trauma module.txt

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Author:
dodgybarnet
ID:
96343
Filename:
trauma module.txt
Updated:
2011-08-07 18:23:20
Tags:
EMR
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Description:
trauma module
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  1. ´╗┐Peripheral vascular resistance?
    chief determination of the diastolic pressure and depends primarily on the caliber of the arterioles.
  2. Stroke volume?
    volume of blood pumped from one ventricle of the heart with each beat
  3. 3 types of Hypovolemia?
    • Low volume shock: absolute Hypovolemia => major fluid loss
    • High space shock: relative Hypovolemia => loss of vascular control
    • Mechanical shock: obstructive Hypovolemia => MI etc
  4. Hare Traction Splint?
    • modern version of the Thomas traction splint.
    • Place the splint under the injured leg until the pad is resting against the bony prominence of the buttocks.
    • A ratchet at the opposite end connects to a foot harness and pulls traction from the foot against the pelvis.
    • The size of this splint is large and very cumbersome to use on patients. Loading tall patients with a Hare Traction Splint can become complicated due to the splint extending beyond the stretcher and beyond the back door.
  5. The Sager Traction Splint?
    • Small & light: and can be used for bilateral femur fractures.
    • Has a padded bar at the top that is fitted snuggly against the pubic bone.
    • The foot harness helps to support traction along the long axis of the femur, once the sliding segment of the splint is activated.
  6. Splinting process?
    • Assess CMS
    • Splint
    • Assess CMS
    • Adjust & repeat
  7. Primary vs. Secondary Triage?
    • Primary triage
    • a. Used to rapidly categorize patient condition for treatment
    • b. Document location of patient and transport needs
    • c. Label patient with triage labels, tags, or tape
    • d. Focus on speed to sort patients quickly
    • e. No care, other than immediate lifesaving airway or hemorrhage management should be rendered during primary triage
    • Secondary triage
    • a. Used at treatment area
    • b. Patients are re-triaged
    • c. May not be necessary at small incidents
  8. START Triage System?
    • Simple Triage and Rapid Transport
    • uses a 60 second assessment that focuses on the following...
    • Ability to walk: Pt.s who can walk and understand basic commands are classified as walking wounded and transport is delayed.
    • Respiratory effort: R/R/D - If breathing is absent, the patient is classified as dead or dying. If resp rate <10 or >30 = critical status.
    • Pulse / Perfusion: no pulse = dead or dying. The presence of carotid pulse & absence of radial pulse = critical status. If both the carotid and radial pulses are present, mental status should be assessed before assigning a triage classification.
    • Assess mental status: Quickly ask the patient to touch their nose with their index finger, and assess to orientation to time, place and self. Patients who can perform these types of tasks would be classified as delayed. If the patient failed to follow these types of commands they would be considered critical.
  9. START Triage System colors?
    • Delayed: can wait > 1 hour = Green
    • Urgent: can wait but less than 1 hour = Yellow
    • Critical: Requires immediate care and transport = Red
    • Dead or dying Critical: obvious mortal injuries or cardiac arrest = Black
  10. START Triage System Other Considerations?
    • Injured rescuer: Red
    • Relative of a rescuer: Red
    • Hysterical patient or relative: removed from the scene as soon as possible
    • Children: before adults in the same category
  11. 5 components of MICS?
    • Medical Incident Command System
    • Medical Command
    • EMS Staging Officer
    • Triage Officer
    • Treatment Officer
    • Transport Officer
  12. MICS EMS Staging Officer?
    • Maintains a log of available units & medical supplies
    • Coordinates physical location of incoming resources
    • Coordinates incoming personnel
    • Provides updates to Medical Command as necessary
  13. MICS Medical Commander?
    • Establish liaisons with on-scene Incident Commander
    • Establishes working MICS with appropriate sectors
    • Ensures that proper rescue/ extrication services are activated
    • Ensures law enforcement involvement as necessary
    • Ensures that helicopter landing zone operations are safely coordinated
    • Determines the amount & type of additional medical resources & supplies so they can prepare for casualties
    • Designates assistance officers & their location
    • Maintains an appropriate span of control
    • Works as a conduit of communications between subordinates & the Incident commander
  14. MICS Triage Officer?
    • Ensures proper utilization of the initial assessment triage system or other local protocol
    • Ensures that triage tags or other visual identification technique is properly completed & secured to the patient
    • Makes requests for addition resources through Medical Command
    • Provides updates to Medical Command as necessary
  15. MICS Transport Officer?
    • Ensures the organized transport of patients off-scene
    • Ensures an appropriate distribution of patients to all local hospitals to prevent hospital overloading.
    • Completes a transportation log
    • Contacts receiving hospitals to advise them of the number of patients & condition.
    • Provides updates to Medical Command as necessary
  16. MICS Treatment Officer?
    • Establishes suitable treatment areas
    • Communicates resource needs to Medical Command
    • Assigns, supervises, & coordinates treatment of patients
    • Provides updates to Medical Command as necessary
  17. Catecholamines?
    group of chemicals of similar structure that act to increase heart rate and BP: norepinephrine and epinephrine

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