So you think you know trauma
A 24-year old was stabbed in the abdomen.
BP 126/78, HR 104, GCS 15
Category Bravo
Penetrating trauma to torso = bravo
Before and after applying nearly any extremity splint, this assessment needs to be documented
Distal pulse, motor, and sensation/neurovascular status
Maryland EMTs may give this medication orally for mild-to-moderate pain
Acetaminophen
MVC on Route 95. Patient has absolutely no spinal pain, tenderness, neurological deficit, AMS, or distracting injury.
No spinal motion restriction
The new trauma assessment sequence puts this letter before ABC.
X
This stands for life-threatening external hemorrhage
A 68-year-old fell down three steps. No major injury is obvious, but his systolic BP is 106 mmHg
Category Alpha
Age 65 or older systolic BP < 110 mmHg = Alpha
Suspected midshaft femur fracture, isolated injury, no pelvic injury. This specialized splint may be appropriate.
Traction splint
A 32-year-old has an isolated ankle injury and rates the pain 4/10. The dose of acetaminophen is this.
640 mg
MVC on Route 1. Patient has midline neck tenderness but walked to you, has GCS 15, and has no neurological deficit.
C-collar only
An isolated penetrating trauma patient generally does not receive this treatment merely because trauma occurred.
Spinal motion restriction
A 30-year-old falls 14 feet from a ladder
Category Charlie
Fall > 10 feet
A patient has an injured forearm. Your splint should immobilize these two joints.
Wrist & elbow
Your patient's ankle hurts 3/10, but he took 1,000 mg of Tylenol two hours ago. Can you administer more?
No
Acetaminophen within the previous 4 hours is a contraindication
MVC on Route 100. Patient has neck pain and tingling in both hands.
C-collar and backboard/full spinal immobilization
A piece of metal is impaled in an eye. Remove it or leave it?
Leave it!
Leave it in place, stabilize, and shield/cover the second eye.
A 72-year-old falls from standing and strikes her head. She takes Eliquis. GCS 15 and vitals are normal.
Category Delta
You splint a badly angulated lower leg and afterward the patient loses the distal pulse. Your next move is this
Reassess the splint/position, attempt to restore distal circulation, and document changes
A trauma patient has a 4/10 headache after striking her head. You have acetaminophen available. Give it or don't?
Don't give it
Head injury is a contraindication
MVC on Landing Road. Patient is minimally responsive with several obvious minor injuries. And no, they didn't OD.
C-collar and backboard/full spinal immobilization
Your trauma patient has a large open chest wound that sucks air with each breath. This is the appropriate BLS treatment.
Vented chest seal
Occlusive dressing if that is unavailable.
A 25-year-old MVC patient is obeying commands and speaking appropriately but cannot move either leg. Vitals are normal.
Category Bravo
Suspected spinal injury with new motor / sensory loss
You suspect a hip fracture in an elderly patient. This device should not be applied.
Traction splint
A 10-year-old with an isolated arm injury rates pain 5/10. The Maryland BLS acetaminophen dose is this.
320 mg / 10 mL
A patient was placed on a long backboard only to get them out of a wrecked car. Once in the ambulance, they do not otherwise require full immobilization. Do they stay on it?
No
Remove the backboard as soon as practical and support them on the stretcher.
Your trauma patient has severe extremity hemorrhage that continues despite direct pressure. Name two appropriate escalation options (besides calling for ALS)
Wound packing/hemostatic dressing and a tourniquet