NREMT EMT 4: Patient Treatment and Transport - Trauma Management

What This Is: Trauma Management

Trauma management is the process of caring for someone who has been injured or hurt badly. This can happen in a car accident, a fall, or even a sports injury. Think of it like fixing a broken toy – you need to assess the damage, clean it up, and make it safe before you can start playing with it again.

Key Steps / Core Facts:

• Scene Safety: Check for danger (oncoming traffic, fire, sharp objects) before approaching the patient. (OPQRSTI)
  • Why it matters: You don't want to become a victim too.
  • Example: A car accident on the highway.
• Primary Survey: Check the patient's airway, breathing, and circulation (ABCs) first. (AVPU)
  • Why it matters: If the patient can't breathe, nothing else matters.
  • Example: A person who is choking on food.
• Airway Management: Clear the patient's airway of any blockages (like food or vomit). (OPQRSTI)
  • Why it matters: You need to get air in and out of the patient's lungs.
  • Example: A person who is choking on a piece of meat.
• Breathing: Check the patient's breathing rate and depth. (AVPU)
  • Why it matters: If the patient is not breathing, you need to start CPR.
  • Example: A person who is having a heart attack.
• Circulation: Check the patient's pulse and blood pressure. (OPQRSTI)
  • Why it matters: If the patient is bleeding or has a broken bone, you need to stop the bleeding.
  • Example: A person who is bleeding from a cut.
• Spinal Injury: Check for any signs of a spinal injury (like numbness or tingling). (SAMPLE)
  • Why it matters: You don't want to make the injury worse.
  • Example: A person who has fallen from a height.
• Bleeding Control: Stop any bleeding with a tourniquet or pressure. (OPQRSTI)
  • Why it matters: You need to prevent the patient from losing too much blood.
  • Example: A person who has been shot.
• Immobilization: Keep the patient's neck and spine stable with a backboard or cervical collar. (AVPU)
  • Why it matters: You don't want to make the injury worse.
  • Example: A person who has been in a car accident.
• Communication: Call 911 or your local emergency number and provide information about the patient's condition. (SAMPLE)
  • Why it matters: You need to get help to the patient as soon as possible.
  • Example: A person who is having a heart attack.

What Laypeople Can Do:

• If someone collapses, first check for danger (oncoming traffic, fire). Then shout and tap their shoulder.
• If someone is bleeding, apply pressure with a cloth or bandage.
• If someone is having trouble breathing, call 911 and try to keep them calm.
• If someone has a head or neck injury, keep them still and call 911.
• If someone is having a seizure, try to keep them safe and call 911.

Common Mistakes:

• Mistake: Not checking the patient's airway first.
  • Fix: Always check the patient's airway before doing anything else.
  • Why: If the patient can't breathe, nothing else matters.
• Mistake: Not calling 911 right away.
  • Fix: Call 911 as soon as possible.
  • Why: You need to get help to the patient as soon as possible.
• Mistake: Not keeping the patient's neck and spine stable.
  • Fix: Use a backboard or cervical collar to keep the patient's neck and spine stable.
  • Why: You don't want to make the injury worse.

Quick Practice Scenarios:

• A person is having a heart attack in a public place. What should you do first?
• Answer: Call 911 and try to keep them calm.

• Reason: You need to get help to the patient as soon as possible.

• A person is bleeding from a cut on their arm. What should you do first?

• Answer: Apply pressure with a cloth or bandage.

• Reason: You need to stop the bleeding as soon as possible.

• A person is having trouble breathing after a car accident. What should you do first?

• Answer: Call 911 and try to keep them calm.
• Reason: You need to get help to the patient as soon as possible.

Last-Minute Exam Cram:

• Normal pulse rate: 60-100 beats per minute.
• Normal blood pressure: 90/60-120/80 mmHg.
• CPR compression depth: at least 2 inches.
• CPR compression rate: 100-120 compressions per minute.
• Agonal breathing is NOT normal breathing – start CPR.
• Always check the patient's airway first.
• Never move a patient with a suspected spinal injury.
• SAMPLE: Size, Age, Mechanism, Allergies, Past medical history, Last meal.
• OPQRSTI: Onset, Provocation, Quality, Region, Severity, Time, Injuries.
• AVPU: Alert, Verbal, Pain, Unresponsive.