity (physiologic criteria, anatomic criteria, MOI) to decide whether to transport to a trauma center or local hospital.


Questions to Consider: Multisystem Trauma

• Is my patient seriously injured or potentially seriously injured?
• Should I expedite my scene time?
• What is the most appropriate transport destination for my patient?


Critical Thinking: Multisystem Trauma
• A patient was involved in a car crash with significant intrusion into the area where the patient was sitting. The patient is alert
and complains of pain in the ribs. Pulse: 96 and regular; respirations: 30 and adequate; blood pressure: 100/62; pupils:
equal and reactive; skin: cool and dry.
• Your partner says the patient is stable and could be easily transported to the community hospital nearby. You think the
patient should be transported to the trauma center. How would you justify your decision to your partner?