Special Trauma Considerations

Course overview

Objectives Describe special trauma considerations EMS providers may be faced with Explain the pathophysiology of pediatric and geriatric emergencies Content Information Covered 1 Trauma in Pregnancy 1 Incidence 1 Mortality morbidity 2 Risk factors 3 Prevention 2 Pathophysiology 1 Exhibit responses different due to physiologic changes during pregnancy 2 Mother 1 Blood volume changes 2 Respiratory changes 3 GI and intra abdominal changes 3 Fetus 4 Fetal death 3 Special Considerations in assessment 4 Special considerations in management 2 Pediatric Trauma 1 Unique Pediatric Aspects of Trauma 2 Pathophysiology 1 Head most common injured 2 Spine 1 SCIWORA 3 Chest 1 Very compliant injury requires great force 2 Commotio cordis sudden impact of blunt force to the chest resulting in cardiac dysfunction even death 4 Abdomen 5 Musculoskeletal 3 Special Considerations in assessment 1 Airway Breathing and Circulation 2 Circulation 3 Head 4 Chest 5 Abdomen 6 Musculoskeletal Trauma 4 Special considerations in management 1 Airway Breathing and Circulation improper management is the most common cause of preventable pediatric death 2 Circulation 3 Head 4 Spinal 5 Abdomen 6 Extremity 7 Transportation 3 Geriatric Trauma 1 Unique Geriatric Aspects of Trauma 2 Pathophysiology 1 Health Most changes occur after age 80 if the patient is in general good health 2 Respiratory 3 Cardiovascular 4 Neurological system 1 Neuron mass reduction 2 Velocity of impulses 3 Mentation changes 4 Thermoregulation changes 5 Gastrointestinal 6 Renal 7 Musculoskeletal 8 Integumentary 9 Immune 3 Special considerations in assessment 4 Special considerations in management 5 Specific injuries diseases management 1 Shock 2 Head injuries 3 Musculoskeletal injuries 4 Burns 5 Abuse 4 Cognitively impaired patient 1 Unique challenges with cognitively impaired patients 1 Ability of individual to communicate complaints 2 Unreliable historians 3 Unusual presentation of common disorders 4 Reduced pain threshold 5 Consent to treat complications 6 Most commonly mental retardation IQ less than 70 7 1 to 2.5 percent of population has mental retardation 8 Autism differences in social communication and ability to purposefully shift attention may become agitated with touch 2 Special considerations in assessment 1 Level of development 2 Use family and caregivers as part of history gathering 3 Assess determine hearing and sight problems 4 Take vital signs when patient is calm 5 Typically helpful to have a caregiver present during physical exam 3 Special considerations in management 1 Treatment is the same 2 Suspect common disorders in the age population 1 Injuries 2 Infections 3 Seizures 4 Delirium 5 Psychiatric disorders