Transcript Basic Rapid Trauma Assessment - NH-TEMS

Basic Trauma
Alton Police Department Tactical Response Team
Presented By
Alton Police Department Tactical Response Team
Basic Trauma
• During a tactical operation, or even training, the
risk of injury is high. Rapid Assessment can be
used by team members to recognize life
threatening injuries based on CPR and First
Responder training.
• This process is an easy to follow outline used to
evaluate the officers condition and provide basic
medical care, if the team medic not immediately
present, prior to transfer to EMS.
• The objective is to enhance survivability.
Alton Police Department Tactical Response Team
Basic Trauma
• Trauma, what is it?
– A serious injury or shock to the body by
violence or accident.
– The leading cause of death in 1-44 year age
group.
– The 3rd leading cause of death in all age groups.
– 60 million injuries each year in the U.S. alone.
• Remember, Only Surgeons Fix Trauma!
Alton Police Department Tactical Response Team
Basic Trauma
The “Golden Hour”
Immediate
(50%) minutes
to one hour
Early (30%)
First 4 hrs
Late (20%) 2 to
5 weeks
Alton Police Department Tactical Response Team
Vest Medical Pouch
• Every officer the same contents, same placement.
• When treating use theirs, not yours.
• Contents:
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(1) Pair Latex or vinyl gloves.
(1) Blood Stopper Dressing.
(2) Rolls of Kerlix gauze
(1) 3”x9” Petroleum gauze dressing
(1) Triangular bandage
(1) Double roll Flexwrap
(1) CPR Shield
(1) Trauma Scissors
Alton Police Department Tactical Response Team
Officer Medical Information
Form
Officer Medical History
Name
DSN
Jones, James A. 9003
DOB
1/21/1967
Drug/Food Allergies
Sulfa Drugs
Medical History
Triple By-pass
Medications
Nitro-as needed
Physician
Smith
SSN
000-00-0000
Additional Information
Has Narcolepsy
Alton Police Department Tactical Response Team
Blood Type
AB-
Rapid Assessment
• First course of action is to eliminate the
threat and/or move downed officer to
safety/cover.
– Only move in necessary for safety.
– Always suspect spinal injuries.
• Maintain as much in-line spinal immobilization as
possible during movement.
• If threat is still present need cover officer
while conducting assessment.
Alton Police Department Tactical Response Team
Rapid Assessment
• Cervical spine immobilization?
• Determine Level of Consciousness (LOC).
– Is he alert? Can he speak? Does he make sense?
• Assess his airway.
– If he can speak, he can breathe.
– If unconscious, open the airway.
• Head tilt, chin lift
• Modified jaw thrust
– Is he having difficulty breathing? What is the rate per
minute?
– Normal adult 12-20 breathes per min.
– <8 or >24 indicates problem, <8 assist.
Alton Police Department Tactical Response Team
Rapid Assessment
• Evaluate pulse.
– What is rate and quality.
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Normal adult 80-100 bpm.
Radial pulse (wrist/thumb side).
Carotid pulse (neck).
No pulse begin CPR.
– Use AED if available.
– AED & Trauma.
Alton Police Department Tactical Response Team
Rapid Assessment
• Look head to toe for bleeding that will
compromise the circulation system.
– “KILLER BLEEDS”
• Large arterial or venous bleeding that could interrupt
circulatory system.
• 1L is serious
• About 60-90 seconds to this point.
Alton Police Department Tactical Response Team
First Aid
• Stop the bleeding
– Determine origin of injury.
– Expose the injury.
• Remove and/or cut away clothing and equipment.
– Determine severity-entrance and exit wounds?
– Apply concentrated or diffused pressure w/dressing.
• Cover largest/biggest bleeder 1st.
• Head trauma with possible fractures.
– Cover lightly with no pressure.
– Includes bleeding and fluid from ears and nose.
Alton Police Department Tactical Response Team
First Aid
• Nose bleeds (no trauma)
– Ensure airway.
• Lean forward to avoid swallowing blood.
• Pinch fleshy portion.
– If trauma, immobilize and prepare for nausea/vomiting.
• GSW
– Check for exit wound, if large may need to pack
w/gauze.
– If chest wound, cover with occlusive dressing and tape
on three sides.
• Lay on wounded side.
• May need to “vent” dressing.
Alton Police Department Tactical Response Team
First Aid
• Impaled objects
– DO NOT REMOVE!
– Stabilize, dress and bandage.
• Evisceration
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Abdominal injury with internal organs protruding.
Cover with sterile wet dressing to keep moist.
Do not attempt to push back in.
No Food or Drink.
Prepare for vomiting.
Alton Police Department Tactical Response Team
First Aid
• Blunt Trauma to Chest
– Look for deformity/bruising
– If one portion moves independently (flail chest), pad
and secure w/gauze.
– Place on affected side
• Amputation
– Bag and keep cool.
– No direct contact with water or ice.
– Do not remove partial amputation.
• Large open neck injury
– Cover with occlusive dressing
Alton Police Department Tactical Response Team
First Aid
• Burns
– If head or face, think airway!
– Stop the burning. Nothing but water!
– Remove smoldering clothing and jewelry.
• DO NOT REMOVE CLOTHING IF STUCK!
– Cover with dry sterile dressing.
– Prepare for hypothermia.
Alton Police Department Tactical Response Team
Communicate
• Extract the injured to or establish a safe
zone where EMS can initiate additional
emergency care and prepare for transport.
– Remember spinal immobilization!
• Use radio to communicate with medical
support elements.
– EMS
– FD
Alton Police Department Tactical Response Team
Head to Toe
• Secondary survey
– While waiting for support/transport (EMS, FD) conduct
secondary survey.
– Re-evaluate ABC’s.
– Re-evaluate for additional injuries.
– Re-evaluate treatment already done.
• Give a brief history of injuries and what you’ve
done when passing patient to higher level of
medical treatment (”K.I.S.S.” is the rule here).
Alton Police Department Tactical Response Team
Basic Trauma
• QUESTIONS?
• EXAM
• PRACTICAL
EXERCISES
Alton Police Department Tactical Response Team