2 1814 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 Cspine ID: 312950
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Slide1
STS 2/18/14TraumaSlide2
Skull fracturesBleeding:Loosely cover bleeding site with sterile gauze (look for CSF)DO NOT attempt to stop blood flow
DO NOT insert
nasopharyngeal airway
Suspect
C-spineSlide3
Eye injuriesForeign 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 dressingSlide4
Blowout fractureFracture of orbit boneGoogly eyesCheck PERLContacts should be kept in eyeUnless chemical in eye
Notify ALS/
Tx
if Pt wearing contacts
Get to hospital ASAPSlide5
EpistaxisBleeding from noseTx:Pinch nose
Tilt forward
Do not tilt backwards
If
Pt
swallows blood, may cause
Pt
to vomit
suction
3) Apply iceSlide6
Mouth injuriesTeeth dislodgedSave 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!Slide7
Soft tissue injuryHematomaPool of blood collects in an area compartment syndrome
May be due to blunt injury
Tx
:
splint and CMSSlide8
Open injuriesAbrasionSuperficial damage no deeper than epidermisTx
: clean and apply
bandaid
/dressing
Avulsion
Flap ripped away, still attached
Tx
:
Clean and place flap back in right position
Control bleedingApply dressingSlide9
Penetrating wound (impaled)Tx:Splint and stabilize impaled objectDO NOT remove object unlessInterferes with CPRObstruction of airway
Gunshot wound (GSW)
Look for entry and exit wound (document)
Tx
:
Control bleeding
Provide O
2 accordingly
Blanket and shock position if in shockSlide10
PneumothoraxAir in pleural spaceLung may collapse within secondsSucking 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 momentarilySlide11
Abdominal woundsEviscerationOrgan protruding through abdomenTx:
Soak big trauma dressing in sterile saline solution, tape over exposed organ
DO NOT touch exposed organ (infection)Slide12
AmputationsWrap severed body part in sterile gauzePlace in plastic bag (zip loc)
Chill
with ice
DO NOT allow body part to freeze or come into direct contact with iceSlide13
NeckJugular vein injuryTx:Occlusive dressing
Tape down on 4 sides
Monitor respirations closely (in case of air embolism)Slide14
Thermal Burns1st degree
superficial
2
nd
degree
dermis
3
rd
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 fluidsSlide15
Chemical burnsTx: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 arrhythmiaSlide16
Scenario