Transcript 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
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Apply a cervical collar
during the rapid trauma assessment
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
Perform a Rapid Trauma Assessment
Inspect
Palpate
Auscultate
Smell
From head-to-toe
Jugular vein distension
Paradoxical motion
Flail chest
Crepitation
Subcutaneous Emphysema
Pulsating mass
Pelvis- Priapism
PMS
PMS
PMS
PMS
PMS
PMS
PMS
PMS
PMS
PMS
PMS
PMS
PMS
PMS
Reconsider mechanism of injury
Determine chief complaint
Perform a focused physical exam
Expose
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
Third collision; organs strike
Examples:
Head-on collision:
Up and over injury
up and over the steering wheel
Down and under injury
down and under the steering wheel
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
Motorcycles and ATVs
Helmet?
Suspect any and all types of injuries
Falls
Height of fall
three times patient height is
severe
Surface they landed on
Penetrating Trauma
Shooting; stabbing
Velocity: Speed of the object
Low velocity
Stabbing
Injury usually isolated to area penetrated
multiple wounds
damage to internal organs
Medium-velocity
Handguns and shotguns
Arrows
High velocity
High powered rifles
Assault rifles
Bullets cause damage in two ways:
Damage directly from the bullet itself
Cavitation
pressure wave
Blunt Force Trauma
maintain a high index of suspicion
Assessment of the Medical Patient
Responsive
Four parts
History of present illness
Focused physical exam
OPQRST
SAMPLE
Baseline VS
Prior history
DCAPBTLS
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
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