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45 Cards in this Set
- Front
- Back
AIRWAY with C-Spine
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1) Vocalization
2) Tongue obstructing airway 3) Loose teeth/foreign objects 4) Blood, vomit or other secretions 5) Edema |
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AIRWAY INTERVENTIONS
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1) Position the patient
2) Jaw thrust or chin lift 3) Remove any foreign objects 4) Suction blood, vomit or secretions 5) Insert OPA or NPA 6) ET intubation 7) Needle or surgical cricothyrotomy |
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BREATHING
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1) Spontaneous breathing
2) Equal rise and fall of chest 3) Rate and pattern of breathing 4) Use of accessory muscles and/or diaphragmatic breathing 5) Skin color 6) Integrity of the soft tissue and bony structures of the chest wall 7) Bilateral breath sounds 8) JVD and tracheal deviation-late signs of breathing compromise |
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BREATHING INTERVENTIONS
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1) Supplemental oxygen
2) Bag mask ventilation 3) Needle thoracentesis/decompression 4) Chest tube 5) Nonporous dressing taped on three sides |
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INNEFECTIVE BREATHING SIGNS
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1) Altered mental status
2) Cyanosis, especially around mouth 3) Assymetric expansion f the chest wall, paradoxical movement of chest wall 4) Use of accessory or abdominal muscles or diaphragmatic breathing 5) Sucking chest wounds 6) Absent or diminished breath sounds-administer O2 via nonrebreather and assist ventilations 7) Anticipate definitive airway-ET tube |
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IF BREATHING ABSENT
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1) Ventilate patient
2) Definitive airway 3) Assess for life threatening injuries that may compromise breathing |
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INJURIES THAT MAY COMPROMISE BREATHING
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1) Tension pneumo-Tx with needle thoracentesis
2) Open pneumo-Tx by covering open chest wound 3) Flail chest with pulmonary contusion 4) Hemothorax-Tx with chest tube |
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CIRCULATION
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1) PALPATE A CENTRAL PULSE for rate and quality
2) Inspect the skin for color, temperature, and moisture 3) Check capillary refill 4) Look for uncontrolled bleeding |
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CIRCULATION INTERVENTIONS
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1) Direct pressure over uncontrolled bleeding sites
2) 2 large bore IV's with warmed isotonic crystalloid solution 3) Infuse fluid rapidly with blood tubing 4) Blood sample for typing 5) Blood administration 6) Pericardiocentesis 7) Emergency Thoracotomy 8) Surgery 9) CPR and ACLS |
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INNEFFECTIVE CIRCULATION SIGNS
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1) Tachycardia
2) Altered mental status (agitated, confused, decreased arousability) 3) Uncontrolled external bleeding 4) Distended or abnormally flattened external jugular veins 5) Distant heart sounds |
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DISABILITY
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1) Neuro checks
2) AVPU 3) GCS-Eye, verbal, and motor response. <9/15 is severe 4) Access pupils 5) Laterilization |
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DISABILITY INTERVENTIONS
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1) Perform further investigation
2) Hyperventilate, if indicated- only if exhibiting signs of herniation or neurologic deteriation that are nonresponsive to other measures and mannitol. |
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EXPOSE PATIENT/ENVIRONMENTAL CONTROL
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1) Remove clothing carefully to avoid provider injury and to avoid destroying evidence
2) Ensure appropriate decontamination (if applicable) 3) Keep patient warm-blankets, warming lights, increase ambient temperature 4) Save clothing as evidence 5) Consider the need for a transfer |
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FAMILY PRESENCE, FULL SET OF VITALS, FOCUSED ADJUNCTS
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PLUGM
1) Pulse oximetry 2) Labs 3) Urinary Catheter 4) Gastric Tube 5) Monitor cardiac rate and rhythm |
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GIVE COMFORT
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Pain management: pain medicine, therapeutic touch, positioning, apply heat or cold, distraction, humor, relaxation exercises, verbal reassurance
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HEAD TO TOE, HISTORY
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History: MIVT=mechanism of injury, injuries sustained, vitals, treatment recieved, PMH, patient generated info
Head to toe |
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INSPECT POSTERIOR SURFACES
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Logroll and protect cervical spine when inspecting back. Support extremities with injuries. Palpate the vertebral column and all posterior surfaces. Assess rectum for blood.
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HEAD TO TOE- GENERAL APPEARANCE
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1) Body position, posture, guarding, and position of limbs.
2) Unusual odors such as gas, alcohol, chemicals, vomit, urine, feces. |
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HEAD TO TOE- HEAD AND FACE
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1) Soft tissue injuries-wounds, crackling associated with subQ emphysema, palpate for tenderness
2) Bony deformities 3) Asymmetry of facial expressions 4) Eyes- ask how many fingers, raccoon eyes, edema 5) PERRLA 6) 6 cardinal fields of gaze 7) Ears- Battle's sign (ecchymosis behind ear-late sign of head injury), drainage (don't pack) 8) Nose- drainage (don't pack), position of nasal septum |
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HEAD TO TOE- NECK
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1) Remove anterior portion of the rigid cervical collar to inspect and palpate the neck
2) Another team member must hold the head while collar is being removed and replaced 3) Inspect for wounds, ecchymosis, deformities, and distended neck veins, position of trachea 4) Palpate for tenderness, note bony crepitus, deformity, subQ emphysema and tracheal position |
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HEAD TO TOE- CHEST
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1) Inspection-rate, depth, wounds, deformities, ecchymosis, use of accessory muscles, paradoxical movement
2) Auscultation- heart AND lung sounds 3) Palpate for tenderness, note bony crepitus, subQ emphysema and deformity |
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HEAD TO TOE- ABD AND FLANKS
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1) Inspect-wounds, distention, ecchymosis and scars
2) Auscultate for bowel sounds 3) Palpate all four quads for tenderness, rigidity, guarding, masses, and femoral pulses |
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HEAD TO TOE- PELVIS/PERINEUM
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1) Inspect for wound, deformities, ecchymosis, priapism, blood and urinary meatus or perineal area
2) Palpate the pelvis and anal sphincter tone 3) Assess pain, urge and abiltiy to void |
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HEAD TO TOE- EXTREMITIES
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1) Inspect for ecchymosis, movement motor function-ROM scale 0-5, 5 is Full ROM, wounds, deformities and splints
2) Palpate for pulses, skin temp, sensation, tenderness, deformities and note bony crepitus |
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HEAD TO TOE- POSTERIOR SURFACES
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1) Maintain C-spine protection and support injured extremities while the patient is logrolled
2) Inspect the posterior surfaces for wounds, deformities and ecchymosis 3) Palpate the posterior surfaces for tenderness and deformities 4) Palpate anal sphincter tone if not previously done |
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SECONDARY FOCUSED ADJUNCTS
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1) Labs
2) X-rays 3) Angiography 4) PASG-pneumatic antishock garment |
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GENERAL DIAGNOSTIC STUDIES
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1) Type, screen, crossmatch
2) H&H 3) BAC 4) Serum Lactate-to identify sepsis 5) Serum pregnancy 6) Kleihauer-Betke-detects transplacental hemorrhage 7) ABG's |
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GENERAL INTERVENTIONS
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1) Operative intervention
2) Admission or transfer 3) GCS and Revised Trauma Score 4) Psychosocial support of family 5) Pain control-medication and nonpharmalogical 6) Other meds: Tetanus, Abx, neuromuscular blockers, sedation |
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HEAD AND FACE DIAGNOSTIC STUDIES
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1) X-rays
2) CT scan 3) MRI 4) Angiography |
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HEAD AND FACE INTERVENTIONS
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1) Position patient
2) Medications, as prescribed 3) Intracranial pressure monitoring 4) Suctioning |
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NECK DIAGNOSTIC STUDIES
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1) X-rays
2) CT scan 3) MRI 4) Angiography |
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NECK INTERVENTIONS
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1) Spinal protection with vertebral column immobilization
2) Steroids, per institutional protocols |
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CHEST DIAGNOSTIC STUDIES
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1) X-rays
2) CT scan 3) MRI 4) Arteriography or aortography 5) FAST- Focused assessment sonography for trauma 6) Bronchoscopy 7) Esophagoscopy 8) EKG 9) Hemodynamic monitoring |
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CHEST INTERVENTIONS
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1) Chest tube
2) Autotransfusion 3) Needle thoracentesis/decompressoin 4) Pericardiocentesis 6) Prepare for thoracotomy |
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ABDOMEN AND FLANK DIAGNOSTIC STUDIES
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1) X-rays
2) CT scan 3) MRI 4) FAST 5) IVP- Intravenous pyelogram 6) DPL- Diagnostic peritoneal lavage 7) Cystogram or urethrogram 8) Angiography |
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ABDOMEN AND FLANK INTERVENTIONS
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1) Urinary catheter
2) Gastric tube 3) Consider pelvic antishock garment for intraabdominal or pelvic bleeding |
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PELVIS AND PERINEUM DIAGNOSTIC STUDIES
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1) X-rays
2) CT scan 3) MRI 4) FAST |
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PELVIS AND PERINEUM INTERVENTIONS
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1) Urinary catheter
2) Pneumatic antishock garment for splinting 3) External pelvic stabilization device |
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EXTREMITIES DIAGNOSTIC STUDIES
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1) X-rays
2) CT scan 3) MRI 4) Measurement of compartment pressures |
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EXTREMITIES INTERVENTIONS
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1) Immobilization/ traction devices
2) Elevation 3) Ice |
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POSTERIOR SURFACE DIAGNOSTIC STUDIES
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1) X-rays
2) CT scan 3) MRI |
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POSTERIOR SURFACE INTERVENTIONS
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1) Spinal protection with vertebral column immobilization
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SURFACE TRAUMA INTERVENTIONS
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1) Irrigation
2) Wound care 3) Ice 4) Care for amputated parts 5) Tetanus prophylaxis 6) Antibiotics |
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PRIMARY ASSESSMENT
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A, B, C, D, E
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SECONDARY ASSESSMENT
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F, G, H, I
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