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Trauma Assessment Basic Trauma Course. The goal of the primary assessment is to rapidly identify potentially life-threatening condition requiring immediate intervention. Airway/Cervical Spine. A- Airway -Open or patent-Cervical Spine immobilized Can they vocalize? Tongue obstructing airway
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Trauma AssessmentBasic Trauma Course The goal of the primary assessment is to rapidly identify potentially life-threatening condition requiring immediate intervention.
Airway/Cervical Spine • A- Airway-Open or patent-Cervical Spine immobilized • Can they vocalize? • Tongue obstructing airway • Loose teeth, blood, or vomit in mouth • Edema • If patient already intubated when arrives: • Equal rise and fall of the chest with ventilation • Listening over epigastrium and then over the lung fields • Specific device to confirm tube placement
Breathing • Assess presence and effectiveness • Spontaneous breathing • Rise and fall of the chest • Rate and pattern of breathing • Use of accessory muscles, diaphragmatic breathing or both • Skin color • Bilateral breath sounds • Tracheal deviation and JVD
Circulation • Presence of major pulses, Presence of external hemorrhage • Palpate a central pulse (carotid, femoral, or brachial in infants under one year of age) • Inspect and palpate skin • Capillary refill time
Disability • Brief neurologic assessment to determine the degree of disability. • Level of consciousness-Determine level of consciousness using the AVPU mnemonic A Alert V Verbal stimuli P Painful stimuli U Unresponsive • Glasgow Coma Scale-Variations for pediatrics • Best Eye Opening • Best Verbal Response • Best Motor Response • Pupillary assessment-Size, shape, equality , and reaction to light
Expose/Environment/Evidence • Get Naked! • Decontaminate if needed. • Cover up & keep warm. • Consider if clothing may be evidence and preserve it.
Consider Transfer • Consider the need for transfer for following conditions: • Significant head or spinal cord injury, major chest wall trauma, open pelvic or solid organ injury, major crush injuries, traumatic amputation with potential for re-implantation, major burns, multiple long bone fractures, and Multi-system trauma.
Secondary Assessment • F-Full set of Vitals, Focused adjuncts (Labs, monitors, F/C, NG), Facilitate family presence • G-Give comfort-touch, talking, and pharmacologic pain management. • H-History-MIVT (MOI, Injuries, VS, TX), Past medical hx, Head to toe- Inspection, palpation, Percussion, Auscultation • I-Inspect Posterior, rectal tone, temp
Focused Assessment • Trauma documentation • Wound care • Tetanus prophyx • Antibiotics • Prepare for transfer
Evaluation & Monitoring • Continually monitor and treat: • Airway patency • Level of Consciousness • Hemodynamic status • Breath sounds and pulse oximetry • Cardiac rate and rhythm • Pain relief • Intake and output