Prehospital Trauma Life Support

Part

Managing the Multi-System Trauma Patient

R-30

Thoracic trauma deaths occur because of...

Inadequate ventilation

Inadequate circulation
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Pathophysiology
Changes in chest wall motion.
Changes in lung expansion.

Changes in diffusion.
Changes in circulation.
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Rib Fractures
Single isolated rib fractures.
Multiple fractures may produce flail chest.

R-33

PHTLS Refresher Course

Closed Pneumothorax

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Closed Pneumothorax
Parietal pleura Air in pleural space Partially collapsed lung Heart

Visceral pleura

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Pericardial Tamponade
Pathophysiology

R-36

Thoracic Trauma
Management

R-37

Abdominal Trauma
Pathophysiology Key indicator

R-38

Suspect Intra-abdominal Bleeding

When signs of shock are NOT explained by other serious injuries.

Head injury.

Thoracic injury.
External hemorrhage.

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PHTLS Refresher Course

On-Scene Management

R-40

PHTLS Refresher Course

En-Route Management

R-41

PHTLS Refresher Course

Head Trauma Pathophysiology

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Head Trauma
Skull fractures.

Depressed. Linear.

Basilar fractures.

CSF from ears, nose. Bleeding from ears. Raccoon eyes. Battles sign.
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PHTLS Refresher Course

Concussion & Contusion

R-44

PHTLS Refresher Course

Intracranial Hemorrhage

R-45

Subdural Hematomas
Acute Subacute Chronic

Dura mater

Subdural hematoma R-46

Suspect possible subdural hematoma.

R-47

Head Trauma Physiology

Cerebral perfusion.
Mean arterial pressure.

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CO2 Potential Vasodilator

Increased intracranial pressure.

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CO2 Potent Vasodilator

Hyperventilation Hyperoxygenation

R-50

PHTLS Refresher Course

Spine & Musculoskeletal Trauma Pathophysiology

R-51

Spine trauma...
A lack of neurological deficit does not rule out an unstable spine.

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Spine Trauma
Signs Symptoms

R-53

Spine Trauma Summary

Method

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Musculoskeletal Trauma
Priorities of care. Missed injuries.

R-55

All musculoskeletal injuries must be treated as fractures by EMTs.

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Musculoskeletal Trauma Special Considerations

Concealed internal bleeding.

R-57

PHTLS Refresher Course

Thermal Injuries

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Burn Trauma
Immediate measures to save lives.

R-59

First treat other trauma, then treat the burn!

R-60

Burn Trauma
Smoke inhalation.

R-61

Chemical Burns
Management. Remove the agent.

R-62

Electrical Burns
Cause of death. Other damage.

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Burn Trauma Summary

Primary considerations.

Management of thermal burns.

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Key Considerations
Recognize critical needs of the patient.

Efficiency of care.
Aggressive intervention.

Rapid packaging.
Rapid transport.

Continue treatment.
Nearest appropriate hospital.
R-65