Signs & Symptoms of Hypoperfusion (Shock)
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-Altered mental status-Pale, cool, clammy skin-Nausea and vomiting-Vital signs changes (BP - Down / Pulse & Respirations - Up)-Thirst, Dilated pupils, Cyanosis |
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External Bleeding (CARE) |
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-Direct Pressure and Elevation-Hemostatic Dressings-Tourniquet |
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Internal Bleeding(CARE) |
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-Maintain PT Airway, Breathing, and Circulation-Administer high-concentration Oxygen-Control any external bleeding-Provide immediate transport (Remember Transport is an intervention) |
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Types of Shock |
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-Hypovolemic Shock (hemorrhagic shock)-Cardiogenic Shock-Neurogenic Shock |
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Hypovolemic Shock |
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-Caused by uncontrolled bleeding -Bleeding can be internal or external-Can also be caused by burns or crush injuries |
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Cardiogenic Shock |
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-Shock caused by inadequate pumping of blood by the heart |
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Neurogenic Shock |
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-Shock caused by uncontrolled dilation of blood vessels due to nerve damage-Vasodilation can also be caused by sepsis (massive infection) or severe allergic reaction |
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Hypoperfusion (CARE) |
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-Maintain PT airway-Control any external bleeding-Elevate legs 8-12 inches (if there is no possibility of spinal injury)-Splint any suspected bone/joint injuries (should be done en route)-Cover the PT (To prevent heat loss)-Transport PT immediately |
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Closed Wounds (CARE) |
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-Manage PT ABC's-Manage as if there is internal bleeding - Treat for Shock-Splint painful, swollen, or deformed extremities-Stay alert for PT vomiting-Closely monitor PT during Transport |
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Open Wounds(CARE) |
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-Expose the wound site-Clean the wound surface-Control bleeding-Provide care for shock-Prevent contamination-Bandage the dressing (after bleeding has been controlled)-Keep the PT still and calm |
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Open Neck Wound(CARE) |
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-Ensure the open airway-Place a gloved hand on the wound-Apply an occlusive dressing over the wound site-Place a dressing over the occlusive dressing-Apply pressure to control bleeding-Bandage dressings in place (Do not restrict airway or blood flow)-Immobilize neck if c-spine injury is possible |
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Flail Chest (CARE) |
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-Perform an initial assessment (Flail chest is a thret to life)-Administer high-concentration oxygen-Stabilize the flail segment with a bulky dressing -Monitor PT closely |
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Open Chest Wound (sucking)(CARE) |
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**A TRUE EMERGENCY that requires rapid initial care and immediate transport**-Maintain the PT airway-Seal open wound as quickly as possible-Apply an occlusive dressing to wound-Administer high-concentration oxygen-Care for shock-Transport ASAP |
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Pneumothorax and Tension Pneumothorax
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-Buildup of air in the chest cavity, capable of collapsing a lung. It puts pressure on the heart, blood vessles, and unaffected lung.Indicators - Diminished lung sounds on damaged side, Jugular vein distention, Signs of shock, Tracheal deviation |
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Hemothorax and Hemopneumothorax |
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Hemothorax - When the chest cavity fills with bloodHemopneumothorax - When the chest cavity fills with blood and airDiminished lung sounds on damaged side, Shock from blood loss |
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Traumatic Asphyxia |
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-Associated with sudden compression of the chest, usually resulting in extensive bruising of the PT head and neck-Can also cause bulging eyes and distended neck veins |
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Cardiac Tamponade |
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-When an injury to the heart allows blood to flow into the pericardial sac. -Does not allow the heart to pump fully -Distended neck veins, signs of shock and narrowed pulse pressure |
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Injuries Within the Chest Cavity(CARE) |
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-Maintain the airway-Administer high-concentration oxygen-Care for shock-Transport ASAP |
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Abdominal Injury(CARE) |
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-Maintain the airway, be alert for vomiting-Place PT on back with legs flexed to reduce abdominal pressure (if no other injuries are present)-Administer high-concentration oxygen-Care for shock-Give nothing to PT by mouth-Constantly monitor vital signs-Transport ASAP |
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Electrical Injuries (CARE) |
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-Maintain Airway-Provide cardiac life support as necessary-Care for shock-Care for spinal injury-Evaluate any burns-Cool the burn areas-Apply a dry sterile dressing-Transport ASAP |
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VocabDressingBandagePressure DressingOcclusive Dressing |
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Dressing - Any material applied to a wound in a effort to control bleeding & prevent contaminationBandage - Any material used to hold a dressing in placePressure Dressing - A dressing applied tightly to control bleedingOcclusive Dressing - Any dressing that creates an airtight seal |
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VocabMusclesCartilageTendonsLigaments |
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Muscles - Tissues or fibbers that cause movement of body parts or organsCartilage - Tough tissue that covers the joint ends of bones and helps to form some body partsTendons - Tissue that connects muscle to boneLigaments - Tissue that connects bone to bone |
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VocabFractureDislocationSprainStrain |
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Fracture - Any break in a boneDislocation - The disruption of a jointSprain - The stretching and tearing of ligamentsStrain - Muscle injury from over-stretching or overexertion |
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Musculoskeletal Injuries(CARE) |
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-BSI Scene Safety-Perform the entire initial assessment (Dramatic looking injuries may not be the most life threatening problems present)-After life threatening conditions have been treated any painful, swollen, or deformed extremity must be splinted |
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The Rule of Splinting |
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For any splint to be effective it must immobilize the adjacent joints and bone ends |
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Realignment of Deformed Extremity |
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Realign when severe deformity exists or if distal pulse is compromised, extremity is cyanotic |
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Should Girdle Injuries (CARE) |
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-Asses PMS-Use a sling and swathe-DO NOT attempt to straighten or reduce any dislocations-Reassess PMS |
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Pelvic Injuries(CARE) |
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-Move the PT as little as possible-Assess PMS-Straighten PT limbs into anatomical positions if possible-Prevent additional injuries to pelvis by securing legs-Assume that there are spinal injuries and treat accordingly-Reassess PMS-Care for shock-Transport PT ASAP, continue to monitor |
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Extremity Splinting(TEST STANDARD) |
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-BSI & Scene Safety-Directs partner to apply manual stabilization-Expose extremity & treat any open wounds-Assess PMS-Apply rigid splint & puts material in the PT's palm-Immobilizes joints above and below injury-Applies Sling & Swathe-Reassess PMS |
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Extremity Splint (A-Frame)(TEST STANDARD) |
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-BSI & Scene Safety-Directs partner to apply manual stabilization-Expose extremity & treat any open wounds-Assess PMS-Apply rigid splint & secure bones above and below the joint injury-Ensure complete immobilization-Reassess PMS |
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