intro to trauma
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Transcript of intro to trauma
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Paramedic Care:Principles & Practice
Volume 5Trauma Emergencies
Death by PowerPoint
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Chapter 1 Trauma and Trauma Systems
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Topics Trauma Trauma as a Disease The Trauma Care System Trauma Center Designation Your Role as a Paramedic
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Trauma
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Trauma Physical injury caused by external force Leading killer of persons under 44 in
US 150,000 deaths annually
Most expensive medical problem
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Trauma Two major categories:
Penetrating Blunt
< 10 % are serious
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Trauma Serious vs. Not Serious
The use of trauma triage criteria will aid you in making this determination.
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Trauma as a Disease
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Trauma as a Disease Highway Safety Act of 1966
Led to development of EMS Trauma was categorized as a disease
Trauma can often be prevented The public health model
Surveillance, risk analysis, intervention development, implementation, and evaluation
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Surveillance The collection of data Epidemiology
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Epidemiology
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Risk Analysis Examines the various factors that impact the
development, course, and consequences of a disease.
Haddon Matrix A three-by-three matrix that describes nine
elements
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Bledsoe et al., Paramedic Care: Principles & Practice, Volume 4: Trauma Emergencies, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
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Intervention Development
Programs to reduce both the incidence and the seriousness of trauma
Examples Safer highway design Autos with better braking systems, crumple zones,
and passive restraint systems Programs that encourage drivers to use their
seatbelts, to not drink and drive, and to drive defensively
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Implementation Act of placing an intervention into practice Includes:
Enforcing traffic laws Reducing speed limits in hazardous areas Rebuilding highways to be safer Building safer autos Encouraging changes in driver behavior Safety education Continuing to improve our EMS system
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Evaluation Accomplished by repeating the processes of
surveillance To identify the benefit or ineffectiveness of an
intervention or program We must continue to search out risk factors,
develop and implement interventions, and evaluate our systems’ performance
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The Trauma Care System
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http://www.doh.state.fl.us/demo/trauma/guidebook.htm
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The Trauma Care System
Integration of EMS Hospital care
Reduces Cost Time to surgery Mortality
Proper Care Immediate surgical intervention to repair
hemorrhage sites
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Trauma Center Designation
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Trauma Center Designation
The trauma system is predicated on the principle that serious trauma is a surgical disease. < 10 % Life threatening Surgical care for trauma patients can drastically
reduce trauma mortality and morbidity.
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Trauma Center Designation
Level I Level II Level III
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Trauma Center Designation
Level I Regional Trauma Center All types of surgical and medical subspecialty Research and teaching commitment
Level II Area Trauma Center Majority of surgical and medical subspecialties
available 24/7 Level III
Community Trauma Center Specialized ED with the majority of surgical and
medical subspecialties available 24/7 (on call)
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Trauma Center Designation
In some remote areas, there is provision for an additional level of trauma patient destination. Level IV
Seriously injured trauma patients may be taken for stabilization and care before transport.
The design of a trauma system should be flexible in order to meet the needs of the region it serves.
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Trauma Center Designation
Specialty Centers Neurocenters Burn Centers Pediatric Trauma Hyperbaric Medicine Microsurgery
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Your Role as a Paramedic
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CUPS
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 4: Trauma Emergencies, 3rd. Ed.© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
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Your Role as a Paramedic
Trauma Triage Criteria START Nearest appropriate facility
Mechanism of Injury Analysis (MOI) Processes and forces that cause trauma Consider inertial forces
Index of Suspicion (IOS) Anticipation of injury to a body region, organ, or
structure based on MOI
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Your Role as a Paramedic
The Golden Period BEST survivability
from incident to surgery is 1 hour
Platinum 10 Minutes Scene time limited to
10 minutes Air Transport
Speed vs. need Type of patients
transported
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Your Role as a Paramedic
The Decision to Transport The trauma triage criteria When applying trauma triage criteria, it is best to
err on the side of precaution.
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Your Role as a Paramedic
Injury Prevention Bicycle safety programs Firearm safety Boat safety Child safety seat classes
and checking Data and Trauma
Registry Data retrieval system for
trauma patient information
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Your Role as a Paramedic
Quality Improvement QI or QM Examine the system performance Evaluate calls Accurate and complete documentation