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Basic Rapid Trauma Assessment 1


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Basic Rapid Trauma Assessment 1

  1. 1. Basic Trauma
  2. 2. <ul><li>Presented By </li></ul>
  3. 3. Basic Trauma <ul><li>During a tactical operation, or even training, the risk of injury is high. Rapid Assessment can be used by team members to recognize life threatening injuries based on CPR and First Responder training. </li></ul><ul><li>This process is an easy to follow outline used to evaluate the officers condition and provide basic medical care, if the team medic not immediately present, prior to transfer to EMS. </li></ul><ul><li>The objective is to enhance survivability. </li></ul>
  4. 4. Basic Trauma <ul><li>Trauma, what is it? </li></ul><ul><ul><li>A serious injury or shock to the body by violence or accident. </li></ul></ul><ul><ul><li>The leading cause of death in 1-44 year age group. </li></ul></ul><ul><ul><li>The 3 rd leading cause of death in all age groups. </li></ul></ul><ul><ul><li>60 million injuries each year in the U.S. alone. </li></ul></ul><ul><li>Remember, Only Surgeons Fix Trauma! </li></ul>
  5. 5. Basic Trauma The “Golden Hour”
  6. 6. Vest Medical Pouch <ul><li>Every officer the same contents, same placement. </li></ul><ul><li>When treating use theirs, not yours. </li></ul><ul><li>Contents: </li></ul><ul><ul><li>(1) Pair Latex or vinyl gloves. </li></ul></ul><ul><ul><li>(1) Blood Stopper Dressing. </li></ul></ul><ul><ul><li>(2) Rolls of Kerlix gauze </li></ul></ul><ul><ul><li>(1) 3”x9” Petroleum gauze dressing </li></ul></ul><ul><ul><li>(1) Triangular bandage </li></ul></ul><ul><ul><li>(1) Double roll Flexwrap </li></ul></ul><ul><ul><li>(1) CPR Shield </li></ul></ul><ul><ul><li>(1) Trauma Scissors </li></ul></ul>
  7. 7. Officer Medical Information Form <ul><ul><li>Officer Medical History </li></ul></ul><ul><ul><li>Name DSN DOB SSN Blood Type </li></ul></ul><ul><ul><li>Jones, James A. 9003 1/21/1967 000-00-0000 AB- </li></ul></ul><ul><ul><li>Drug/Food Allergies Medical History Sulfa Drugs Triple By-pass </li></ul></ul><ul><ul><li>Medications Physician Additional Information </li></ul></ul><ul><ul><li>Nitro-as needed Smith Has Narcolepsy </li></ul></ul>
  8. 8. Rapid Assessment <ul><li>First course of action is to eliminate the threat and/or move downed officer to safety/cover. </li></ul><ul><ul><li>Only move in necessary for safety. </li></ul></ul><ul><ul><li>Always suspect spinal injuries. </li></ul></ul><ul><ul><ul><li>Maintain as much in-line spinal immobilization as possible during movement. </li></ul></ul></ul><ul><li>If threat is still present need cover officer while conducting assessment. </li></ul>
  9. 9. Rapid Assessment <ul><li>Cervical spine immobilization? </li></ul><ul><li>Determine Level of Consciousness (LOC). </li></ul><ul><ul><li>Is he alert? Can he speak? Does he make sense? </li></ul></ul><ul><li>Assess his airway. </li></ul><ul><ul><li>If he can speak, he can breathe. </li></ul></ul><ul><ul><li>If unconscious, open the airway. </li></ul></ul><ul><ul><ul><li>Head tilt, chin lift </li></ul></ul></ul><ul><ul><ul><li>Modified jaw thrust </li></ul></ul></ul><ul><ul><li>Is he having difficulty breathing? What is the rate per minute? </li></ul></ul><ul><ul><ul><ul><li>Normal adult 12-20 breathes per min. </li></ul></ul></ul></ul><ul><ul><ul><ul><li><8 or >24 indicates problem, <8 assist. </li></ul></ul></ul></ul>
  10. 10. Rapid Assessment <ul><li>Evaluate pulse. </li></ul><ul><ul><li>What is rate and quality. </li></ul></ul><ul><ul><ul><li>Normal adult 80-100 bpm. </li></ul></ul></ul><ul><ul><ul><li>Radial pulse (wrist/thumb side). </li></ul></ul></ul><ul><ul><ul><li>Carotid pulse (neck). </li></ul></ul></ul><ul><ul><ul><li>No pulse begin CPR. </li></ul></ul></ul><ul><ul><ul><ul><li>Use AED if available. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>AED & Trauma. </li></ul></ul></ul></ul>
  11. 11. Rapid Assessment <ul><li>Look head to toe for bleeding that will compromise the circulation system. </li></ul><ul><ul><li>“ KILLER BLEEDS” </li></ul></ul><ul><ul><ul><li>Large arterial or venous bleeding that could interrupt circulatory system. </li></ul></ul></ul><ul><ul><ul><li>1L is serious </li></ul></ul></ul><ul><li>About 60-90 seconds to this point . </li></ul>
  12. 12. First Aid <ul><li>Stop the bleeding </li></ul><ul><ul><li>Determine origin of injury. </li></ul></ul><ul><ul><li>Expose the injury. </li></ul></ul><ul><ul><ul><li>Remove and/or cut away clothing and equipment. </li></ul></ul></ul><ul><ul><li>Determine severity-entrance and exit wounds? </li></ul></ul><ul><ul><li>Apply concentrated or diffused pressure w/dressing. </li></ul></ul><ul><ul><ul><li>Cover largest/biggest bleeder 1 st . </li></ul></ul></ul><ul><li>Head trauma with possible fractures. </li></ul><ul><ul><li>Cover lightly with no pressure. </li></ul></ul><ul><ul><li>Includes bleeding and fluid from ears and nose. </li></ul></ul>
  13. 13. First Aid <ul><li>Nose bleeds (no trauma) </li></ul><ul><ul><li>Ensure airway. </li></ul></ul><ul><ul><ul><li>Lean forward to avoid swallowing blood. </li></ul></ul></ul><ul><ul><ul><li>Pinch fleshy portion. </li></ul></ul></ul><ul><ul><li>If trauma, immobilize and prepare for nausea/vomiting. </li></ul></ul><ul><li>GSW </li></ul><ul><ul><li>Check for exit wound, if large may need to pack w/gauze. </li></ul></ul><ul><ul><li>If chest wound, cover with occlusive dressing and tape on three sides. </li></ul></ul><ul><ul><ul><li>Lay on wounded side. </li></ul></ul></ul><ul><ul><ul><li>May need to “vent” dressing. </li></ul></ul></ul>
  14. 14. First Aid <ul><li>Impaled objects </li></ul><ul><ul><li>DO NOT REMOVE! </li></ul></ul><ul><ul><li>Stabilize, dress and bandage. </li></ul></ul><ul><li>Evisceration </li></ul><ul><ul><li>Abdominal injury with internal organs protruding. </li></ul></ul><ul><ul><li>Cover with sterile wet dressing to keep moist. </li></ul></ul><ul><ul><li>Do not attempt to push back in. </li></ul></ul><ul><ul><li>No Food or Drink. </li></ul></ul><ul><ul><li>Prepare for vomiting. </li></ul></ul>
  15. 15. First Aid <ul><li>Blunt Trauma to Chest </li></ul><ul><ul><li>Look for deformity/bruising </li></ul></ul><ul><ul><li>If one portion moves independently (flail chest), pad and secure w/gauze. </li></ul></ul><ul><ul><li>Place on affected side </li></ul></ul><ul><li>Amputation </li></ul><ul><ul><li>Bag and keep cool. </li></ul></ul><ul><ul><li>No direct contact with water or ice. </li></ul></ul><ul><ul><li>Do not remove partial amputation. </li></ul></ul><ul><li>Large open neck injury </li></ul><ul><ul><li>Cover with occlusive dressing </li></ul></ul>
  16. 16. First Aid <ul><li>Burns </li></ul><ul><ul><li>If head or face, think airway! </li></ul></ul><ul><ul><li>Stop the burning. Nothing but water! </li></ul></ul><ul><ul><li>Remove smoldering clothing and jewelry. </li></ul></ul><ul><ul><ul><li>DO NOT REMOVE CLOTHING IF STUCK! </li></ul></ul></ul><ul><ul><li>Cover with dry sterile dressing. </li></ul></ul><ul><ul><li>Prepare for hypothermia. </li></ul></ul>
  17. 17. Communicate <ul><li>Extract the injured to or establish a safe zone where EMS can initiate additional emergency care and prepare for transport. </li></ul><ul><ul><li>Remember spinal immobilization! </li></ul></ul><ul><li>Use radio to communicate with medical support elements. </li></ul><ul><ul><li>EMS </li></ul></ul><ul><ul><li>FD </li></ul></ul>
  18. 18. Head to Toe <ul><li>Secondary survey </li></ul><ul><ul><li>While waiting for support/transport (EMS, FD) conduct secondary survey. </li></ul></ul><ul><ul><li>Re-evaluate ABC’s. </li></ul></ul><ul><ul><li>Re-evaluate for additional injuries. </li></ul></ul><ul><ul><li>Re-evaluate treatment already done. </li></ul></ul><ul><li>Give a brief history of injuries and what you’ve done when passing patient to higher level of medical treatment (”K.I.S.S.” is the rule here). </li></ul>
  19. 19. Basic Trauma <ul><li>QUESTIONS? </li></ul><ul><li>EXAM </li></ul><ul><li>PRACTICAL EXERCISES </li></ul>