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Prehospital Trauma Life Support

Lesson

13

Principles in the Care of the Trauma Patient

Developed by the

National Association of Emergency Medical Technicians


In cooperation with

The Committee on Trauma, American College of Surgeons

This slide presentation is intended for use only in approved PHTLS courses.

13-1B

Scenario

continued...

The 911 dispatcher receives a call for a twocar MVC. He determines there are three patients involved; one is still in the car and unresponsive.

The dispatcher simultaneously dispatches police, fire and EMS. Moments later, the first police unit arrives on the scene and confirms three patients.

In your system, what would you do now?


13-2

Scenario

continued...

You pull into the scene behind the first engine company. The fire department sets up protection. You, the police sergeant, and the fire captain set up an incident command system (ICS).

Your partner initiates triage. You request two more


EMS units, and your partner informs you that there are two stable patients and one critical.

How would you manage the manpower you have on the scene now?
13-3

Scenario

continued...

The fire captain assigns two firefighters to treat the patients with minor injuries. Your second unit arrives on the scene and, with your partner, they assess the critical patient.

Your partners primary survey reveals: fast, shallow respirations; absent breath sounds on the right; and rapid, weak pulse.

What are you going to do now?


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Scenario

continued...

The team that is caring for the critical patient has rapidly extricated her from the car. Her airway is secured, she is hyperoxygenated and her chest is being decompressed. You have alerted the trauma center to expect a critical patient, and that a detailed report will follow. The unit leaves the scene after a total scene time of 9 minutes.

Would this scenario differ in your system?


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Scenario

contd.

The unit arrives at the ED, the patient is transferred and a report given to the trauma team. The patient is evaluated and a decision made to bring her to the operating room for surgery.

After two weeks in the surgical ICU, and despite complications associated with ARDS, the patient is eventually discharged.

How do trauma centers and systems save lives?


13-6

Principles Summary

continued...

Care of the critically injured trauma patient begins with global evaluation, and includes the kinematics of the injury. The cornerstone of prehospital care of the critical patient includes a rapid primary survey to detect life-threatening injuries, as well as aggressive management of those injuries. If indicated, extricate rapidly and transport to an appropriate facility.
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Principles Summary

contd.

Everybody has an important job to do when it comes to the survival potential of the trauma patient. Whether you have 10 years of medical training, or 40 hours of EMS training, everyone must do their job for the patients greatest chance of survival.

13-8

Remember the Patient


The most important person in trauma.

Do your job well!


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