18 TRAUMA

1.                  Secure and maintain airway.  Consider C-spine precautions.

2.                  Administer O2 to maintain SaO2 >95% (90% if hx COPD).

3.                  Complete Primary Survey.  Initiate BCLS as needed.

4.                  Control external hemorrhages.

MAJOR TRAUMA (RTS <11)                                                MINOR TRAUMA (RTS >11)

1.         CALL FOR INTERCEPT.                                           1.         Obtain Secondary Survey, History,

                                                                                                            Vital Signs.

2.         Ventilate with 100% O2.                                              2.         Splint possible fractures.

3.         Obtain Secondary Survey, History,                            3.         Place in position of comfort.

            Vital Signs.

4.         Consider MAST trousers/splints.                                4.         Contact Medical Control.

5.         Contact Medical Control.                                            5.         Monitor Vital Signs and Neuro

            (Inflate MAST trousers as directed)                                       statue en route.

6.         Monitor Vital Signs and Neuro status en route.

7.         Associated symptoms = appropriate SOG.

Examples of Major Trauma

• Amputations proximal to wrist and ankle
• Limb paralyzed
• Suspected pelvic fractures
• Flail Chest
• Penetrating injuries to head, neck torso, or extremities proximal to elbow or knee
• Combination trauma with burns or inhalation injury
• Two or more long bone fractures (femur or humerus)
• Falls greater than 20 feet
• MVA / ATV / Snowmobile / Bicycle accident with:

-          Ejection from machine

-          Death of a passenger

-          High speed impact – greater than 40 MPH/major deformity of auto greater than 20 inches

-          Auto vs. pedestrian accident with significant impact (greater than 5 MPH)

-          Snowmobile crash > 25 MPH or with separation of the rider and machine > 10 feet

-          Rollover

* Additional variable than may convert minor to major injuries:

            Age <5 years or >55 years

            Known history of heart, lung, or diabetic disease

            Patients with bleeding disorder