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ASSESSMENT AND INITIAL

MANAGEMENT OF

TRAUMA PATIENT

Tim Diklat IRD RSSA

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OVERVIEW

- SIX STAGES OF AN AMBULANCE CALL.

- TRAUMA ASSESSMENT.

- PRELIMINARY ACTIONS AT THE SCENE

- PATIENT ASSESMENT AND MANAGEMENT

- CRITICAL INJURIES/CONDITION.- SECONDARY SURVEY

- REASSESMENT SURVEY.

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SIX STAGE OF AN

AMBULANCE CALL.

1. PREDISPATCH.

2. DISPATCH.

3. TRAVEL TO SCENE

4. ACTIONS AT THE SCENE

. TRAVEL TO THE HOSPITAL

!. ACTIONS AT THE HOSPITAL

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SCENE SURVEY

1. ASSESS FOR HA"ARDS

2. EXTRICATION RE#UIRED.

3. NOTE MECHANIMS OF INJURY.

4. NOTE NUMBER OF VICTIMS.

. RE#URIES ANY ADDITIONAL HELP NOW!

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HA"ARDS

$ LOO% BEFORE YOU LEAP $

. PAR% VEHICLE IN NEAREST SAFE PLACE.

- IS IT SAFE TO APPROCH VICTIM &

- IS SPECIAL E#UIPMENT NEEDED &

- IS IMMEDIATE MOVEMENT OF VICTIM INDICATED

&

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SAFETY FIRST

YOUR FIRST

RESPONBILITY IS TOTA%E CARE OF YOURSELF

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ESSENTIAL E#UIPMENT

1. PERSONAL PROTECTION E#UIPMENT.

2. LONG BAC% BOARD

3. CERVICAL COLLAR.

4. AIRWAY E#UIPMENT - OXYGEN

  - SUCTION.

. TRAUMA BOX.

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ASSESSMENT AND INITIAL

MANAGEMENT

1. PRIMARY SURVEY - ABC'.

2. TRANSPORT DECISION AND CRITICAL

INTERVENTIONS

3. SECONDARY SURVEY

4. REASSESSMENT SURVEY.

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PRIMARY SURVEY

- RAPID HEAD -TO-FEET EXAM.

- FOCUS ON IMMEDIATE LIVE THEATENING

CONDITION.

- SHOULD TA%E NO LONGER THAN 2 MINUTE.

- STOP SURVEY ONLY FOR AIRWAY OBSTRUCTION

OR CARDIAC ARREST.

- CONTROL MAJOR BLEEDING DURING THIS TIME.

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PRIMARY SURVEY

-TOTAL OVERVIEW OF PATIENT SITUATION

WHILE YOU APPROACH.

- AIRWAY( C-SPINE CONTROL.( AND LOG ROLL.

- BREATHING.

- CIRCULATION

- CONTROL HEMORRHAGE.

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WHEN PRIMARY SURVEY

COMPLETED...

. TRANSFER PATIENT TO BAC%BOARD

  - CHEC% BAC%.

- MA%E TRANSPORT AND CRITICAL DECISIONS.

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TRANSPORT DECISION

AND

CRITICAL

INTERVENTIONS.

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LOAD AND GO SITUATIONS

- TRANSPORT THESE PATIENTS IMMEDIATELY )

 - ABNORMAL RESPIRATION

 - ABNORMAL CIRCULATION  - SHOC%.

  - UNCONTROLLABLE BLEEDING

- DECREASED LOC

- TENDER ABDOMEN

- PELVIC INSTABILITY

- BILATERAL FEMUR FRACTURES

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IN $ LOAD AND GO*

SITUATIONS+..- ON-SCENE INTERVENTIONS ARE LIMITED TO

CORRECTING IMMEDIATE THREATS TO LIFE ,  - AIRWAY

  - DECOMPRESS TENSION PNEUMOTHORAX.

  -CONTROL MAJOR BLEEDING.

- ALL OTHER INTERVENTIONS SHOULD TA%E

PLACE ENROUTE TO HOSPITAL

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SECONDARY SURVEY

- DETAILED EXAM

- PROVIDES BASELINE FOR FUTURE DECISIONS- SPLINT FRACTURES

- DRESS WOUNDS

- RECORD YOUR FINDINGS.

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SECONDARY SURVEY

- VITAL SIGN

- HISTORY

- HEAD-TO-TOE EXAM

- FURTHER BANDAGING AND SPLINTING

- CONTINUALLY MONITOR 

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HISTORY OF INJURY

- S YMPTOMS- A LLERGIES.

- M EDICATIONS

- P AST MEDICAL HISTORY

- L MAST MEAL

- E VENT PRECEDING THE INJURY

- SOURCES OF INFORMATION

  - PERSONAL OBSERVATION.

  - PATIENT BYSTANDRES

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NEUROLOGICAL EXAM

LEVEL OF CONSIOUSNESS

  A - ALERT

  V - RESPONSE TO VERBAL

  P - RESPONSE TO PAIN

  U - UNRESPONSIVE

MOTOR 

SENSATION

PULSATION

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REASSESSMENT SURVEY

- PURPOSE,

  - TO MONITOR FOR CHANGES IN PATIENTS

CONDITION.

- PERFORM ,

  - EVERY 1 MINUTES DURING TRANSPORT

  - E0 5670' 89 PATIENTS CONDITION

WORSENS

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REASSESSMENT SURVEY- LOC

- AIRWAY

- BREATHING

  - RATE #UALITY

  - CHEC% FOR JVD TRACHEA POSITION

  - LISTEN FOR BREATH SOUNDS

- CIRCULATION

  - PULSE RATE AND #UALITY

  - BLOOD PRESSURE

  - S%IN CONDITION

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REASSESSMENT SURVEY

. CHEC% ABDOMEN

- ASSESS ANY PERTINENT FINDING

NOTE IN PRIMARY OR SECONDARY SURVEY

- CHEC% INTERVENTIONS

  - INTUBATIONS

  - DRESSINGS

  - SPLINTS

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COMMUNICATIONS WITH

MEDICAL DIRECTION

- EARLY CONTACT- CONCISE AND TO THE POINT

- DESTINATION AND E'7:70; 98 T0 A:<

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SUMMARY. PRELIMINARY ACTIONS AT THE SCENE

  - SCENE AND PERSONAL SAFETY

  - MECHANISM OF INJURY

- PATIENT ASSESSMENT AND MANAGEMENT

  - PRIMARY SURVEY

  - CRITICAL INJURIES/CONDITIONS

  - TRANSPORT DECISION

  - SECONDARY SURVEY

  - REASSESSMENT SURVEY

- CONSTANT MEDICAL DIRECTION AT HOSPITAL

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THAN% YOU