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STS 9/30/ 14 Trauma

STS 9/30/ 14 Trauma. Skull fractures. Bleeding Loosely cover bleeding site with sterile gauze (look for CSF) DO NOT attempt to stop blood flow DO NOT insert nasopharyngeal airway Suspect C-spine. Eye injuries. Foreign objects in eye:

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STS 9/30/ 14 Trauma

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  1. STS 9/30/14 Trauma

  2. Skull fractures • Bleeding • Loosely cover bleeding site with sterile gauze (look for CSF) • DO NOT attempt to stop blood flow • DO NOT insert nasopharyngeal airway • Suspect C-spine

  3. Eye injuries • Foreign objects in eye: • Irrigate with saline/water (flush middle of eye to outside corner) • Never attempt to remove object from cornea (only remove if object is on eyelid) • Impaled • stabilize with roller gauze • Chemical in eye • flush with saline/water for 20 min • Thermal burn • cover with burn dressing

  4. Blowout fracture • Fracture of orbit bone • Googly eyes • Check PERL • Contacts should be kept in eye • Unless chemical in eye • Notify ALS/Tx if Pt wearing contacts • Get to hospital ASAP

  5. Epistaxis • Bleeding from nose • Tx: • Pinch nose • Tilt forward • Do not tilt backwards • If Pt swallows blood, may cause Pt to vomit  suction 3) Apply ice

  6. Mouth injuries • Teeth dislodged • Save teeth in container mixed with Pt’s saliva/milk • If bleeding in mouth is heavy • Check airway • Prepare to suction Never stick your hand into someone’s mouth!

  7. Soft tissue injury • Hematoma • Pool of blood collects in an area  compartment syndrome • May be due to blunt injury Tx: splint and CMS

  8. Open injuries • Abrasion • Superficial damage no deeper than epidermis • Tx: clean and apply bandaid/dressing • Avulsion • Flap ripped away, still attached • Tx: • Clean and place flap back in right position • Control bleeding • Apply dressing

  9. Penetrating wound (impaled) • Tx: • Splint and stabilize impaled object • DO NOT remove object unless • Interferes with CPR • Obstruction of airway • Gunshot wound (GSW) • Look for entry and exit wound (document) • Tx: • Control bleeding • Provide O2 accordingly • Blanket and shock position if in shock

  10. Pneumothorax • Air in pleural space • Lung may collapse within seconds • Sucking chest wound • Open chest wound allows air into pleural space • Tx: • Occlusive dressing • Tape 3 sides down  allow air out when pressure builds • Lung sounds every 5 min • If lung sounds absent after applying occlusive dressing  ventilate, remove dressing momentarily

  11. Abdominal wounds • Evisceration • Organ protruding through abdomen • Tx: • Soak big trauma dressing in sterile saline solution, tape over exposed organ • DO NOT touch exposed organ (infection)

  12. Amputations • Wrap severed body part in sterile gauze • Place in plastic bag (zip loc) • Chill with ice • DO NOT allow body part to freeze or come into direct contact with ice

  13. Neck • Jugular vein injury • Tx: • Occlusive dressing • Tape down on 4 sides • Monitor respirations closely (in case of air embolism)

  14. Thermal Burns 1st degree superficial 2nd degree dermis 3rd degree full thickness • Tx: • - Stop burning  submerse in cool water/saline • - If severe, apply burn dressing (non-adhesive) • Treat for shock • Pt’s with critical burns lose a lot a fluids

  15. Chemical burns Tx: • Remove clothing • For powder chemicals: brush off powder first 3) Flush with water for 20 min Electrical burns • Look for entry and exit wounds • Prepare to perform CPR • Cardiac arrhythmia

  16. DCAPBTLS • Deformities • Contusions • Abrasions • Punctures • Burns • Tenderness • Lacerations • Swelling

  17. Scenario

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