Injuries
What are a few examples of injuries we can SEE without any equipment?
Rib fracture, flail chest, chest contusion, sternal fracture, sucking chest wound
With a Great Vessel tear, what is the number 1 worry?
Hypovolemic shock (caused by lack of blood)
For MOST internal contusions, what are the interventions we can do?
02 titrated to 94% - 96% SP02
Semi fowlers position/POC
Assess and reassess vitals and LOC
Call for ALS rendezvous
Transport
What is the main indicator of flail chest?
Unequal chest rise during breathing with entire segments (usually on one side) failing to rise
Is the prognosis good or bad for a lacerated aorta? Why?
Bad because it pumps all of the blood to the body
What are some signs and symptoms of someone with abdominal trauma?
Shortness of breath
Chest pain
Hemoptysis
Cyanosis
Tracheal deviation
Asymmetrical movement
JVD
Pallor
Low SP02
Mentation changes
Muffle heart tones
Signs and symptoms
Chest wall contusion
Open wounds
Subcutaneous emphysema
Tenderness, instability,
crepitation (TIC)
Abnormal BS
Tachcardia
Tachypnea
Hypopnea
High ETC02
What is a Great Vessel tear?
HINT: which vessels are affected?
Aorta or vena cava
When dressing a sucking chest wound, we tape down _____ sides of the square dressing.
3
What is a pulmonary contusion and what are some signs and symptoms?
Bruising of the lung tissue
Dyspnea
Altered or decreased L.O.C. depending on severity
Pallor
Diaphoresis
Chest pain
Tachypnea
Hypopnea
Low SP02
High ETC02
Tachycardia with weak peripheral pulses
Point tenderness
Chest wall contusions
What are some signs and symptoms of abdominal trauma?
Abdominal pain
Altered to decreasing L.O.C.
Hypotension
Pallor
Abdominal pain
Tachypnea and Hypopnea
Low SP02, High ETC02
Tachycardia
Weak peripheral pulses
Cool extremities
Guarding
Abdominal rigidity - discoloration
What is 'hooding' and what do we see it with?
Cyanosis above the point of injury and is commonly seen with traumatic asphyxiation
Name 2 hollow organs and 2 solid organs as well as the main issue if each is punctured.
Hollow: stomach, bile duct, bladder, gallbladder and intestines
Release its contents and causes sepsis
Solid: pancreas, kidneys, liver, spleen
Highly vascularized and may lead to profuse bleeding
When treating a Great Vessel tear, we SHOULD NOT transport ______ and instead transport ____ to prevent blood loss.
Semi to high fowlers, supine
How can we treat a sucking chest wound?
Occlusive dressing to prevent air from going in and causing a pneumothorax
Why is determining the location of closed abdominal injuries so difficult?
Pain often spreads from the point of origin, especially when accompanied with bleeding
What are the three categories of penetration wounds, and give an example of each.
Low velocity: stab wounds
Medium velocity: shotgun and handguns
High velocity: high-powered hunting rifles
Name 2 structures in each quadrant of the abdomen
Upper right: liver, gallbladder, right kidney
Upper left: pancreas, left kidney
Lower right: appendix, right ureter, small intestine, large intestine
Lower left: left ureter, small intestine, large intetsine
Patients with abdominal trauma should be transported in what position and why?
Supine to prevent blood loss
A tension pneumothorax and hemothorax display very similar symptoms. What noticeable and VISIBLE symptom differs between the two?
Pneumothorax- JVD
Hemothorax- flat neck veins
What is hematemesis and what does it indicate?
Vomiting blood, usually means GI or stomach bleeding
What is evisceration?
A laceration that leads to fat or organs protruding out of the body
Someone is eviscerated to the point of having a kidney hanging out of their body. What is 1 thing we should NOT do and 3 things we SHOULD do?
DON'T try and put the organ back
DO...
Keep the organs moist and warm.
Cover with moistened, sterile gauze or occlusive dressing.
Secure dressing with bandage.
Secure bandage with tape.
A valve placed over a sucking chest wound is there to...
Prevents air from moving in and allows trapped air to escape
Beck's Triad is composed of what symptoms and what does it indicate?
JVD, muffled heart sounds, hypotension
Cardiac tamponade
Peritonitis, the inflammation of the peritoneum (lining of the abdominal organs) would most likely be caused when we rupture a _____ organ.
Hollow