Trauma Protocols Critical Care and Paramedic Levels Trauma

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Trauma Protocols Critical Care and Paramedic Levels

Trauma Protocols Critical Care and Paramedic Levels

Trauma: Unstable Patients • Traumatic Arrest/Unstable Airway – Closest facility • Transport unstable patients

Trauma: Unstable Patients • Traumatic Arrest/Unstable Airway – Closest facility • Transport unstable patients to hospital/landing zone within 10 minutes of extrication

Trauma: Transport Guidelines

Trauma: Transport Guidelines

Trauma: General Guidelines • Prolonged transport – Consider aeromedical utilization – > 45 minutes

Trauma: General Guidelines • Prolonged transport – Consider aeromedical utilization – > 45 minutes by ground air not available • Call medical direction – consider transporting to closest emergency department – Transporting trauma to non-trauma center • Notify emergency department as early as possible

Trauma: Aeromedical Utilization • Must SIGNIFICANTLY reduce transport time • Signs of life!!! •

Trauma: Aeromedical Utilization • Must SIGNIFICANTLY reduce transport time • Signs of life!!! • Don’t wait for the helicopter • <20 mile transport? • Entrapment

Trauma: Pregnant Patients • Adult trauma pt > 20 weeks gestation – Not meeting

Trauma: Pregnant Patients • Adult trauma pt > 20 weeks gestation – Not meeting trauma criteria – ER of their choice – Meeting trauma criteria – Adult trauma center!

Trauma: Burn Patients • Burn Criteria for transport to burn center – >10% BSA

Trauma: Burn Patients • Burn Criteria for transport to burn center – >10% BSA partial thickness burns – Involvement of face, hands, feet, genitalia, or major joints – Third degree burns – Electrical burns, including lightning injuries – Chemical burns – Inhalation injury – Circumferential burns

Trauma: Burn Management • • Fentanyl added Less BP effect Med control only Rigid

Trauma: Burn Management • • Fentanyl added Less BP effect Med control only Rigid chest with rapid push

Trauma: Chest • Fentanyl added

Trauma: Chest • Fentanyl added

Trauma: Crush Injury • New Protocol • For prolonged entrapment only • Tourniquet use?

Trauma: Crush Injury • New Protocol • For prolonged entrapment only • Tourniquet use? • Pre-medicate

Trauma: Head Injury • No changes

Trauma: Head Injury • No changes

Trauma: Extremity Injury • Tourniquet use • Hemostatic dressing • Once applied do not

Trauma: Extremity Injury • Tourniquet use • Hemostatic dressing • Once applied do not remove • Fentanyl added

Trauma: Hypoperfusion • Differing fluid goals for compressible injury • Reflects current ITLS/ATLS guidelines

Trauma: Hypoperfusion • Differing fluid goals for compressible injury • Reflects current ITLS/ATLS guidelines