NREMT Exam Trauma Module
Trauma is the leading cause of death for people ages 1-44 and something that all prehospital personnel will be required to respond to and manage. A systematic approach to the trauma patient is critical to address life-threatening emergencies as soon as possible without getting distracted by other injuries that may be present. Understanding how to appropriately approach the trauma patient as well as how the trauma system works provides the framework for making sure that all trauma patients get the care that they need as quickly as possible. In this module, we will take a look at the systems and processes that have been put into place to do just that.
BLEEDING AND SOFT TISSUE TRAUMA
In an effort to maintain homeostasis, our bodies have developed amazing mechanisms by which it prevents decompensation in trauma. Hemostasis is one of these mechanisms and is the process our body uses to stop blood loss. As first responders, our job is to aid the body in achieving hemostasis. The techniques we use to control bleeding and treat soft tissue trauma support the body in its effort to compensate and function despite hemorrhage and injury. In this module we will learn exactly how our body responds and reacts to bleeding in trauma as well as some of the types of injuries we may see and respond to in the field.
Due to its involvement of major organs, the chest cavity is a priority area of protection. Compromise of this area almost always leads to life-threatening injuries. It’s also worth noting that the types of mechanisms that cause chest compromise are forces that are most likely going to cause trauma to other body systems too. With good assessment skills and quick procedures, we need to be able to prioritize the worst injuries and systematically stabilize our patients. We’ve covered assessment and now can quickly recognize that treatment of chest injuries will take precedence. In this module, we cover just what those treatments are. You’ll learn all about these unique emergencies and how they require a more advanced assessment as well as much more specialized and potentially invasive treatments.
Whether from a penetrating injury or blunt force, trauma to the abdomen carries a high risk of serious injury due to the large amount of vital and highly vascularized organs that reside within it. The abdomen can be easily overlooked in a trauma scenario because of distracting injuries and a lack of obvious physical exam findings. Understanding how to properly assess the abdomen and how to suspect underlying organ injuries is imperative for any trauma specialist. In this module, we will show you how to do just that, as well as manage and stabilize patients with both obvious and not so obvious trauma to their abdomen.
NERVOUS SYSTEM TRAUMA
Your brain only weighs about three pounds and yet contains 100 billion nerve cells. Each nerve cell is connected to about 100,000 other nerve cells meaning your brain has over 1000 trillion connections within it. Protected by the skull and spinal column, the brain, and spinal cord carry nerve impulses to the entire body so that we can function, think, and reason. Thousands of people a year suffer from minor to severe traumatic brain and spinal cord injuries. As a part of our trauma assessment and management, being able to know how different brain and spinal cord injuries present can be critical in preventing worsening injury and decompensation.
HEAD, FACE, AND NECK TRAUMA
Management of trauma to the Head, Face, and Neck can present a difficult challenge to the first responder. Airway compromise in patients with facial trauma requires special considerations and techniques. In the neck, trauma to vital underlying structures such as the trachea and carotid arteries require early intervention in order to prevent serious complications. Proper management of trauma to the eyes can help prevent lifelong vision loss. These are some of the challenges we face as the ones first on the scene. Here we will cover many of these injuries including skull fractures, facial fractures, orbital fractures, penetrating neck trauma, and trauma to the larynx and trachea.
Your skeletal system consists of 206 bones and 360 joints that work together to allow for movements, support, and protection of underlying organs. Orthopedic injuries account for a great deal of trauma-related emergency department visits each year, and though not commonly life-threatening, without proper management can lead to disability. The first responder is charged with identifying injury patterns and mechanisms that may suggest underlying skeletal complications and working to prevent further injury or complications. An understanding of common mechanisms of injury as well as different injury types and complications will allow you to recognize patients who may need particular management and further evaluation and help you decide who should be seen quickly by more advanced providers to prevent lifelong disability.
Burns are some of the most challenging injuries you’ll be responding to. Not only does a burn transfer energy in ways other trauma doesn’t, but your patient’s response also can quickly take unexpected turns for the worst. Once past the initial stabilization, a long and painful road is ahead as long-term treatment commences. Frontline responders like you use skillful assessment and practiced techniques to prevent burns from becoming life-altering, or even life-ending.. We’ll learn how to apply these tools as we cover the ins and outs of burn trauma.
Trauma to the body includes all forms of physical injury and what we are exposed to in our environment can predispose us to and even be the cause of significant bodily harm. In this lecture, we will discuss the most important environmental injuries and how to manage them including submersion injuries, temperature-related illness, bites and envenomation, and high altitude illness. Left untreated these injuries can quickly lead to the loss of life, however, proper identification and management can significantly decrease mortality from environmental trauma.
MULTI-SYSTEM TRAUMA OVERVIEW
Understanding how to manage trauma to different organ systems is a critical component of prehospital care. In other lectures we’ve discussed the specific management of different body systems such as the chest and abdomen, however, trauma does not always affect only one body system. In fact, the majority of trauma will affect more than one major body system. Assessing the patient, starting with the ABCs and followed by a head-to-toe examination is critical to discovering how many body systems have suffered an injury and to help prioritize management of those injuries. When two or more systems are affected, such as the head and the chest, or the chest and the abdomen, a systematic approach is key to identifying and managing injuries appropriately. We call this multi-system trauma and here we will discuss how to systematically approach these patients to reduce their morbidity and mortality.