CC Trauma 1 Final Exam

used as a triage marker

• no penetration of skin
• force or speed is significant
• accel or decel forces
• external AND internal injuries common

A= INcrease in speed of moving object, person still

D= decrease in speed of moving object, victim is moving

S= tearing of tissues

• inc abd pressure ->
• can lacerate liver, spleen, rupture stomach, bruise duodenum, and damage kidneys

external wound NOT reflective of internal wound

this can damage solid or hollow organs and cx massive bld loss

hollow organ penetration leads to sepsis

DO NOT remove a stab wound, this is only done in OR

• speed, velocity, and mass are important
• Primary thing affecting injuries are speed and weight

Force = Mass x Acceleration

Ex: 130lbs x 60mph = 7800 lbs of force

• 70-79 yr 2x more likely to die
• >80 yr 5x
• age related changes inc risk as well

• 1. head injury
• 2. chest/thorax
• 3. abd

1= 50% of deaths occur w/n minutes (spinal, aortic rupture)

2= 30% occur w/n minutes to hours (brain bld)

3= 20% occur w/n days to weeks (sepsis, MODS)

• dec time to definitive care
• inc expertise of care (specialty surgeons)

level 1 - regional resource center

• req's:
• neurosurgeon 24/7
• CP bypass capability
• Rehab, research, prevention programs

goal = ID of injuries. stabiliztion, transport

victim may need to be extricated which inc rick of complications

• rapid assessment
• verification of injuries
• resuscitation
• definitive care (OR or something to dx extent of injuries)

if you can feel a pulse at these spots, then the BP is at least this amount:

• Carotid - 60 mmHg
• Femoral - 70 mmHg
• Radial - 80 mmHg

estimates acuity and severity of pt's physiological response to injury

• Range 0-12
• SBP 0-4
• RR 0-4
• GCS 0-4

Trauma center rec'd if <11

both the EMS and the ED

goal is ID and Tx LIFE-THREATENING injures (ensure survival)

ABC's are priority of care

• A= airway and spine stabiliztion
•  =use jaw thrust instead of head tilt is neck injury suspected

B= breathing

c= circulation, pulse?, rapid BP assess, insert 2 large bore IV's (14 or 16g)

D= disability, neuro assess

E= Expose pt, remove clothes to look at all areas of body for injuries

• can be used for 24 hrs
• rapid absorption

quick method of classifying neuro assessment

• Alert
• response to Verbal stimuli
• response to Painful stimuli
• Unresponsive

goal is ID of ALL injuries (only after all lifesaving measures have been taken)

continue with alphabet F G H I

• Fahrenheit - keep pt warm
• Get VS and add gadgets (NG, OG, Foley, etc.)
• Head-to-toe exam and Hx
• Inspect posterior surfaces
•  -log rolled and full SPINAL imobilization

REASSESS ABC's after care

>25 people

Goal is rapid categorization of injuries

Priority is Tx and transport victims with greatest need AND best chances of survival w/ least expenditure of equipment and staff

• black - dead or dying
• red- serious injury, immediate transport
• yellow - less serious, significant MOI, delayed transport up to 1hr
• green - walking wounded, delay care up to 3 hrs

simple triage and rapid assessment

• RPM
• Respirations (rate and airway)
• Pulse (radial, femoral, and corotid)
• Mental Status (follow commands, alert, responsive)

unemotional, quick Tx

• open airway/insert airway
• stop blding
• elevate limbs (inc venous return)