Blunt/Penetratiing Trauma Injury Standard

OW OW OW

Consider life Threats Abdomen

• Rupture, perforation, Laceration or hemorrhage of organs in abdomen

• Spinal cord injury

If Pt is eviscerated

• Do not push intestines back in

• Cover eviscerated intestines using moist, sterile, large, bulky dressings

If Pt has pelvic fracture

• Stabilize pelvis with sheet wrap or pelvic wrap

• Secure pt to spinal board or scoop

• Avoid putting straps on pelvic area

• immobilize lower limbs to prevent further injury

Consider Life Threats Chest

• Tension Pneumothorax

• Hemothorax

• Cardiac Tamponade

• Myocardial contusion

• Spinal cord injury

• Flail Chest

Chest Auscultation

• Auscultate for air entry and adventitious sounds

If Pt has a a penetrating Chest Injury Assess for

• Entry or exit wounds

• Tracheal Deviation

• JVD

• Airway/Vascular penetration

If Pt has an open or sucking chest wound

• Seal wound with commercial occlusive dressing

• Apply dressing large enough to cover wound and more

• Monitor for tension pneumothorax

• Release occlusive dressing or replace if tension pneumo develops

For Pt’s with Tension Pneumothorax

Ventilate with lower tidal vol + rate to prevent exacerbation of increasing inter-thoracic pressure

Potential Problems to Prepare for

• Tension Pneumothorax

• Cardiac Tamponade

• Cardiac Dysrythmias

• Hemoptysis

Potential Life Threats Head

• Intracranial or intracerebral hemorrhage

• Neck/Spine injuries

• Facial/Skull fractures

• Concussion

Observe for In head injuries

• Fluid from ears/nose

• Mastoid brusing

• Abnormal posturing

• Periorbital Ecchymosis

• Agitation or fluctuating behaviour

• Incontinence

• Emeisis

Ventilations for Head Injuries

• Ventilation if Pt is Apneic or respirations are inadequate

• 35-45mmHg ETCO2

• Hyperventilate to 30-35 mmHg is Pt has cerebral herniation

Signs of Cerebral Herniation

• Deteriorating GCS < 9

• Dilated and unreactive pupils

• Asymmetric pupillary response

• A motor response that shows either unilateral or bilateral posturing

Cerebral herniation Hyperventilation rate

• ADULT: 20 BPM

• CHILD: 25 BPM

• INFANT < 1 y/o: 30 BPM

Protruding Brain tissue treatment

• Cover with non adherent material

Cerebrospinal Fluid leak treatment

Apply loose, sterile dressing over source opening

Potential Problems to Prepare for Head Injuries

• Respiratory distress/arrest

• Seizures

• deacreasing LOC

• Agitation and combativeness