emt 34

Multiple trauma

more than one serious injury

Multisystem-trauma

one or more injuries serious enough to affect multiple body systems

3 most critical trauma patient decisions

1: priority 2: load n go vs stay and play 3: which hospital/trauma center

Altered mental status GCS

below 14, indicator of head injury

Hypotension

systolic below 90, sign of shock/internal bleeding

Abnormal resp rates

above 29 indicate shock, below 10 indicate head injury/late stage shock, below 20 in infants is grave

Anticoagulants

blood thinners

Traumatic falls

adults: 20+ ft, children 10+ft or 2-3x height

High-risk MV collisions

intrusion, ejection, death in same vehicle, vehicle telemetry data shows high injury risk

Pneumothorax

air enters the pleural space and collapses a part of the lung

Pneumothorax symptoms

diminished lung sounds, resp distress, high pulse, chest injury

Tension pneumothorax

pressure in the pleural space collapse the vena cava and reduces blood flow to the heart/puts pressure on it

Tension pneumothorax symptoms

JVD, hypotension, narrowing pulse pressure, high pulse, trach deviation

Cardiac tamponade

blood in the pericardial sac around the heart, creates pressure + prevents adequate filling of the heart, reduces cardiac output

Cardiac tamponade symptoms

beck’s triad: JVD, hypotension, muffled heart sounds also narrowing pulse pressure, high pulse/resp rate

Solid organ damage

severe internal bleeding, can cause shock

Hollow organ damage

spilling of contents into surrounding tissue, irritates/inflames

Older adult considerations

risk of injury/death increases after 55, systolic below 110 may = shock after 65, low impact injuries may become severe

ataxic respirations

pattern of irregular/unpredictable breathing, caused by injury

cheyne-stokes breathing

distrinct pattern of breathing w quick/deep respirations and apnea

central neurogenic hyperventilation

rapid deep breathing caused by brain injury

spinal column function

to protect the spinal cord

scalp bleeding sign

profuse bleeding

traumatic brain injury effects

altered mental status and unequal pupils

late brain injury sign

fever

distraction injury cause

when the spine is excessively pulled

transporting a child in a car sear

use rapid extrication from car seat procedure

c-spine misconception

collar completely eliminates neck movement

steps for apply vaste-type extrication

position device behind patient, secure torso, secure head, reaccess csm