Trauma Flashcards
What 3 criteria need to be in place in order to perform a needle decompression.
1) Severe respiratory distress
2) SBP less than 90 or loss of radial pulse due to shock
3) Unilateral decreased breath sounds with hx of chest trauma
What to titrate BP in a trauma pt?
90-100 for pt meeting trauma triage protocol….for pt meeting physiological criteria start a second line.
Where to perform a needle decompression?
On the affected side @ 2nd intercostal space- mid clavicular line
What gauge needle is used for a needle decompression ? What length?
14g
3.25” long
Optional site for needle decompression.
3rd or 4th intercostal space, anterior axillary line
Amputation Treatment
Dressing?
What to do with amputated part?
Dress stump with dry sterile dressing.
Place amputation in sterile, dry container or bag and close.
Place first container in second container or bag and tie it closed.
Place on ice-amputated part should not directly contact ice or water.
How to dress Evisceration of Abdomen?
Cover with large saline soaked dressing. Do not replace abdominal contents.
How to treat a flail chest?
Stabilize injured side with pillow or hand. Remove if Respiration deteriorate or pressure does not help with the pain.
How to treat impaled object?
Only remove when interferes with CPR. Or if impaled object interferes with airway.
How to treat open chest wound?
Cover with an occlusive dressing and tape on 3 sides loosely.
If open chest wound and occlusive placed…then S/S develop of decreased breath sounds, distended neck veins, dyspnea, failing BP….what do you do?
Remove dressing and allow air to escape.
If you have a angulated Fx with no pulse what do you do?
Attempt to gently straighten, unless pain or resistance is met, and splint
If fx is angulated and good pulse…how to treat
Splint in position unless transport would be compromised
Open fx treatment.
Moist sterile dressing….only exception is open femur fx.
Treatment of chemicals-acid or alkali
Irrigate profusely
What happens if you go over 10 minutes of scene time.
You must document why.
When to start a second IV on a trauma pt.
If pt meets physiological criteria start a second large bore IV
Hemorrhage Control in trauma pt
first method of control is direct pressure. If unable to control, see hemorrhage policy.
If you have a occlusive dressing taped down and you start getting signs of tension pneumo (name 6) you should do what?
Remove the dressing allow air to escape and reapply dressing.
If severely angulated fx what do you do_____
May gently straighten. Check pulse before and after positioning.
Open fractures should be treated with ___________ and not reduced. The exception would be a ______________ to an ___________. in this case, it is essential to notify hospital staff of the presence of an _____ ________
moist sterile dressing
traction splint
open femur fracture
open fracture
Eye injuries- Chemical : acid or alkali
irrigate with water or normal saline on all chemical injuries. Irrigate profusely until the pt reaches the hospital.
Remove contact lens
Eye injuries - trauma -
Cover both eyes loosely with protective dressing and avoid pressure to globe.
Spinal immobilization when indicated.
Position pt, sitting upright if comfortable.
Note: impaled object should be stabilized, not removed. Embedded foreign bodies in eye- cover both eyes.
Head Trauma
Oxygen
Airway adjunct
Spinal immobilization- tx while immobilized with backboard on side if airway problems occur.
If in shock, treat according to shock protocol.
Scalp hemorrhage can be life threatening - dress with a pressure dressing.
Further assessment - check for : AVPU
