Universal Patient Protocols

Tourniquet indications

major bleeding in extremity, arterial bleed

Reference for adequate tourniquet application

mfg’s instructions

Adequate tourniquet application finding

absent distal pulse and cessation of bleeding

Distal pulse and/or bleeding still present after tourniquet indication

apply 2nd proximally

What do document after tourniquet application

location and time

If multiple pt’s with tourniquet, you should

mark “T” on forehead w/marker

Splint indications suspected extremity fracture, joint dislocation or sprain

What to document prior to splint application

PMS

What to remove prior to splint application

obstruction clothing and jewelry

Sites to secure splint

proximally and distally to injury

Do not secure a splint

directly over injury

What to document after splint application

PMS

No PMS after splint application indication

remove and reassess

Extend traction splint proximal to

suspected fracture

What to document prior to traction splint application

PMS

Inability to extend traction splint proximal to suspected fracture indications

possible pelvic involvement

Extend traction splint distally

at least 6 in beyond foot

Twist traction splint until

moderate resistance is met

What to document after traction splint application

PMS

No PMS after traction splint application indication

remove and reassess

Pelvic Binder indication

suspected hip fracture

Pelvic Binder contraindication

proximal femur fracture

Removal of pelvic binder

never remove prior to hospital

NAIDS Mnemonic are indications used for

SMR

‘N’ in NAIDS

Neurological deficit

‘A’ in NAIDS

Alertness….GCS <15, confusion

‘I’ in NAIDS

Intoxication

‘D’ in NAIDS

Distracting Injury

‘S’ in NAIDS

Spinal tenderness or pain

SMR indications

NAIDS, torticollis, dangerous MOI, fall >6 ft (or ≥5 stairs), high speed MVC/rollover/ejection, bicycle crash, ATV crash

Prior to SMR, you should be maintaining

manual stabilization of c-spine

When moving pt with SMR, you should

log roll to maintain in-line stabilization of entire spine

Pt position indication w/SMR

supine