Multisystem Trauma Flashcards
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?
