EMT-Basic Trauma

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Signs & Symptoms of Hypoperfusion (Shock)
-Altered mental status-Pale, cool, clammy skin-Nausea and vomiting-Vital signs changes (BP - Down / Pulse & Respirations - Up)-Thirst, Dilated pupils, Cyanosis
External Bleeding (CARE) -Direct Pressure and Elevation-Hemostatic Dressings-Tourniquet
Internal Bleeding(CARE) -Maintain PT Airway, Breathing, and Circulation-Administer high-concentration Oxygen-Control any external bleeding-Provide immediate transport (Remember Transport is an intervention)
Types of Shock -Hypovolemic Shock (hemorrhagic shock)-Cardiogenic Shock-Neurogenic Shock
Hypovolemic Shock -Caused by uncontrolled bleeding -Bleeding can be internal or external-Can also be caused by burns or crush injuries
Cardiogenic Shock -Shock caused by inadequate pumping of blood by the heart
Neurogenic Shock -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
Hypoperfusion (CARE) -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
Closed Wounds (CARE) -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
Open Wounds(CARE) -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
Open Neck Wound(CARE) -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
Flail Chest (CARE) -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
Open Chest Wound (sucking)(CARE) **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
Pneumothorax and Tension Pneumothorax
-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
Hemothorax and Hemopneumothorax 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
Traumatic Asphyxia -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
Cardiac Tamponade -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
Injuries Within the Chest Cavity(CARE) -Maintain the airway-Administer high-concentration oxygen-Care for shock-Transport ASAP
Abdominal Injury(CARE) -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
Electrical Injuries (CARE) -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
VocabDressingBandagePressure DressingOcclusive Dressing 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
VocabMusclesCartilageTendonsLigaments 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
VocabFractureDislocationSprainStrain Fracture - Any break in a boneDislocation - The disruption of a jointSprain - The stretching and tearing of ligamentsStrain - Muscle injury from over-stretching or overexertion
Musculoskeletal Injuries(CARE) -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
The Rule of Splinting For any splint to be effective it must immobilize the adjacent joints and bone ends
Realignment of Deformed Extremity Realign when severe deformity exists or if distal pulse is compromised, extremity is cyanotic
Should Girdle Injuries (CARE) -Asses PMS-Use a sling and swathe-DO NOT attempt to straighten or reduce any dislocations-Reassess PMS
Pelvic Injuries(CARE) -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
Extremity Splinting(TEST STANDARD) -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
Extremity Splint (A-Frame)(TEST STANDARD) -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