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19 Cards in this Set

  • Front
  • Back
What is important in trauma transport
Who needs transport

When


Where


How

What are the physiologic reasons for a transport
1. RR < 10 or > 30

2. GCS < 11


3. Focal neurologic deficit


4. Pregnancy > 20 weeks with FHR < 120 or > 160


5. Children

What are the anatomic reasons for transport
1. Amputation proximal to knee or elbow

2. 2 or more proximal long bone fracture


3. Spinal cord injury


4. Severe facial injury (potential airway problem)


5. Bruns > 15% TBSA


6. Open head injury


7. Major chest wall or pulmonary contusion


8. Unstable pelvic fracture


9. Significant injury to more than 1 body region


10. Intra-abdominal injury

What are some mechanism for transport
1. GSW proximal to knee/elbow

2. Significant penetrating injury to head, neck, chest, abdomen, groin


3. Ejection from vehicle


4. Person hit by car


5. Fall greater than 20 feet

What is the logistical reason to transport
Multiple injured patients
What are the discretionary reasons to transfer a patient
Patients injury are out of your capability
When should you transfer a patient
1. Depends how stable they are and their condition

2. How far the transfer is


3. How much you can do for the patient


4. What your hospital has to offer

What is the trauma service in at HSC called
Gold Surgery
If you are unsure if you should transfer a patient who do you call
Gold Service Team
How are the patients transferred
1. Ambulance with basic or advanced skilled paramedics

2. Ambulance with transport team (RT and Paramedic)


3. Air ambulance

Who is responsible for the patient while the transfer is occurring
Referring care provider
What must you attempt to do before you transport
Resuscitate ABCs
WHat should be done to the airway before you transport
Intubate if there is a risk and insert NG/OG
When is a chest tube needed
1. Any Pneumothorax

2. Patient being transferred by air


3. Positive ventilation is being used


4. Traumatic chest injury

How do you deal with shock
1. Resuscitate with bolus and reassess after each bolus



2. Use blood early if not getting better. Can always send blood with transport team

Should you continue using the C-spine even if the x-ray is normal during transfer
Yes, especially if there are multiple injuries
What do you do with msk injuries
1. Stabilize pelvic transport

2. Splint fracture


3. Control bleeding


4. Cover open wounds with sterile dressing

Describe the communication aspect of a transfer
1. Communicate with trauma service early and keep the updated on the patients condition



2. Write legible transfer note with request for follow up (want to know how the pt is doing and if you could have done anything different)




3. Communicate with the family with short and frequent updates

What would you do for analgesia and sedation during a transfer
1. Provide it while in your department so you can observe if any complications



2. Insert a foley catheter because a full bladder would be uncomfortable and you can assess circulation during transport