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Assessment of the Trauma Patient

Assessment of the Trauma Patient. Focused History and Physical Exam for the Trama Patient. No significant mechanism of injury Focus assessment on just the areas of injury or compliant. Includes Physical Exam VS SAMPLE. D C A P B T L S e o b u u e a w f n r n r n c e

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Assessment of the Trauma Patient

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  1. Assessment of the Trauma Patient

  2. Focused History and Physical Exam for the Trama Patient

  3. No significant mechanism of injury • Focus assessment on just the areas of injury or compliant. • Includes Physical Exam VS SAMPLE

  4. D C A P B T L S e o b u u e a w f n r n r n c e o t a c n d e l m u s t s e r l i s I u r a i t I o r n t n i o n e e I g e n s s s o s s s n s

  5. Apply a cervical collar during the rapid trauma assessment

  6. Trauma patient with a significant mechanism of injury • Remember with children same type of injury may take less force. • Continue spinal immobilization • Reconsider transport decision • Reassess MS

  7. Perform a Rapid Trauma Assessment • Inspect • Palpate • Auscultate • Smell From head-to-toe

  8. Jugular vein distension • Paradoxical motion Flail chest • Crepitation • Subcutaneous Emphysema • Pulsating mass • Pelvis- Priapism

  9. PMS PMS PMS PMS PMS PMS PMS PMS PMS PMS PMS PMS PMS PMS

  10. Reconsider mechanism of injury • Determine chief complaint • Perform a focused physical exam

  11. Expose

  12. Mechanism of Injury Index of suspicion • Law of inertia: A object in motion stays in motion until acted upon by another force Three collisions: First; vehicle strikes something Second; Victim strikes something on impact

  13. Third collision; organs strike

  14. Examples: Head-on collision: • Up and over injury up and over the steering wheel • Down and under injury down and under the steering wheel

  15. Rear-end collision Head and neck injury • Side impact collision Skeletal and internal injuries • Rollover Possibility of ejection • Rotational Impact Observe damage to the windshield, steering wheel, dash and pedals

  16. Motorcycles and ATVs • Helmet? • Suspect any and all types of injuries

  17. Falls • Height of fall three times patient height is severe • Surface they landed on

  18. Penetrating Trauma Shooting; stabbing • Velocity: Speed of the object • Low velocity Stabbing Injury usually isolated to area penetrated multiple wounds damage to internal organs

  19. Medium-velocity Handguns and shotguns Arrows • High velocity High powered rifles Assault rifles

  20. Bullets cause damage in two ways: • Damage directly from the bullet itself • Cavitation pressure wave

  21. Blunt Force Trauma maintain a high index of suspicion

  22. Assessment of the Medical Patient Responsive • Four parts History of present illness Focused physical exam OPQRST SAMPLE Baseline VS • Prior history • DCAPBTLS

  23. Unresponsive • Patient history from family, bystanders etc. • Rapid assessment Abd: distension, firmness, rigidity Pelvis: Incontinence of urine, feces • ID bracelets • Baseline VS • Consider need for ALS • History of present illness and SAMPLE

  24. History of present illness and SAMPLE • Patient’s name • What happened what did family/bystander see • Did patient complain of anything prior • Know illness • Medications

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