Module 7: Trauma Emergencies

By the end of this module, you will be able to:

• Understand the mechanisms of injury and how they affect patient care.

• Recognize and manage different types of traumatic injuries, including bleeding, fractures, and shock.

• Perform spinal motion restriction procedures.

• Prioritize care in multi-system trauma.

Importance

• Predicts Potential Injuries

• Guides Assessment

Types of MOI

• Blunt Trauma

  • Falls, motor vehicle collisions (MVCs), assaults.

  • Forces: Compression, deceleration, shearing.

• Penetrating Trauma

  • Stab wounds, gunshot wounds.

  • Damage depends on object velocity and path.

Types of Bleeding

• Arterial: Bright red, spurting with heartbeat.

• Venous: Dark red, steady flow.

• Capillary: Oozing, slow flow.

Control Techniques

• Direct Pressure

  • Apply firm pressure with gloved hand and dressing.

• Elevation

  • Raise the injured area above heart level (if no fractures).

• Pressure Dressings

  • Bandages that apply continuous pressure.

• Tourniquet

  • Use when direct pressure is ineffective.

  • Apply proximal to the injury.

  • Document time applied.

• Hemostatic Agents

  • Substances that promote clotting.

  • Clotting gauze (ex. QuikClot)

Types

• Abrasions

  • Scrapes affecting the outer skin layers.

• Lacerations

  • Cuts with either smooth or jagged edges.

• Avulsions

  • Flap of skin torn loose or completely detached.

• Punctures/Penetrations

  • Deep wounds caused by sharp objects.

• Amputations

  • Complete severing of a body part.

Management

• Control bleeding.

• Prevent contamination.

• Preserve amputated parts (wrap in sterile dressing, keep cool).

Types

• Fractures

  • Break in the continuity of a bone.

  • Open Fracture: Bone protrudes through the skin.

  • Closed Fracture: Skin remains intact.

• Dislocations

  • Displacement of bones at a joint.

• Sprains

  • Stretching or tearing of ligaments.

• Strains

  • Overstretching or tearing of muscles or tendons.

Assessment

• Signs and Symptoms: Pain, swelling, deformity, inability to move.

Management

• Immobilization

  • Splint fractures and dislocations.

  • Check distal pulses before and after splinting.

• Spinal Motion Restriction

  • Use when spinal injury is suspected.

  • Apply cervical collar, secure patient to backboard.

More information can be found in: NJ State Resources.

Types of Shock

• Hypovolemic Shock:

  • Cause: Severe blood or fluid loss, common in trauma cases.

  • Signs: Rapid, weak pulse; low blood pressure; pale, cool, and clammy skin.

  • Management: Control bleeding, administer IV fluids (NS or LR), and provide oxygen.

• Cardiogenic Shock:

  • Cause: Poor heart function, often following a heart attack or CHF.

  • Signs: Low blood pressure, pulmonary edema, difficulty breathing, cyanosis.

  • Management: Provide high-flow oxygen, assist ventilation if needed, and initiate IV fluids cautiously. Consider medications like dopamine to support blood pressure.

• Distributive Shock:

  • Cause: Blood vessel dilation from conditions like septic shock or anaphylaxis.

  • Signs: Warm, flushed skin (early); rapid, weak pulse; hypotension.

  • Management:

    • Anaphylactic Shock: Epinephrine, antihistamines, and steroids.

    • Septic Shock: IV fluids, antibiotics, and vasopressors if needed.

• Obstructive Shock:

  • Cause: Blockage of blood flow, such as in pulmonary embolism or tension pneumothorax.

  • Signs: Difficulty breathing, cyanosis, hypotension, jugular vein distention.

  • Management: Treat the underlying cause (ex., needle decompression for pneumothorax).

Signs and Symptoms

• Altered mental status.

• Pale, cool, clammy skin.

• Rapid, weak pulse.

• Rapid breathing.

• Low blood pressure (late sign).

Management

• Control external bleeding.

• Maintain airway; administer oxygen.

• Keep patient warm.

• Rapid transport.