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Special Trauma Considerations

Special Trauma Considerations

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. 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 cognitive impaired patients
      1. ability of individual to communicate complaints
      2. unreliable historian’s
      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% 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

Content Creator: Joyce Lockwood

CAPCE Course Number: 18-EMTP-F3-2206

Total CE Hours: 1

Level: Advanced

EMT-CE uses the NEMSES guidelines as the foundation for every course outline.