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20 Cards in this Set

  • Front
  • Back

1. MIST Report on incoming pt.



What does MIST stand for?


M - Mechanism of Injury


I - Injuries Sustained


S - Signs



T - Treatment and Trends in the Vital Signs

2, 3 Preparation and Triage



Name 4 Things

1. Activate the trauma team


2. Prepare trauma room


a. Rapid Infuser


b. Chest trauma equipment


c. Warm the trauma room


3. Dawn Personal Protective Equipment (PPE)


4. Consider the need for Trauma Cener



4. Across the room Observations

1. Is there any uncontrolled bleeding


a. If so intervene & reevaluate



5. Assess LOC **

AVPU




Alert


Verbal


Painful stimuli


Unresponsive

Primary Survey **

A. Airway & Alertness with C-spine Immobilization


B. Breathing & Ventilation


C. Circulation & Control of Hemorrhage


D. Disability (Neurological status)


E. Exposure & Environment Control

6 & 7 Airway **




Identify 4

I need a second person to manually take C-spine, gonna use the Modified Jaw-Thrust to open airway


Look Listen Feel




1. Is the Tongue obstruction


2. Are there any Loose or missing teeth


3. Any Foreign objects


4. Is there any Blood, vomit, secretions


5. Is there any Edema


6. Is there any Snoring, Gurgling, or Stridor


8 & 9 & 10 **




Snoring is heard when the jaw-thrust is released


I would like to insert an OPA measuring for correct size for this pt.



Consider a definitive airway at this time ET TUBE



Reassess Is my airway patent




At this time I would like someone to assist with ventilation's if needed Bag Valve Mask pt.




B **






11 & 12 Breathing & Ventilation



Assess my pt.'s breathing





Identify 4


1. Is there spontaneous breathing


2. Is there Symmetrical chest rise


3. What is the depth, pattern and rate of respiration's



4. Is there increased work of breathing


5. Skin color


6. Any open wounds, deformities, subconscious emphysema



7. Tracheal deviation or JVD


8. Are breath sounds present and equal


13 & 14 **





ET TUBE has been placed




NAME 8 THINGS TO DO


1. Attach CO2 detector & Capnography sensor


2. Observe for rise and fall of chest


3. Listen over stomach


4. Listen for bilateral breath sounds


5. After about 5-6 breaths check CO2 detector for evidence of CO2 in exhaled air


6. Assess for improvement in skin color


7. Not number at the teeth and secure the ET tube


8. I would insert a gastric tube if needed at this time


15. Ventilation

1. Begin mechanical ventilation's or assisted ventilation's



C **





16. Circulation & Control of Hemorrhage





NAME ALL 3


1. Inspect for any uncontrolled Breathing


2. Palpate Central & peripheral pulses


3. Inspect Skin for:


a. Color, Temperature, & Moisture


17 & 18 & 19 **

IV

Assess the prehospital IV patent




1. I would place another large bore IV


2. Obtain labs


a. Blood typing


b. ABG's


c. Lactate


3. Start warm isotonic crystalloids with blood tubing at a controlled rate



D **




20, 21, & 22




Disability (Neurological Status)

Glassgow Coma Sacle




1. Best eye


a. Assess pupils PERRLA


2. Best Verbal


3. Best motor


4. Consider Head Cervical Spine CT


E




23 & 24




Exposure & Environmental Control

1. Remove all clothing for inspect for


a. Uncontrolled bleeding


b. Obvious injuries


2. Need to keep pt. warm


a. Warm Blankets


b. Warming lights


c. Increased room Temp


d. Warm fluids


e. Warm humidified O2

25 & 26 F





1. Full set of vitals including SpO2


a. make necessary adjustments after vitals ie. Bolus for BP


2. Facilitate Family (assign liaison)

27 - 33 G *




Get Resuscitation Adjuncts

L M N O P




1. Blood samples taken if not already


2. Cardiac Monitoring baseline ECG


3. Consider Naso or Orogastric tube if not already done


4. Oximetry & capnography


5. Pain assessment


a. Nonpharm ( Ice to swollen areas, repositioning, padding over bony areas, other as appropriate)


b. Consider order for Analgesic Rx

34




Secondary Survey




Identify 1

Need to get pertinent past medical Hx before the start of my head to toe survey




MIST (past medical Hx)

35 - 49 Begin Head to toe Survey

Inspect and Palpate


1. Head & face for injuries noting any abnormalities


2. Maintain C-Spine remove C-collar inspect & palpate for JVD, Trachea Deviation, palpate back of neck blood or abnormalities


3. Inspect & palpate Chest for symmetry & abnormalities


4. Listen for breath & heart sounds


5. Inspect abdomen and flank for injuries


6. Listen for bowel sounds in all 4 quadrants


7. Palpate abdomen in all 4 quadrants


8. Inspect & palpate pelvis and perineum for injuries


9. Consider Foley catheter any contraindications


10. Inspect & palpate all 4 extremities for deformities CSM's


11. Maintain C-spine log roll pt. Inspect & palpate posterior


12. Consider removal of backboard

50 Head to Toe Review

State injuries as they are found



51 Reevaluation Adjuncts



State atleast 3

Reevaluation of:



1. C-Spine CT scan, Chest CT, Pelvic x-ray, Revised trauma score, Clean and dress any wounds, Tetanus immunizations


2. Reevaluate primary assessment


3. Reevaluate Vital signs


4. Reevaluate pain


5. Reevaluate all injuries and interventions


6. Consider Tx plan:


a. Transfer to trauma center



b. Surgery


c. Admission