Trauma Med Surg Flashcards
Level 4 trauma
Rual facility, initial assessment of patient, 24/7 care by a provider, transfer agreement with 3,2,1 trauma center
Level 3 trauma
Prompt assessment, resuscitation and emergency surgery and arranges transportation as needed, continuous general surgery staffing,back up care for rural communities.
Level 2 trauma
Comprehensive trauma care regardless of injury type, can be academic community center in urban or rural areas.
Level 1 trauma
Regional recourse hospital that is center for trauma care. Total care for any injury, center for research and academics. Usually associated with a university.
Golden hour/golden period
Critical time between injury and treatment. During this time if bleeding is uncontrolled then tissue is not perfused which results in lower chance in survival. May be more or less time than a hour.
Primary survey
ABCDE
Airway with c spine
Breathing
Circulation with hemorrhage
Disability(neuro)
Exposure( temperature)
When do you do jaw thrust
Open airway for possible broken spine. Good at creating seal on face mask
Airway
Jaw thrust or chin lift. Assess for airway o struction. Suction as needed. If unable to maintain then intubate
Breathing
All trauma patients get o2 via face mask. Assess breathing and chest. Obtain chest xray. Asses for tracheal shift, pneumothorax and crepitus
Tension pneumothorax s/s
Diminished breath sounds, deviated trachea, muffled heart sounds, decreased CO and BP
Flail chest s/s and treatment
Paradoxical breathing. Treat with intubation
Open pneumothorax treatment
Chest tube. Tape 3 sides of dressing
Circulation
Priority intervention is iv access and fluid resuscitation. 18 gage iv or bigger bilaterally.
Disability
Maintain spine immobilization and assess LOC and GCS and pupils
Exposure
Remove clothing for assessment, prevent hypothermia.
