intro to trauma
- 3. Topics Trauma Trauma as a Disease The Trauma Care System Trauma Center Designation Your Role as a Paramedic
- 4. Trauma
- 5. Trauma Physical injury caused by external force Leading killer of persons under 44 in US 150,000 deaths annually Most expensive medical problem
- 6. Trauma Two major categories: Penetrating Blunt < 10 % are serious
- 7. Trauma Serious vs. Not Serious The use of trauma triage criteria will aid you in making this determination.
- 8. Trauma as a Disease
- 9. Trauma as a Disease Highway Safety Act of 1966 Led to development of EMS Trauma was categorized as a disease Trauma can often be prevented The public health model Surveillance, risk analysis, intervention development, implementation, and evaluation
- 10. Surveillance The collection of data Epidemiology
- 11. Epidemiology
- 12. Risk Analysis Examines the various factors that impact the development, course, and consequences of a disease. Haddon Matrix A three-by-three matrix that describes nine elements
- 13. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 4: Trauma Emergencies, 3rd. Ed. © 2009 by Pearson Education, Inc.
- 14. Intervention Development Programs to reduce both the incidence and the seriousness of trauma Examples Safer highway design Autos with better braking systems, crumple zones, and passive restraint systems Programs that encourage drivers to use their seatbelts, to not drink and drive, and to drive defensively
- 15. Implementation Act of placing an intervention into practice Includes: Enforcing traffic laws Reducing speed limits in hazardous areas Rebuilding highways to be safer Building safer autos Encouraging changes in driver behavior Safety education Continuing to improve our EMS system
- 16. Evaluation Accomplished by repeating the processes of surveillance To identify the benefit or ineffectiveness of an intervention or program We must continue to search out risk factors, develop and implement interventions, and evaluate our systems’ performance
- 18. The Trauma Care System
- 20. The Trauma Care System Integration of EMS Hospital care Reduces Cost Time to surgery Mortality Proper Care Immediate surgical intervention to repair hemorrhage sites
- 22. Trauma Center Designation The trauma system is predicated on the principle that serious trauma is a surgical disease. < 10 % Life threatening Surgical care for trauma patients can drastically reduce trauma mortality and morbidity.
- 23. Trauma Center Designation Level I Level II Level III
- 24. Trauma Center Designation Level I Regional Trauma Center All types of surgical and medical subspecialty Research and teaching commitment Level II Area Trauma Center Majority of surgical and medical subspecialties available 24/7 Level III Community Trauma Center Specialized ED with the majority of surgical and medical subspecialties available 24/7 (on call)
- 25. Trauma Center Designation In some remote areas, there is provision for an additional level of trauma patient destination. Level IV Seriously injured trauma patients may be taken for stabilization and care before transport. The design of a trauma system should be flexible in order to meet the needs of the region it serves.
- 26. Trauma Center Designation Specialty Centers Neurocenters Burn Centers Pediatric Trauma Hyperbaric Medicine Microsurgery
- 27. Your Role as a Paramedic
- 28. CUPS Bledsoe et al., Paramedic Care: Principles & Practice, Volume 4: Trauma Emergencies, 3rd. Ed. © 2009 by Pearson Education, Inc.
- 29. Your Role as a Paramedic Trauma Triage Criteria START Nearest appropriate facility Mechanism of Injury Analysis (MOI) Processes and forces that cause trauma Consider inertial forces Index of Suspicion (IOS) Anticipation of injury to a body region, organ, or structure based on MOI
- 30. Your Role as a Paramedic The Golden Period BEST survivability from incident to surgery is 1 hour Platinum 10 Minutes Scene time limited to 10 minutes Air Transport Speed vs. need Type of patients transported
- 31. Your Role as a Paramedic The Decision to Transport The trauma triage criteria When applying trauma triage criteria, it is best to err on the side of precaution.
- 32. Your Role as a Paramedic Injury Prevention Bicycle safety programs Firearm safety Boat safety Child safety seat classes and checking Data and Trauma Registry Data retrieval system for trauma patient information
- 33. Your Role as a Paramedic Quality Improvement QI or QM Examine the system performance Evaluate calls Accurate and complete documentation