Patients With Traumatic Injuries презентация

Patients With Traumatic Injuries Name : Kishanchandra Group : LA2-CO-161A

Objectives contd.. In order to: Identify the differences between a Category I, II and III trauma patient. Understand what the mechanism of injury is and the information it provides Understand the difference between the index of suspicion and the general impression

Causes and types of trauma Mechanical - Asphyxia -Blunt -Penetrating

Level I Trauma Centers Prepared and committed to handle all types of specialty trauma 24/7 Provides leadership and resources to other levels of trauma care in the Region Participates in data collection, research, continuing education, and public education programs.

Level II Trauma Centers Increased commitment to trauma care for the most common trauma emergencies with surgical capability available 24/7 Participates in data collection, continuing education, and public education programs

Trauma Transport Systolic B/P < 90 on 2 consecutive readings (or peds < 80) Transport to the highest level Trauma Center within 25 minutes 25 minute clock starts from the time of injury

Trauma Transport... Traumatic arrest, isolated burns >20% Transport to the closest Trauma Center No airway Transport to the closest Emergency Department

Mechanism of Injury The process and forces that cause trauma Mentally recreate the incident from the evidence noted Identify strength of forces involved Identify direction forces came from Identify areas of the patient’s body most likely affected by the forces Start to identify the mechanism of injury during the scene size-up

Injury Patterns – Pedestrians Adults Generally turn away & present lateral surfaces Anatomically, impact is low on the body Injuries to tibia, fibula, femur, knee, lateral chest, upper extremity, then head & neck Pediatrics Generally turn and face the vehicle Injuries anatomically higher on the body than adults Injuries to femur, pelvis and then those sustained when run over or pushed aside by the vehicle

Injury Patterns – Motor Vehicle Rotational (38% of MVC) Injuries similar to frontal & lateral Deceleration is usually more gradual & injuries less serious although the vehicles look worse Frontal (32% of MVC) Up and over pathway Femur fractures Blunt abdominal injury via compression Lower chest injuries after steering wheel impact Head & neck injuries with windshield impact And still more different kinds of motor vehicle is possible...

Index of Suspicion Your anticipation of injury to a body, region, organ, or structure based on identification of the mechanism of injury Your index of suspicion is honed from experience and time on the job

Documentation To Include of The Complaint O - onset P – provocation/palliation Q - quality R - radiation S – severity (0 – 10) T – timing – when did it start

Trauma Care – Amputated Parts Routine trauma care To remove gross contamination, gently rinse with normal saline DO NOT use distilled water to irrigate open wounds Normal saline is isotonic and less harmful to tissue Cover stump with damp (normal saline) sterile dressing and ace wrap Ace provides uniform pressure to stump Cover wounds with sterile dressing

Care of Amputated Parts Place part in a plastic zip lock bag Place bag in larger bag or container over ice and water Do not ice the part alone

GCS – Motor Response 1-6 Points Obeys command (6) Localizes pain (5) Patient who pulls equipment off; pushes your hands away; purposeful movement This patient knows where the obnoxious stimuli is contacting his body Withdraws to pain (4) Pt cannot isolate where they feel the noxious stimuli so just pulls back/withdraws Flexion (3) – arms bent towards midline when stimulated Extension (2) – arms extended when stimulated None (1) – remains flaccid