EMT-Chapter 27-Trauma Overview: the Trauma Patient and the Trauma System

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EMT-Chapter 27-Trauma Overview: the Trauma Patient and the Trauma System
2013-07-29 12:33:33
emt trauma

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  1. Mechanism of Injury(MOI)
    The factors and force that cause traumatic injury
  2. Kinetics of Trauma
    The science of analyzing MOI
  3. Three Impacts
    • Vehicle collision
    • Body collision
    • Organ collision
  4. High Index of Suspicion to the Followings
    • Death of another occupant of the vehicle.
    • An unresponsive patient with an AMS.
    • Intrusion of greater than 12 inches for the occupant site or greater than 18 inches anywhere to the vehicle.
    • Ejection from the motor vehicle.
  5. Frontal Impact
    • Partial ejection
    • Injuries to the abdomen, chest, face, head, and neck
    • Dashboard
  6. Rear-end Impact
    • Whiplash injury
    • Improper positioned headrest
    • Up-and-over or down-and-under injuries
  7. Lateral Impact
    • T-bone
    • Injuries to the head, neck, chest, abdomen, and the pelvis
  8. Rotational or Rollover
    • Multiple injuries
    • Vehicles with high center of gravity
  9. Vehicle-Pedestrian
    • Adult-up and over, usually from the side of the vehicle
    • Child-down and under, usually facing the vehicle
  10. Restraints
    • Hidden injuries
    • Belts, airbags
  11. Motorcycle Collisions
    • Head-on Impact: the bike tips forwards
    • Angular Impact: the rider strikes an object at an angle
    • Ejection: after the collision, the rider is ejected
  12. Falls
    Greater than 15 ft or 2 times the patient's height.
  13. Penetrating Injuries
    • Low velocity
    • Medium velocity
    • High velocity
  14. Medium and High velocity Injuries
    • Dissipation of Energy: How energy is transferred to the human body by the forces acting on it. It is affected by 
    • 1. Drag: The factors that slow a projectile
    • 2. Profile: The size and shape of a bullet's point of impact
    • 3. Cavitation: A cavity formed by a pressure wave resulting from the kinetic energy of a bullet travelling through body tissue; also called pathway expansion
    • 4. Fragmentation: The braking up of a bullet into small pieces on impact
  15. Low-velocity Injuries
    • Slash marks
    • stabbing
  16. Blast Injuries
    • Primary phase
    • Secondary phase
    • Tertiary phase
  17. Primary Phase Injuries
    • Due to the pressure wave of the blast
    • Primarily affects the gas containing organs
    • Severe damage and death might occur without any external signs of injury
  18. Secondary Phase Injuries
    • Due to flying debris propelled by the force of the blast, or blast wind.
    • Lacerations, impaled objects, fractures, and burns
  19. Tertiary Phase Injuries
    • Occur when the patient is thrown away from the source of the blast.
    • Ejections
  20. The Golden Period
    The hour from the onset of injury to the ER
  21. The Platinum 10 minutes
    10 from arrival to transportation.
  22. Indication of On-scene time 0f 10min or Rapid Transport
    • Airway occlusion
    • Respiratory rate < 10 or > 29
    • Inadequate tidal volume
    • Hypoxia (SpO2<95%)
    • Respiratory distress, failure, or arrest
    • Suspected skull fracture
    • Flail chest
    • Suspected pneumothorax, hemothorax, or tension pneumothoroax
    • Pelvic fracture
    • Two or more proximal long bone fracture
    • Crushed or mangled extremity
    • Uncontrolled external hemorrhage
    • Suspected internal hemorrhage
    • Signs and symptoms of shock
    • Significant external blood loss
    • Glascow Coma Scale <15
    • AMS
    • Seizure activity
    • Sensory or motor deficit
    • Any penetrating trauma to head, neck, anterior or posterior chest or abdomen, and above elbow or knee
    • Amputation of an extremity proximal to the finger
    • Trauma in patient with significant medical history(cardiac condition, pregnancy)
    • Multisystem trauma
    • Open or depressed skull fracture
    • Suspected brain injury
    • Paralysis
  23. The Trauma System
    • Level I-Regional Trauma Center: All trauma 24-7+ research
    • Level II-Area Trauma Center: All trauma 24-7
    • Level III-Community Trauma Center: stablizing patient for transport
    • Level IV-Trauma Facility: stablizing