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Trauma Triage Scenario 1. Scenario 1. Scene Info. Motorcycle v. Pickup Truck Truck traveling 40 mph, ? Cycle speed 30 y/o male thrown 20 feet Truck has damage Rider’s helmet has few, minor scratches. What does this information provide us? What additional information do you need?.
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Scene Info • Motorcycle v. Pickup Truck • Truck traveling 40 mph, ? Cycle speed • 30 y/o male thrown 20 feet • Truck has damage • Rider’s helmet has few, minor scratches What does this information provide us? What additional information do you need?
Initial Assessment • Opens eyes to loud verbal stimuli • Localizes painful stimuli • Confused verbal response to questions • Airway is open and clear • RR=32, ≠ chest expansion, R. wall bruising • Strong radial pulses, no major bleeding • Skin pale, moist, cool Can you estimate GCS & RTS? What is the Patient Status?
Focused H&P • No obvious head injury, PERRLA • No JVD or tracheal tugging, C-spine non-tender • ≠ Chest expansion, crepitus, lung sounds R. • Abdomen soft, pelvis stable • Open L. femur fracture • Abrasions and small laceration on R. arm • Pulse = 100, BP 110/68, RR = 32 • Medic alert tag for Coumadin use Confirm or dispute your initial severity determination.
Trauma Communications What pertinent information will you communicate to medical control?
Transport Decision • Injury Severity • Hospital capability, location, driving time • Area Level III Trauma Hospital is 10 minutes • Regional Level I Hospital is 20 minutes • ALS intercept is unavailable • Helicopter is available and ETA to scene is 20 minutes What decision will Medical Control make and why?