EMT Chapter 27,29,30

Test 2

• primary (which includes ABC), secondary (which includes stroke assessment)

• stridor is upper respiratory sound, high pitched, that can be indicitave of choking

Chapter 27 Trauma Overview

• Golden Period and Platinum 10 minutes

  • We want a PT from injury to off scene

• critical trauma patient goes straight to trauma center, moderate trauma patient can be received and evaluated in normal receiving center

• MOI = suspicion of how pt is injured

• cavitation = vibrating of the tissue away from initial wound that can cause damage to distal organs (from the wound)

• vehicle collision, body collision, organ collision

  • frontal impact

    • up and over pathway, look for injuries to abdomen, chest, face, head, neck

    • down and under pathway, look for injuries to kneews, femurs, hips, spine

  • rear impact

    • head and neck

  • lateral impact , look at head, neck, chest, abdomen, pevlis, and extremeties

  • rotational or rollover crash

    • less predictable, multisystem trauma

• restraints downside

  • you can still be injured if improperly placed

• severe fall

  • >20 feet for adults

  • >10 feet for children

• falls

  • feet first

    • injuries to lower extremeties, spine, internal organs

  • head first

    • neck, spine, head

• medium to high velocity injuries

  • include pellets, bullets

• blast injuries

  • primary, secondary, tertiary phases (see MYBRADY)

    • primary - tissue and organ damage caused from the blast

    • secondary - high velocity fragments injure you

    • tertiary - strong wind and air throw you off

• always approach the helicopter from the first, and get “ok” from pilot/crew chief

Chapter 29 Burns

• Types (see MYBRADY)

  • first - superficial, on the epidermis

  • second - partial thickness with blisters

  • third - full thickness - tough leather skin

  • electrical - 4th degree burns, may affect heart rhythm

• burn pt

  • in secondary assessment, look for singed hairs, blistered mouths

  • be especially aware of airway and oxygenation

  • burns increase capillary permeability, which decreases intravascular fluid (all vessles will leak), which will result in hypovolemia

• circumfrential burns encircle a body area - serious burns

• children an elderlies have less tolerance for burns

  • children lose more fluids

• rule of 9s

  • chest and abdomen (anterior) are each 18%, posterior portion of boths are 18%

  • arms are 9%

  • lower extremeties are 18%

  • head 9%

  • genitals 1%

• remove clothing if you can get it off without peeling skin

• for isolated burns, you can use saline to stop the burn process

• don’t place any topicals on the burns

• apply sterile gauze to BOTH eyes

Chapter 30 Muscoskeletal Trauma

• fractures

  • open vs closed - open punctures skin, closed is within the skin

  • sign and symptom

    • pain and tenderness, deformity and discoloration, inhibited movement and sensation

• for dislocations, we don’t put bones back in place

• femur and pevlis fractures are critical, lots of blood loss

• secondary assessment for fractures - 6 P’s

• compartment syndrom MYBRADY