TRAUMA (MULTIPLE SYSTEMS)
ALL LEVELS
DESIGNATION OF CONDITION
Signs and symptoms may include any or all of the following: mechanism of injury suggestive of trauma to two or more body systems.
EMPHASIS ON PATIENT CARE
1. Primary Management - Assess ABC’s and manage as indicated.
a. Stabilize airway if necessary: oral / nasal airway; SGA; suction
2. Control of hemorrhage, 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. Utilize a Buretrol in PEDIATRICS at rate of 20 ml./kg. administered as a bolus. Repeat as needed. If unable to initiate a peripheral IV, consider intraosseous access if patient condition warrants
3. For use of analgesics, see Pain Management Guidelines.
PARAMEDIC
1. Consider airway management: ET intubation, SGA or surgical airway.
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 of the following: mechanism of injury suggestive of trauma to two or more body systems.
EMPHASIS ON PATIENT CARE
1. Primary Management - Assess ABC’s and manage as indicated.
a. Stabilize airway if necessary: oral / nasal airway; SGA; suction
2. Control of hemorrhage, 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. Utilize a Buretrol in PEDIATRICS at rate of 20 ml./kg. administered as a bolus. Repeat as needed. If unable to initiate a peripheral IV, consider intraosseous access if patient condition warrants
3. For use of analgesics, see Pain Management Guidelines.
PARAMEDIC
1. Consider airway management: ET intubation, SGA or surgical airway.
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.