TRAUMA
The 1st slide is nothing but FYI. She won’t ask a question on it so I’m not typing it out.
* Work off of "HIS"-high index of suspicion.....can have unintentional injury...often missed.
FOR EXAMPLE…depending on where you are sitting in the vehicle, can give the RN an idea of what kind
of injury you will have….Basically trauma is just a guessing game in a way. You can “assume” that the
person will have a certain injury even though you can’t see it based off of where and what the person
was doing during the accident….get it?...I hope so….good!
BLUNT INJURY- contact sports, crushing injuries, etc...
-injury related to rapid change in velocity….EX…your head his the
dashboard…your brain moves forward and then
bounces back and hits the back of your head.
PENETRATING INJURY- getting shanked, etc
-damage created along a path
-misleading at entry, ex: high velocity into internal cavity can be
10xdiameter of bullet
-degree of injury dependent on: type of gun shot wound, type,
the kind of knife that shanked yo ass!, etc...
IT’S VERY IMPORTANT TO KNOW EVERYTHING YOU CAN ABOUT THE SCENE!!!!!
GOLDEN HOUR....60 MIN TO:
-activate EMS in field
-EMS stabilize and transport
-rapid resuscitation
-provide definitive care
TIME=LIFE
TRIAGE:
-identifies and categorizes pts....life threatening seen 1st
-sorts in ESI 5 categories....which we'll talk about later
-You guys know this…the person that is the worst off gets care 1 st. Doesn’t take a rocket scientist
to figure that out….nor does it take a 5 th level RN to figure that out. ;)
, EMERENCY SEVERITY INDEX (ESI)
ESI 1-unstable/life threat obvious/staff has to be @ bed24-7/basically a code situation
....SEE IMMEDIATELY EX: cardiac arrest, OD, servere resp. distress
ESI 2-Life or organ threat likely but not always obvious. Have threat
potential...SEE W/IN 10 MIN!!!! Require cont. monitoring… EX: chest pain…
unless yo ass goes to LSU bc you could be holding your heart in your
hand and you’re still not getting seen!!
ESI 3- Stable/threat unlikely/ SEE W/IN 1 HR EX: ABD PAIN, HIP FX IN OLD CREEP LADIES/MEN
ESI 4- Stable/No threat/ EX: SIMPLE LACERATION/FRACTURE
ESI 5- Stable/No Threat. can delay being seen EX: COLD, RX REFILL…these are the pt. that the
staff are saying “why the hell are they
here?!”
ER ASSESSMENT -if you happen to wake up one evening in an alley, you have
been shanked and your head is bleeding….GO TO LSU!! Yea, you will probably die in the waiting room
from waiting so long, BUT once you get back there you will be taken great care of!
Primary Survey.....A,B,C,D,E
A: airway…if one of the answers deals with airway…pick it!!
*obstruction...secretions/bld/saliva: teeth, tongue, KEEPING NECK IN NEUTRAL
POSITION!!!!!!
*Suspect C-spine/Neck
-STABALIZE THE NECK/C-SPINE!!!!!! PLACED ON BOARD AT SCENE!!!
-UNCONCIOUS: jaw thrust maneuver *PUSH JAW FORWARD...DON'T
HYPERFLEX
*TRAUMA TO NECK NOT SUSPECTED: head tilt/chin lift like you learned in CPR!!!
*PROVIDE AIRWAY
-may use RSI-rapid sequence intubation…if they are “with it”
-cricothyrotomy...if airway obsutrcted
*PUSH JAW FORWARD...DON'T HYPERFLEX
*WORRY WORRY WORRY WORRY ABOUT THE NECK!!!!
The 1st slide is nothing but FYI. She won’t ask a question on it so I’m not typing it out.
* Work off of "HIS"-high index of suspicion.....can have unintentional injury...often missed.
FOR EXAMPLE…depending on where you are sitting in the vehicle, can give the RN an idea of what kind
of injury you will have….Basically trauma is just a guessing game in a way. You can “assume” that the
person will have a certain injury even though you can’t see it based off of where and what the person
was doing during the accident….get it?...I hope so….good!
BLUNT INJURY- contact sports, crushing injuries, etc...
-injury related to rapid change in velocity….EX…your head his the
dashboard…your brain moves forward and then
bounces back and hits the back of your head.
PENETRATING INJURY- getting shanked, etc
-damage created along a path
-misleading at entry, ex: high velocity into internal cavity can be
10xdiameter of bullet
-degree of injury dependent on: type of gun shot wound, type,
the kind of knife that shanked yo ass!, etc...
IT’S VERY IMPORTANT TO KNOW EVERYTHING YOU CAN ABOUT THE SCENE!!!!!
GOLDEN HOUR....60 MIN TO:
-activate EMS in field
-EMS stabilize and transport
-rapid resuscitation
-provide definitive care
TIME=LIFE
TRIAGE:
-identifies and categorizes pts....life threatening seen 1st
-sorts in ESI 5 categories....which we'll talk about later
-You guys know this…the person that is the worst off gets care 1 st. Doesn’t take a rocket scientist
to figure that out….nor does it take a 5 th level RN to figure that out. ;)
, EMERENCY SEVERITY INDEX (ESI)
ESI 1-unstable/life threat obvious/staff has to be @ bed24-7/basically a code situation
....SEE IMMEDIATELY EX: cardiac arrest, OD, servere resp. distress
ESI 2-Life or organ threat likely but not always obvious. Have threat
potential...SEE W/IN 10 MIN!!!! Require cont. monitoring… EX: chest pain…
unless yo ass goes to LSU bc you could be holding your heart in your
hand and you’re still not getting seen!!
ESI 3- Stable/threat unlikely/ SEE W/IN 1 HR EX: ABD PAIN, HIP FX IN OLD CREEP LADIES/MEN
ESI 4- Stable/No threat/ EX: SIMPLE LACERATION/FRACTURE
ESI 5- Stable/No Threat. can delay being seen EX: COLD, RX REFILL…these are the pt. that the
staff are saying “why the hell are they
here?!”
ER ASSESSMENT -if you happen to wake up one evening in an alley, you have
been shanked and your head is bleeding….GO TO LSU!! Yea, you will probably die in the waiting room
from waiting so long, BUT once you get back there you will be taken great care of!
Primary Survey.....A,B,C,D,E
A: airway…if one of the answers deals with airway…pick it!!
*obstruction...secretions/bld/saliva: teeth, tongue, KEEPING NECK IN NEUTRAL
POSITION!!!!!!
*Suspect C-spine/Neck
-STABALIZE THE NECK/C-SPINE!!!!!! PLACED ON BOARD AT SCENE!!!
-UNCONCIOUS: jaw thrust maneuver *PUSH JAW FORWARD...DON'T
HYPERFLEX
*TRAUMA TO NECK NOT SUSPECTED: head tilt/chin lift like you learned in CPR!!!
*PROVIDE AIRWAY
-may use RSI-rapid sequence intubation…if they are “with it”
-cricothyrotomy...if airway obsutrcted
*PUSH JAW FORWARD...DON'T HYPERFLEX
*WORRY WORRY WORRY WORRY ABOUT THE NECK!!!!
