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Initial Trauma Assessment and Care - Revision history
2024-03-29T02:29:49Z
Revision history for this page on the wiki
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http://roaddoc.com/scems/index.php?title=Initial_Trauma_Assessment_and_Care&diff=1515&oldid=prev
Treloars at 14:30, 24 April 2020
2020-04-24T14:30:35Z
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 14:30, 24 April 2020</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* AIRWAY / C-SPINE: Manual C-spine immobilization may be indicated in patients with injury indicative of spinal loading or stretching, significant injury above clavicles, head injury resulting in AMS, or mechanism of injury that suggests sudden or violent movement of the spine. Refer to [[Selective Spinal Immobilization|SELECTIVE SPINAL IMMOBILIZATION PRACTICE PARAMETER]] (6.03). Position airway and suction as needed. If intubation required, utilize in-line or nasotracheal technique unless contraindicated. If unable to secure airway by other means and airway not patent, perform Cricothyrotomy.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* AIRWAY / C-SPINE: Manual C-spine immobilization may be indicated in patients with injury indicative of spinal loading or stretching, significant injury above clavicles, head injury resulting in AMS, or mechanism of injury that suggests sudden or violent movement of the spine. Refer to [[Selective Spinal Immobilization|SELECTIVE SPINAL IMMOBILIZATION PRACTICE PARAMETER]] (6.03). Position airway and suction as needed. If intubation required, utilize in-line or nasotracheal technique unless contraindicated. If unable to secure airway by other means and airway not patent, perform Cricothyrotomy.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* BREATHING: Check breath sounds, assess for JVD and tracheal deviation, use of accessory muscles of respiration. Assess for tension pneumothorax. If ineffective breathing pattern / impaired gas exchange, deliver [[<del style="font-weight: bold; text-decoration: none;">Medical Gases</del>|OXYGEN]] via NRB mask or assist with BVM.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* BREATHING: Check breath sounds, assess for JVD and tracheal deviation, use of accessory muscles of respiration. Assess for tension pneumothorax. If ineffective breathing pattern / impaired gas exchange, deliver [[<ins style="font-weight: bold; text-decoration: none;">Oxygen</ins>|OXYGEN]] via NRB mask or assist with BVM.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* CIRCULATION:Evaluate peripheral pulses for presence, quality and equality. CPR as indicated. Treat severe external hemorrhage with direct pressure. If patient has AMS or diabetes, assess blood glucose level, if < 100 mg / dl refer to [[Altered Mental Status (AMS)|AMS PRACTICE PARAMETER]] (5.03).</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* CIRCULATION:Evaluate peripheral pulses for presence, quality and equality. CPR as indicated. Treat severe external hemorrhage with direct pressure. If patient has AMS or diabetes, assess blood glucose level, if < 100 mg / dl refer to [[Altered Mental Status (AMS)|AMS PRACTICE PARAMETER]] (5.03).</div></td></tr>
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Treloars
http://roaddoc.com/scems/index.php?title=Initial_Trauma_Assessment_and_Care&diff=950&oldid=prev
Treloars at 21:09, 31 January 2018
2018-01-31T21:09:54Z
<p></p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 21:09, 31 January 2018</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>'''</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>'''</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>THE UNSTABLE PATIENT MUST BE TRANSPORTED IMMEDIATELY.'''</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>THE UNSTABLE PATIENT MUST BE TRANSPORTED IMMEDIATELY.'''</div></td></tr>
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Treloars
http://roaddoc.com/scems/index.php?title=Initial_Trauma_Assessment_and_Care&diff=840&oldid=prev
Treloars at 14:20, 27 September 2017
2017-09-27T14:20:36Z
<p></p>
<table style="background-color: #fff; color: #202122;" data-mw="interface">
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 14:20, 27 September 2017</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l4">Line 4:</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>'''GENERAL:'''</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>'''GENERAL:'''</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"># </del>Assess and secure scene safety.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* </ins>Assess and secure scene safety.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"># </del>Use universal blood and body substance isolation precautions on all patients.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* </ins>Use universal blood and body substance isolation precautions on all patients.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"># </del>Assess for potential injuries based on mechanism of energy transfer.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* </ins>Assess for potential injuries based on mechanism of energy transfer.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"># </del>Identify and treat immediate life threats per specific PRACTICE PARAMETERS.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* </ins>Identify and treat immediate life threats per specific PRACTICE PARAMETERS.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"># </del>Initiate trauma alert when appropriate from scene.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* </ins>Initiate trauma alert when appropriate from scene.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"># </del>Attempt to limit on-scene time to no longer than 10 minutes.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">** Perform blood draw of all tubes on a trauma alert patient. The crew shall hold onto the tubes at the hospital until a staff member is ready to label the blood tubes. Document that blood was drawn.</ins></div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"># </del>Apply initial medical care.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* </ins>Attempt to limit on-scene time to no longer than 10 minutes.</div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* </ins>Apply initial medical care.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>'''INITIAL ASSESSMENT:'''</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>'''INITIAL ASSESSMENT:'''</div></td></tr>
</table>
Treloars
http://roaddoc.com/scems/index.php?title=Initial_Trauma_Assessment_and_Care&diff=63&oldid=prev
Treloars: Created page with "==Section 2 - PRIMARY CARE== ===2.02 INITIAL TRAUMA ASSESSMENT AND CARE=== '''GENERAL:''' # Assess and secure scene safety. # Use universal blood and body substance isolatio..."
2012-02-01T18:43:23Z
<p>Created page with "==Section 2 - PRIMARY CARE== ===2.02 INITIAL TRAUMA ASSESSMENT AND CARE=== '''GENERAL:''' # Assess and secure scene safety. # Use universal blood and body substance isolatio..."</p>
<p><b>New page</b></p><div>==Section 2 - PRIMARY CARE==<br />
===2.02 INITIAL TRAUMA ASSESSMENT AND CARE===<br />
<br />
<br />
'''GENERAL:'''<br />
# Assess and secure scene safety.<br />
# Use universal blood and body substance isolation precautions on all patients.<br />
# Assess for potential injuries based on mechanism of energy transfer.<br />
# Identify and treat immediate life threats per specific PRACTICE PARAMETERS.<br />
# Initiate trauma alert when appropriate from scene.<br />
# Attempt to limit on-scene time to no longer than 10 minutes.<br />
# Apply initial medical care.<br />
<br />
'''INITIAL ASSESSMENT:'''<br />
<br />
'''GENERAL IMPRESSION'''<br />
<br />
'''Level of Consciousness'''<br />
{| class="wikitable"<br />
|-<br />
| A|| Alert<br />
|-<br />
| V|| Respond to Verbal Stimuli<br />
|-<br />
| P|| Respond to Painful Stimuli<br />
|-<br />
| U|| Unresponsive<br />
|}<br />
<br />
<br />
'''ORIENTATION x 4/4:''' <br />
{| class="wikitable"<br />
|-<br />
| 4/4|| Person, place, time, incident.<br />
|-<br />
| 3/4|| One faculty absents<br />
|-<br />
| 2/4|| Two faculties absent.<br />
|-<br />
| 1/4|| Three faculties absent.<br />
|}<br />
<br />
'''DISTAL:'''<br />
{| class="wikitable"<br />
|-<br />
| P|| Pulse<br />
|-<br />
| M|| Motor<br />
|-<br />
| S|| Sensory<br />
|}<br />
<br />
'''Altered Mental Status (AMS) is defined as an alteration in either the patient’s LOC or Orientation'''<br />
<br />
<br />
* AIRWAY / C-SPINE: Manual C-spine immobilization may be indicated in patients with injury indicative of spinal loading or stretching, significant injury above clavicles, head injury resulting in AMS, or mechanism of injury that suggests sudden or violent movement of the spine. Refer to [[Selective Spinal Immobilization|SELECTIVE SPINAL IMMOBILIZATION PRACTICE PARAMETER]] (6.03). Position airway and suction as needed. If intubation required, utilize in-line or nasotracheal technique unless contraindicated. If unable to secure airway by other means and airway not patent, perform Cricothyrotomy.<br />
<br />
* BREATHING: Check breath sounds, assess for JVD and tracheal deviation, use of accessory muscles of respiration. Assess for tension pneumothorax. If ineffective breathing pattern / impaired gas exchange, deliver [[Medical Gases|OXYGEN]] via NRB mask or assist with BVM.<br />
<br />
* CIRCULATION:Evaluate peripheral pulses for presence, quality and equality. CPR as indicated. Treat severe external hemorrhage with direct pressure. If patient has AMS or diabetes, assess blood glucose level, if < 100 mg / dl refer to [[Altered Mental Status (AMS)|AMS PRACTICE PARAMETER]] (5.03).<br />
** ADEQUATE PERFUSION: large bore IV @ KVO. <br />
** INADEQUATE PERFUSION: Institute [[Shock|SHOCK PARAMETER]] (5.13) therapies enroute unless delayed by extrication<br />
'''<br />
THE UNSTABLE PATIENT MUST BE TRANSPORTED IMMEDIATELY.'''</div>
Treloars