Rapid Trauma Assessment and Prioritizing Fractures

Drill Topic: Rapid Trauma Assessment,and Prioritizing Fractures

Level of Instruction: 2

Time Required: Two Hours

Materials Needed:

   • Drill Transparencies/Blackboard

   • Overhead Projector

   • Screen

   • Live Victims

   • BSI

References: EMT-B Bridge Student Guide, Lesson 1, Brady Emergency Care, Seventh Edition, Chapter 27

Preparation:

Motivation: Upon arrival on the scene, EMT-B's sometimes mistake dramatic fractures for life threatening injuries. The intent of this drill is to remind rescuers that extremity trauma rarely causes a life threatening situation. In cases where significant MOI exits, ABC's and Rapid Trauma Assessment is your first action

Objective(SPO):1-1

The student will demonstrate a basic understanding of rapid trauma assessment, and prioritizing fractures.

Overview:

Rapid trauma assessment, and assessing and fractures

   • Introduction

   • Rapid PA

   • Prioritizing fractures

   • Principles of treating fractures

Session 1 Rapid PA/ Assessment And Prioritize Fractures

SPO 1-1 Describe the indications for performing a rapid trauma assessment

1-2 Describe in order how to perform a rapid trauma assessment

1-3 Describe how to prioritize fractures

1-4 List the general principles for the management of suspected fractures or dislocations

I. Introduction

A. EMT-B's responding to incidents with a report of significant Mechanism of Injury, should be prepared to perform the following basic objectives:

  1. Scene Survey

  2. Simultaneous Actions (LOC, c-spine, jaw thrust)

  3. Assessment of the airway

  4. Assessment of breathing

  5. Possible support of ventilation/supplemental 02

  6. Assessment of circulation

  7. Control bleeding

  8. DCAP-BTLS patients entire body (Fx assessed and stabilized)

  9. Determine if patient is a critical trauma

  10. Load and go/ or treat patient at scene

  11. Baseline vitals

  12. SAMPLE HISTORY

  13. Detailed physical exam

  14 Ongoing assessment(en route to trauma center)

Note: It is important to do a scene size up prior to starting patient care. Depending on the number of victims, and the MOI, your treatment can drastically change from incident to incident.

II. Rapid patient assessment

A. SCENE SURVEY

  1. Body substance isolation

  2. Scene safety/ Hazards

  3. Determine MOI or NOI (mechanism of injury or nature of illness).

  4. How many victims?

  5. Are other resources needed?

B. SIMULTANEOUS ACTIONS

  1. Determine LOC using the following scale:

      a. A=Alert

      b. V=Responds to verbal stimulus

      c. P=Responds to painful stimulus

      d. U=Unresponsive

  2. Manually immobilize C-spine

  3. Jaw thrust to establish airway if necessary

C. Assessment of AIRWAY

  1. Jaw thrust needed?

  2. Is airway open?

  3. Inspect for foreign bodies

  4. Need suctioning?

  5. Consider airway adjunct

D. Assessment of BREATHING

  1. Is it present?

  2. Approximate rate

  3. Character of respirations

  4. Are respirations adequate?

E. Supporting VENTILATIONS

  1. Give 15 lpm O2 via NRB if rate is greater than 8 and breathing is adequate

  2. Bag Valve Mask w/reservoir and 15 lpm O2 at 24 per minute if:

      a. Respiratory rate less than 8

      b. Breathing is inadequate

      c. Head trauma is suspected

F. Assessment of CIRCULATION

  1. Carotid pulse

       a. Present?

       b. Approximate rate?

       c. Character?

  2. What is the general skin color and temperature?

G. CONTROL BLEEDING

H. ASSESS THE HEAD (quickly through) DCAP-BTLS for obvious injury (inspect and palpate)

      Deformity

      Contusions

      Abrasions

      Punctures/penetrations

      Burns

      Tenderness

      Lacerations

      Swelling

I. Assess the NECK (anterior and posterior) DCAP-BTLS

  1. Trachea: midline or deviated?

  2. Jugular veins distended or flat?

  3. Any signs of trauma?

  4. Stoma?

  5. Medic Alert Tag?

  6. Apply a cervical spinal immobilization collar

J. Assess the CHEST

  1. Expose, inspect and palpate the chest DCAP-BTLS