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
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