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Trauma Assessment: The 20 Commandments

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... learn the language of EMS and the names of many disease ... 'Patient pregnant, having benson and hedges contractions' 'Briggs and Stratton contractions' ... – PowerPoint PPT presentation

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Title: Trauma Assessment: The 20 Commandments


1
Trauma AssessmentThe 20 Commandments
  • Paul A. Werfel, NREMT-P
  • Director, Paramedic Program
  • Clinical Assistant Professor of Health Science
  • Assistant Professor of Clinical Emergency
    Medicine
  • School of Health Technology Management
  • Department of Emergency Medicine
  • Stony Brook University, New York

2
For copies of this presentation, feel free to
email me atpaul.werfel_at_stonybrook.edu
3
There are dilemmas in life
4
Some patient injuries/illnesses are obvious
5
1. GENERAL PATIENT ASSESSMENT
  • WE ARE IN THE INFORMATION BUISNESS

6
2. GENERAL PATIENT ASSESSMENT
  • THERE ARE MORE ILLNESSES THAN PROTOCOLS TO TREAT
    THEM

7
3. GENERAL PATIENT ASSESSMENT
  • DIABETICS, WOMEN, AND THE ELDERLY HAVE ATYPICAL
    MI PRESENTATIONS

8
4. GENERAL PATIENT ASSESSMENT
  • ASSESSING PATIENTS THAT HAVE
  • CONSUMED ADULT BEVERAGES OR RECREATIONAL
    DRUGS MAY BE DIFFICULT

9
WHILE WE ARE ON THE SUBJECT OF MEDICATIONS
10
You will learn the language of EMS and the names
of many disease entities
  • The baby has screaming meemmee Jesus
  • I have pileups in my Eucharist
  • I am afraid that she has old-timers disease
  • My wife is taking Latex
  • My wife is not an epileptic, she is catholic
  • I have very close veins
  • I have a ferocious liver

11
5. TRAUMA PATIENT ASSESSMENT
  • WOMEN WITH ABDOMINAL PAIN MUST GO TO THE HOSPITAL
    FOR EVALUATION

12
Some people hurt themselves bad enough to
dieAnonymous Trauma Surgeon
13
6. TRAUMA PATIENT ASSESSMENT
  • HYPOTENSION IS A LATE SIGN OF SHOCK

14
7. TRAUMA PATIENT ASSESSMENT
  • ADULTS CANNOT BECOME HYPOTENSIVE EXCLUSIVELY DUE
    TO CLOSED HEAD TRAUMA

15
8. TRAUMA PATIENT ASSESSMENT
  • SHORT BOARDS, KEDs AND HARE TRACTION SPLINTS WORK
    WELL FOR STABLE TRAUMA VICTIMS--NOT FOR UNSTABLE
    ONES
  • SAGER SPLINTS CAN BE PLACED VERY QUICKLY

16
9. TRAUMA PATIENT ASSESSMENT
  • THE MULTI-TRAUMA PATIENT WITH HEAD TRAUMA AND
    SHOCK NEEDS TO BE TREATED LIKE ANY OTHER
    MULTI-TRAUMA VICTIM

17
In life, its always later than you think
18
10. TRAUMA PATIENT ASSESSMENT
  • GERIATRIC PATIENTS MAY NEVER EXHIBIT TACHYCARDIA,
    PALLOR OR HYPOTENSION FROM BLOOD LOSS

19
11. TRAUMA PATIENT ASSESSMENT
  • FALL OR DRUNK?

THE 4 STAGES OF LIFE
20
12. TRAUMA PATIENT ASSESSMENT
  • THE ELDERLY CAN HAVE CATASTROPHIC ABDOMINAL
    TRAUMA WITH LITTLE OR NO PAIN

21
Language of EMS-Its not always the patients
  • Patient has a burning sensation in his penis,
    which goes to his feet
  • The patient must have internal injuries, because
    there were no outernal ones
  • I started an ivy on the patient
  • 3 liters of nasal oxygen by mask
  • Patient pregnant, having benson and hedges
    contractions
  • Briggs and Stratton contractions
  • The patient has Cozumels breathing

22
The two things that children wear out are
clothes and parents
23
DADDYS IDEA OF BABYSITTING
24

25
13. TRAUMA PATIENT ASSESSMENT
  • CHILDREN ARE NOT ADULTS THAT HAVE BEEN LEFT IN
    THE DRYER TOO LONG

26
14. TRAUMA PATIENT ASSESSMENT
  • CRYING, SCREAMING CHILDREN ARE USUALLY STABLE

27
15. TRAUMA PATIENT ASSESSMENT
  • BLOOD PRESSURE IS AN UNRELIABLE SIGN OF PEDIATRIC
    SHOCK

28
16. TRAUMA PATIENT ASSESSMENT
  • LETHARGY AND MINIMAL RESPONSE TO PAINFUL STIMULI
    IN CHILDREN IS AN OMINOUS FINDING

29
17. TRAUMA PATIENT ASSESSMENT
  • In EMS, it is the mechanism, not the injury that
    we are treating

30
18. TRAUMA PATIENT ASSESSMENT
  • If the news media gets footage of you treating a
    trauma patient that is not trapped, you have been
    on scene too long

31
19. TRAUMA PATIENT ASSESSMENT
  • Dont miss things because they are not obvious

32
20. TRAUMA PATIENT ASSESSMENT
  • Patients with unexplained hypotension frequently
    have abdominal bleeds

33
CONCLUSIONS
  • Keep yourself out of trouble
  • "Be careful The toes you step on today may be
    connected to the butt you'll be kissing
    tomorrow."
  • Stay up to date
  • Role of experience
  • So, I see that you have 20 years of EMS
    experience, is that really 20 years or 1 year of
    experience that you repeated 20 times?

34
Questions?
35
THANK YOU
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