Transcript bledsoe_V4_ch12

Paramedic Care
Principles & Practice
Volume 4
Trauma Emergencies
Second Edition
Chapter 12
Shock Trauma
Resuscitation
Figure 12-1
Motor vehicle crashes account for about 30 percent of trauma fatalities in the United States. (© Craig
Jackson/In the Dark Photography)
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-2
A sample home safety inspection form.
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-3
Young males account for a disproportionate representation of mortality and morbidity among trauma
victims. (© Mark C. Ide)
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-4
Assess the emergency scene quickly and carefully, looking for scene hazards, possible mechanisms of
injury, the location of patients, and the possible need for additional resources. (© Jeff Forster)
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-5
Analyze the forces of a vehicle collision, and based on that analysis, anticipate possible patient injuries.
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-6
Analyze the scene carefully to determine the need for body substance isolation procedures.
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-7
Assess the emergency scene to determine the need for any additional resources.
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-8
A trauma assessment form can help you organize priorities at any emergency scene.
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-9
Form a general impression of the patient during the initial assessment and refine it during the rest of
your time at the patient’s side. (© Craig Jackson/In the Dark Photography)
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-10
Auscultate for the presence and quality of breath sounds.
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-11
Inspect the chest carefully for signs of injury.
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-12
At the end of the rapid trauma assessment or the focused assessment, make the final decision on
whether to provide stabilization on the scene or to expedite transport of the patient.
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-13
With a seriously injured trauma patient, employ the aggressive care steps of shock trauma
resuscitation. (© Craig Jackson/In the Dark Photography)
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-15
Use intravenous fluid warmers as necessary.
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-16
Seriously injured patients who require rapid transport may be immobilized to a long spine board for
effective splinting of limb fractures. (© Craig Jackson/In the Dark Photography)
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-14
Hypothermia poses a serious threat to trauma patients. Assure that your care helps the patient maintain
his body temperature.
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-17
Anatomical and physiological considerations with infant and child patients.
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-18
Paramedics must make special efforts to gain the confidence of pediatric patients.
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-19
Consider intraosseous placement in the tibia when administering fluids and medications in children
under age 6 if you cannot obtain normal intravenous access.
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-20
Geriatric patients represent one of the fastest growing groups requiring emergency medical services.
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-21
Age-related changes in geriatric patients.
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-22
It is essential that information exchange among care providers be rapid, thorough, and accurate.
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-23
In recent years, use of helicopters has become widely available to EMS systems throughout the
country. (© Mark C. Ide)
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-24
Helicopters can provide special services like search and rescue, vertical lifting, and specialized
transport. (© Jeff Forster)
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-25
Special considerations with helicopters.
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 12-26
The working space in a helicopter is limited, so try to complete all crucial procedures before you load
the patient. (© Mark C. Ide)
Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry
Paramedic Care, Principles & Practice: Trauma Emergencies
Copyright ©2006 by Prentice-Hall, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.