TRAUMA (MULTIPLE SYSTEMS)
ALL LEVELS
DESIGNATION OF CONDITION
Signs and symptoms may include any or all the following: mechanism of injury suggestive of trauma to two or more body systems.
EMPHASIS ON PATIENT CARE
1. Primary Management - Assess X-ABC’s and manage as indicated.
a. X- control hemorrhage as priority.
b. Stabilize airway if necessary: oral / nasal airway; SGA; suction
2. , Inspection of C-spine, minimize scene time
a. Apply pelvic binder if hypotensive and evidence of pelvic injury
b. Consider use of tourniquet as indicated
3. Initiate transport to appropriate medical facility. Consider aeromedical evacuation to definitive care. If in doubt, contact medical control.
4. Secondary Management - History, physical exam, vital signs
5. Consider traction splint for mid-shaft femur fractures
6. Immobilize long bone fractures
7. Cover patient to prevent hypothermia
8. Cover suspected open chest wounds with an occlusive dressing. Stabilize fractured and/or flail segments.
a. Be vigilant for developing tension pneumothorax. If a tension pneumothorax is suspected, release the seal over the wound and allow any air under pressure to escape. Then reseal the wound and monitor the patient.
AEMT
1. In-route, initiate one or two large bore IVs of an isotonic solution and infuse at a flow rate to maintain adequate end organ perfusion.
2. Don’t overdue crystalloid fluids but use judiciously in all age groups to maintain adequate perfusion. 20 ml./kg. as an initial bolus is usually acceptable. Maintain fluids as indicated.
3. For use of analgesics, see Pain Management Guidelines.
PARAMEDIC
1. Refer to Trauma Cardiac Arrest guideline if indicated.
2. Consider chest decompression for suspected pneumothorax. Consider bilateral in cardiac arrest.
3. See Pain Management Guidelines
4. See Airway Management Treatment Guidelines.
5. For significant suspected or overt non-compressible hemorrhage consider TXA administration within three hours of onset of hemorrhage:
Adult Initial Bolus (16 years and older)
Mix 2 grams vial in 250 ml. bag of fluid.
Administer 2 grams (250 ml.) IV/IO over 10 minutes.
ALL LEVELS
DESIGNATION OF CONDITION
Signs and symptoms may include any or all the following: mechanism of injury suggestive of trauma to two or more body systems.
EMPHASIS ON PATIENT CARE
1. Primary Management - Assess X-ABC’s and manage as indicated.
a. X- control hemorrhage as priority.
b. Stabilize airway if necessary: oral / nasal airway; SGA; suction
2. , Inspection of C-spine, minimize scene time
a. Apply pelvic binder if hypotensive and evidence of pelvic injury
b. Consider use of tourniquet as indicated
3. Initiate transport to appropriate medical facility. Consider aeromedical evacuation to definitive care. If in doubt, contact medical control.
4. Secondary Management - History, physical exam, vital signs
5. Consider traction splint for mid-shaft femur fractures
6. Immobilize long bone fractures
7. Cover patient to prevent hypothermia
8. Cover suspected open chest wounds with an occlusive dressing. Stabilize fractured and/or flail segments.
a. Be vigilant for developing tension pneumothorax. If a tension pneumothorax is suspected, release the seal over the wound and allow any air under pressure to escape. Then reseal the wound and monitor the patient.
AEMT
1. In-route, initiate one or two large bore IVs of an isotonic solution and infuse at a flow rate to maintain adequate end organ perfusion.
2. Don’t overdue crystalloid fluids but use judiciously in all age groups to maintain adequate perfusion. 20 ml./kg. as an initial bolus is usually acceptable. Maintain fluids as indicated.
3. For use of analgesics, see Pain Management Guidelines.
PARAMEDIC
1. Refer to Trauma Cardiac Arrest guideline if indicated.
2. Consider chest decompression for suspected pneumothorax. Consider bilateral in cardiac arrest.
3. See Pain Management Guidelines
4. See Airway Management Treatment Guidelines.
5. For significant suspected or overt non-compressible hemorrhage consider TXA administration within three hours of onset of hemorrhage:
Adult Initial Bolus (16 years and older)
Mix 2 grams vial in 250 ml. bag of fluid.
Administer 2 grams (250 ml.) IV/IO over 10 minutes.