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Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective
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Day 1 | CME- Trauma Symposium | Master nurse trauma panel perspective

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  • 1. Master Nurse PanelMaster Nurse Panel Kentucky Trauma SymposiumKentucky Trauma Symposium 20132013
  • 2. TopicsTopics  1. Pretransfer: How much do we do?1. Pretransfer: How much do we do?  2. Sedation Protocols2. Sedation Protocols  3. Identifying Critical Errors3. Identifying Critical Errors  4. PI / QA / Training new staff4. PI / QA / Training new staff  5. Resuscitating the clinically Brain Dead5. Resuscitating the clinically Brain Dead  6. Starting/Maintaining a Trauma Program6. Starting/Maintaining a Trauma Program
  • 3. Case #1Case #1  57M: Restrained driver involved in an57M: Restrained driver involved in an MVC (speed likely 20-30 mph). Arrives toMVC (speed likely 20-30 mph). Arrives to your ED with diffuse mild contusions, ayour ED with diffuse mild contusions, a GCS 15, HDA, and c/o moderateGCS 15, HDA, and c/o moderate generalized abdominal pain.generalized abdominal pain.
  • 4.  The key to managing trauma victims isThe key to managing trauma victims is getting them to a facility that can managegetting them to a facility that can manage the suspected / identified injuries anthe suspected / identified injuries an efficient manner.efficient manner.  Work up should be focused. QuestionWork up should be focused. Question doing a test that you will be unable to actdoing a test that you will be unable to act on.on.
  • 5. Case #2Case #2  28M soccer player arrives from scene with28M soccer player arrives from scene with lower leg and ankle trauma. There islower leg and ankle trauma. There is concern for vascular compromise and youconcern for vascular compromise and you need to attempt reduction.need to attempt reduction.  How would pain / sedation be handled?How would pain / sedation be handled?
  • 6. Case #3Case #3  During sedation of the injured soccerDuring sedation of the injured soccer player, a medication error results in heavyplayer, a medication error results in heavy over sedation, aspiration and intubation.over sedation, aspiration and intubation.  How is the Error Found and Addressed?How is the Error Found and Addressed?
  • 7. Case #4Case #4  23M tractor rollover while transporting23M tractor rollover while transporting equipment between farms. Isolatedequipment between farms. Isolated catastrophic head injury. Upon EMScatastrophic head injury. Upon EMS arrival there is a faint pulse with noarrival there is a faint pulse with no respiratory effort. He arrives to your EDrespiratory effort. He arrives to your ED with secured airway and systolic BP inwith secured airway and systolic BP in 90s.90s.
  • 8. Case #5Case #5  35M sharp chest pain while running. No35M sharp chest pain while running. No Hx of trauma. Attending physicianHx of trauma. Attending physician evaluates pt and thinks its an element ofevaluates pt and thinks its an element of bronchospasm.bronchospasm.  Treated with a broncodialator, says heTreated with a broncodialator, says he feels slightly better, but is clearly laboring.feels slightly better, but is clearly laboring.  As the patient is getting prepped to leave,As the patient is getting prepped to leave, you notice his CXR.you notice his CXR.
  • 9.  The physicians say: “Oh your justThe physicians say: “Oh your just overreacting, he’ll be fine.”overreacting, he’ll be fine.”
  • 10. Case #6Case #6  Starting / Maintaining a Trauma ProgramStarting / Maintaining a Trauma Program  KYHA.com (Trauma Resource Manual)KYHA.com (Trauma Resource Manual)
  • 11. ObjectivesObjectives Objectives:Objectives: 1. Photo review of common traumatic1. Photo review of common traumatic injuries.injuries. 2. Review initial management.2. Review initial management. 3. Review possibly associated trauma based3. Review possibly associated trauma based on common patterns seen with specificon common patterns seen with specific injuriesinjuries
  • 12. ChestChest
  • 13. Things you could talk aboutThings you could talk about Airway, Breathing:Airway, Breathing: PTX, HTX, Tracheobronchial InjuryPTX, HTX, Tracheobronchial Injury Circulation: Blunt CardiacCirculation: Blunt Cardiac Injury(dysrythmia),Injury(dysrythmia), Cardiac Tamp.Cardiac Tamp.
  • 14. ManagementManagement  Field:Field:  IntubationIntubation  Needle DecompressionNeedle Decompression  ACLSACLS  ER:ER:  Formal Chest TubeFormal Chest Tube  Selective Airway IntubationSelective Airway Intubation  FAST, PericardiocentesisFAST, Pericardiocentesis
  • 15. Heat InjuryHeat Injury
  • 16. Things you could talk aboutThings you could talk about  AirwayAirway  Fluid ShiftsFluid Shifts  Initial Management of the Actual BurnsInitial Management of the Actual Burns  Eschar RestrictionEschar Restriction
  • 17. ManagementManagement  FieldField  Remove Source of BurnRemove Source of Burn  Intubation (low threshold)Intubation (low threshold)  IVFIVF  Cover Wounds with Clean DRY ClothCover Wounds with Clean DRY Cloth  ERER  EscharotomyEscharotomy  Targeted Fluid ResuscitationTargeted Fluid Resuscitation  Intial Wound CleaningIntial Wound Cleaning
  • 18. Cold InjuryCold Injury
  • 19.  Mention rewarming techniques / Rate ofMention rewarming techniques / Rate of rewarmingrewarming  Watch for Cardiac ProblemsWatch for Cardiac Problems
  • 20. Electrical BurnElectrical Burn
  • 21. Things you could talk aboutThings you could talk about  FluidsFluids  Cardiac IssuesCardiac Issues  Potential for devastating internal injuries,Potential for devastating internal injuries, even with a mild appearance on theeven with a mild appearance on the outsideoutside
  • 22. SnakebiteSnakebite
  • 23. Things you could talk aboutThings you could talk about  Just a brief review of managementJust a brief review of management  Indications for antivenomIndications for antivenom
  • 24. Femur FractureFemur Fracture

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