Standard

Rev.03/29/03

EMS 131 – Trauma

(To Review Previous Version of this Standard and Guide, Click Here)

Course Description

This Unit is designed to introduce the student to assessment and management of the trauma patient, to include: systematic approach to the assessment and management of trauma, demonstration of the assessment and management of certain types of trauma patients and bodily injuries. Student should complete the requirements for the Basic Trauma Life Support Course or the Pre-Hospital Trauma Life Support Course.

 

 

Competency Areas

Hours

 

Systemic Approach To The Assessment And Management Of Trauma

Class

4

Demonstrate Assessment And Management For:

  1. Hemorrhage/Shock, Burns, And The Following Types Of Trauma:
  2. Soft Tissue, Head/Facial, Spinal, Thoracic, Abdominal, And Musculoskeletal  

D. Lab

2

Successfully Complete BTLS/PHTLS Certification

P. Lab/O.B.I.

0

     

Credit

5

 

 

 


Prerequisite:

ENG 101,  SCT 100, EMS126, EMS 127, EMS 128, EMS 129, EMS 200

Corequisite:

     

 

Course Guide

 

Competency

After completing this section, the student will:

Hours

Class

D.Lab

P.Lab/

O.B.I.

 

 

 

 

SYSTEMATIC APPROACH TO THE ASSESSMENT AND MANAGEMENT OF TRAUMA

3

0

0

 

List and describe the components of a comprehensive trauma system.

 

 

 

 

Describe the role of and differences between levels of trauma centers.

 

 

 

 

Describe the criteria for transport to a trauma center.

 

 

 

 

Describe the criteria and procedure for air medical transport.

 

 

 

 

Define energy and force as they relate to trauma.

 

 

 

 

Define laws of motion and energy and understand the role that increased speed has on injuries.

 

 

 

 

Describe each type of impact and its effect on unrestrained victims (e.g., “down and under,” “up and over,” compression, deceleration).

 

 

 

 

Describe the pathophysiology of the head, spine, thorax, and abdomen that results from the above forces.

 

 

 

 

List specific injuries and their causes as related to interior and exterior vehicle damage.

 

 

 

 

Describe the kinematics of penetrating injuries.

 

 

 

 

List the motion and energy considerations of mechanisms other than motor vehicle crashes.

 

 

 

 

Define the role of kinematics as an additional tool for patient assessment.

 

 

 

DEMONSTRATE ASSESSMENT AND MANAGEMENT FOR HEMORRHAGE/SHOCK, BURNS, AND THE FOLLOWING TYPES OF TRAUMA:  SOFT TISSUE, HEAD/FACIAL, SPINAL, THORACIC, ABDOMINAL, AND MUSCULOSKELETAL INJURIES

6

12

0

Hemorrhage and shock

Describe the epidemiology, including the morbidity/ mortality and prevention strategies, for shock and hemorrhage.

 

 

 

 

Discuss the anatomy and physiology of the cardiovascular system.

 

 

 

 

Predict shock and hemorrhage based on mechanism of injury.

 

 

 

 

Discuss the various types and degrees of shock and hemorrhage.

 

 

 

 

Discuss the pathophysiology of hemorrhage and shock.

 

 

 

 

Discuss the assessment findings associated with hemorrhage and shock.

 

 

 

 

Identify the need for intervention and transport of the patient with hemorrhage or shock.

 

 

 

 

Discuss the treatment plan and management of hemorrhage and shock.

 

 

 

 

Discuss the management of external hemorrhage.

 

 

 

 

Differentiate between controlled and uncontrolled hemorrhage.

 

 

 

 

Differentiate between the administration rate and amount of IV fluid in a patient with controlled versus uncontrolled hemorrhage.

 

 

 

 

Relate internal hemorrhage to the pathophysiology of compensated and decompensated hemorrhagic shock.

 

 

 

 

Relate internal hemorrhage to the assessment findings of compensated and decompensated hemorrhagic shock.

 

 

 

 

Discuss the management of internal hemorrhage.

 

 

 

 

Define shock based on aerobic and anaerobic metabolism.

 

 

 

 

Describe the incidence, morbidity, and mortality of shock.

 

 

 

 

Describe the body's physiologic response to changes in perfusion.

 

 

 

 

Describe the effects of decreased perfusion at the capillary level.

 

 

 

 

Discuss the cellular ischemic phase related to hemorrhagic shock.

 

 

 

 

Discuss the capillary stagnation phase related to hemorrhagic shock.

 

 

 

 

Discuss the capillary washout phase related to hemorrhagic shock.

 

 

 

 

Discuss the assessment findings of hemorrhagic shock.

 

 

 

 

Relate pulse pressure changes to perfusion status.

 

 

 

 

Relate orthostatic vital sign changes to perfusion status.

 

 

 

 

Define compensated and decompensated hemorrhagic shock.

 

 

 

 

Discuss the pathophysiological changes associated with compensated shock.

 

 

 

 

Discuss the assessment findings associated with compensated shock.

 

 

 

 

Identify the need for intervention and transport of the patient with compensated shock.

 

 

 

 

Discuss the treatment plan and management of compensated shock.

 

 

 

 

Discuss the pathophysiological changes associated with decompensated shock.

 

 

 

 

Discuss the assessment findings associated with decompensated shock.

 

 

 

 

Identify the need for intervention and transport of the patient with decompensated shock.      

 

 

 

 

Discuss the treatment plan and management of the patient with decompensated shock.

 

 

 

 

Differentiate between compensated and decompensated shock.

 

 

 

 

Relate external hemorrhage to the pathophysiology of compensated and decompensated hemorrhagic shock.

 

 

 

 

Relate external hemorrhage to the assessment findings of compensated and decompensated hemorrhagic shock.

 

 

 

 

Differentiate between the normotensive, hypotensive, or profoundly hypotensive patient.

 

 

 

 

Differentiate between the administration of fluid in the normotensive, hypotensive, or profoundly hypotensive patient.

 

 

 

 

Discuss the physiologic changes associated with the pneumatic anti-shock garment (PASG).

 

 

 

 

Discuss the indications and contraindications for the application and inflation of the PASG.

 

 

 

 

Apply epidemiology to develop prevention strategies for hemorrhage and shock.

 

 

 

 

Integrate the pathophysiological principles to the assessment of a patient with hemorrhage or shock.

 

 

 

 

Synthesize assessment findings and patient history information to form a field impression for the patient with hemorrhage or shock.

 

 

 

 

Develop, execute and evaluate a treatment plan based on the field impression for the hemorrhage or shock patient.

 

 

 

 

Demonstrate the assessment of a patient with signs and symptoms of hemorrhagic shock.

 

 

 

 

Demonstrate the management of a patient with signs and symptoms of hemorrhagic shock.

 

 

 

 

Demonstrate the assessment of a patient with signs and symptoms of compensated hemorrhagic shock.

 

 

 

 

Demonstrate the management of a patient with signs and symptoms of compensated hemorrhagic shock.

 

 

 

 

Demonstrate the assessment of a patient with signs and symptoms of decompensated hemorrhagic shock.

 

 

 

 

Demonstrate the management of a patient with signs

and symptoms of decompensated hemorrhagic shock.

 

 

 

 

Demonstrate the assessment of a patient with signs and symptoms of external hemorrhage.

 

 

 

 

Demonstrate the management of a patient with signs and symptoms of external hemorrhage.

 

 

 

 

Demonstrate the assessment of a patient with signs and symptoms of internal hemorrhage.

 

 

 

 

Demonstrate the management of a patient with signs and symptoms of internal hemorrhage.

 

 

 

SOFT TISSUE INJURIES

2

0

0

 

Discuss the assessment findings associated with open soft tissue injuries.

 

 

 

 

Discuss the assessment of hemorrhage associated with open soft tissue injuries.

 

 

 

 

Differentiate between the various management

techniques for hemorrhage control of open soft tissue

injuries, including:

1.      Direct pressure

2.      Elevation

3.      Pressure dressing

4.      Pressure point

5.      Tourniquet application

 

 

 

 

Differentiate between the types of injuries requiring the use of an occlusive versus non-occlusive dressing.

 

 

 

 

Identify the need for rapid assessment, intervention and appropriate transport for the patient with a soft tissue injury.

 

 

 

 

Discuss the management of the soft tissue injury patient.

 

 

 

 

Define and discuss the following:

       1.    Dressings

1.      Sterile

2.      Non-sterile

3.      Occlusive

4.      Non-occlusive

5.      Adherent

6.      Non-adherent

7.      Absorbent

8.      Non-absorbent

9.      Wet

10.  Dry

         2.  Bandages

11.  Absorbent

12.  Non-absorbent

13.  Adherent

14.  Non-adherent

         3.  Tourniquet

 

 

 

 

Predict the possible complications of an improperly applied dressing, bandage, or tourniquet.

 

 

 

 

Discuss the assessment of wound healing.

 

 

 

 

Discuss the management of wound healing.

 

 

 

 

Discuss the pathophysiology of wound infection.

 

 

 

 

Discuss the assessment of wound infection.

 

 

 

 

Discuss the management of wound infection.

 

 

 

 

Integrate pathophysiological principles to the assessment of a patient with a soft tissue injury.

 

 

 

 

Formulate treatment priorities for patients with soft

tissue injuries in conjunction with:

1.      Airway/face/neck trauma

2.      Thoracic trauma (open/closed)

      3.   Abdominal trauma

 

 

 

 

Synthesize assessment findings and patient history information to form a field impression for the patient with soft tissue trauma.

 

 

 

 

Develop, execute, and evaluate a treatment plan based on the field impression for the patient with soft tissue trauma.

 

 

 

 

Defend the rationale explaining why immediate life-threats must take priority over wound closure.

 

 

 

 

Defend the management regimens for various soft tissue injuries.

 

 

 

 

Defend why immediate life-threatening conditions take priority over soft tissue management.

 

 

 

 

Value the importance of a thorough assessment for patients with soft tissue injuries.

 

 

 

 

Attend to the feelings that the patient with a soft tissue injury may experience.

 

 

 

 

Appreciate the importance of good follow-up care for patients receiving sutures.

 

 

 

 

Understand the value of the written report for soft tissue injuries in the continuum of patient care.

 

 

 

 

Demonstrate the assessment and management of a

patient with signs and symptoms of soft tissue injury,

including:

1.      Contusion

2.      Hematoma

3.      Crushing

4.      Abrasion

5.      Laceration

6.      Avulsion

7.      Amputation

8.      Impaled object

9.      Penetration/puncture

    10.   Blast

 

 

 

BURN INJURIES

3

0

0

 

At the completion of this unit, the paramedic student

will be able to integrate pathophysiological principles

and the assessment findings to formulate a field

impression and implement the management plan for the

patient with a burn injury.

 

 

 

 

Describe the anatomy and physiology pertinent to burn injuries.

 

 

 

 

Describe the epidemiology, including incidence,

mortality/morbidity, risk factors, and prevention

strategies for the patient with a burn injury.

 

 

 

 

Describe the pathophysiologic complications and systemic complications of a burn injury.

 

 

 

 

Identify and describe types of burn injuries, including a

thermal burn, an inhalation burn, a chemical burn, an

electrical burn, and a radiation exposure.

 

 

 

 

Identify and describe the depth classifications of burn

injuries, including a superficial burn, a partial-thickness

burn, a full-thickness burn, and other depth

classifications described by local protocol.

 

 

 

 

Identify and describe methods for determining body

surface area percentage of a burn injury including the

"rules of nines," the "rules of palms," and other methods

 described by local protocol.

 

 

 

 

Identify and describe the severity of a burn including a

minor burn, a moderate burn, a severe  burn, and other

severity classifications described by local protocol.

 

 

 

 

Differentiate criteria for determining the severity of a

burn injury between a pediatric patient and an adult

patient.

 

 

 

 

Describe special considerations for a pediatric patient with a burn injury.

 

 

 

 

Discuss considerations which impact management and prognosis of the burn injured patient.

 

 

 

 

Discuss mechanisms of burn injuries.

 

 

 

 

Discuss conditions associated with burn injuries,

including trauma, blast injuries, airway compromise,

respiratory compromise, and child abuse.

 

 

 

 

Describe the management of a burn injury, including

airway and ventilation, circulation, pharmacological,

non-pharmacological, transport considerations,

psychological support/ communication strategies, and

other management described by local protocol.

 

 

 

 

Describe the epidemiology of a thermal burn injury.

 

 

 

 

Describe the specific anatomy and physiology pertinent to a thermal burn injury.

 

 

 

 

Describe the pathophysiology of a thermal burn injury.

 

 

 

 

Identify and describe the depth classifications of a thermal burn injury.

 

 

 

 

Identify and describe the severity of a thermal burn injury.

 

 

 

 

Describe considerations which impact management and

prognosis of the patient with a thermal burn injury.

 

 

 

 

Discuss mechanisms of burn injury and conditions associated with a thermal burn injury.

 

 

 

 

Describe the management of a thermal burn injury,

including airway and ventilation, circulation,

pharmacological, non-pharmacological, transport

considerations, and psychological support/

communication strategies.

 

 

 

 

Describe the epidemiology of an inhalation burn injury.

 

 

 

 

Describe the specific anatomy and physiology pertinent to an inhalation burn injury.

 

 

 

 

Describe the pathophysiology of an inhalation burn injury.

 

 

 

 

Differentiate between supraglottic and infraglottic inhalation injuries.

 

 

 

 

Identify and describe the depth classifications of an inhalation burn injury.

 

 

 

 

Identify and describe the severity of an inhalation burn injury.

 

 

 

 

Describe considerations which impact management and

prognosis of the patient with an inhalation burn injury.

 

 

 

 

Discuss mechanisms of burn injury and conditions associated with an inhalation burn injury.

 

 

 

 

Describe the management of an inhalation burn injury, including airway and ventilation, circulation, pharmacological, non-pharmacological, transport considerations, and psychological support/ communication strategies.

 

 

 

 

Describe the epidemiology of a chemical burn injury and a chemical burn injury to the eye.

 

 

 

 

Describe the specific anatomy and physiology pertinent

to a chemical burn injury and a chemical burn injury to

the eye.

 

 

 

 

Describe the pathophysiology of a chemical burn injury,

including types of chemicals and their burning

processes and a chemical burn injury to the eye.

 

 

 

 

Identify and describe the depth classifications of a

chemical burn injury.

 

 

 

 

Identify and describe the severity of a chemical burn injury.

 

 

 

 

Describe considerations which impact management and

prognosis of the patient with a chemical burn injury and

a chemical burn injury to the eye.

 

 

 

 

Discuss mechanisms of burn injury and conditions associated with a chemical burn injury.

 

 

 

 

Describe the management of a chemical burn injury and

a chemical burn injury to the eye, including airway and

ventilation, circulation, pharmacological, non-

pharmacological, transport considerations, and

psychological support/ communication strategies.

 

 

 

 

Describe the epidemiology of an electrical burn injury.

 

 

 

 

Describe the specific anatomy and physiology pertinent to an electrical burn injury.

 

 

 

 

Describe the pathophysiology of an electrical burn injury.

 

 

 

 

Identify and describe the depth classifications of an electrical burn injury.

 

 

 

 

Identify and describe the severity of an electrical burn injury.

 

 

 

 

Describe considerations which impact management and

prognosis of the patient with an electrical burn injury.

 

 

 

 

Discuss mechanisms of burn injury and conditions associated with an electrical burn injury.

 

 

 

 

Describe the management of an

electrical burn injury, including airway

and ventilation, circulation,

pharmacological, non-pharmacological,

transport considerations, and

psychological support/communication strategies.

 

 

 

 

Describe the epidemiology of a radiation exposure.

 

 

 

 

Describe the specific anatomy and physiology pertinent to a radiation exposure.

 

 

 

 

Describe the pathophysiology of a radiation exposure, including the types and characteristics of ionizing radiation.

 

 

 

 

Identify and describe the depth classifications of a radiation exposure.

 

 

 

 

Identify and describe the severity of a radiation exposure.

 

 

 

 

Describe considerations which impact management and

prognosis of the patient with a radiation exposure.

 

 

 

 

Discuss mechanisms of burn injury associated with a radiation exposure.

 

 

 

 

Discuss conditions associated with a radiation exposure.

 

 

 

 

Describe the management of a radiation exposure,

including airway and ventilation, circulation,

pharmacological, non-pharmacological, transport

considerations, and psychological support/

communication strategies.

 

 

 

 

Integrate pathophysiological principles to the assessment of a patient with a thermal burn injury.

 

 

 

 

Integrate pathophysiological principles to the assessment of a patient with an inhalation burn injury.

 

 

 

 

Integrate pathophysiological principles to the assessment of a patient with a chemical burn injury.

 

 

 

 

Integrate pathophysiological principles to the assessment of a patient with an electrical burn injury.

 

 

 

 

Integrate pathophysiological principles to the assessment of a patient with a radiation exposure.

 

 

 

 

Synthesize patient history information and assessment findings to form a field impression for the patient with a thermal burn injury.

 

 

 

 

Synthesize patient history information and assessment

findings to form a field impression for the patient with

an inhalation burn injury.

 

 

 

 

Synthesize patient history information and assessment

findings to form a field impression for the patient with a

chemical burn injury.

 

 

 

 

Synthesize patient history information and assessment findings to form a field impression for the patient with an electrical burn injury.

 

 

 

 

Synthesize patient history information and assessment findings to form a field impression for the patient with a radiation exposure.

 

 

 

 

Develop, execute and evaluate a management plan based on the field impression for the patient with a thermal burn injury.

 

 

 

 

Develop, execute and evaluate a management plan based on the field impression for the patient with an inhalation burn injury.

 

 

 

 

Develop, execute and evaluate a management plan based on the field impression for the patient with a chemical burn injury.

 

 

 

 

Develop, execute and evaluate a management plan based on the field impression for the patient with an electrical burn injury.

 

 

 

 

Develop, execute and evaluate a management plan based on the field impression for the patient with a radiation exposure.

 

 

 

 

Value the changes of a patient's self-image associated with a burn injury.

 

 

 

 

Value the impact of managing a burn injured patient.

 

 

 

 

Advocate empathy for a burn injured patient.

 

 

 

 

Assess safety at a burn injury incident.

 

 

 

 

Characterize mortality and morbidity based on the pathophysiology and assessment findings of a patient with a burn injury.

 

 

 

 

Value and defend the sense of urgency in burn injuries.

 

 

 

 

Serve as a model for universal precautions and body substance isolation (BSI).

 

 

 

 

Take body substance isolation procedures during assessment and management of patients with a burn injury.

 

 

 

 

Perform assessment of a patient with a burn injury.

 

 

 

 

Perform management of a thermal burn injury, including airway and ventilation, circulation, pharmacological, non-pharmacological, transport considerations, psychological support/ communication strategies, and other management described by local protocol.

 

 

 

 

Perform management of an inhalation burn injury, including airway and ventilation, circulation, pharmacological, non-pharmacological, transport considerations, psychological support/ communication strategies, and other management described by local protocol.

 

 

 

 

Perform management of a chemical burn injury, including airway and ventilation, circulation, pharmacological, non-pharmacological, transport considerations, psychological support/ communication strategies, and other management described by local protocol.

 

 

 

 

Perform management of an electrical burn injury, including airway and ventilation, circulation, pharmacological, non-pharmacological, transport considerations, psychological support/ communication strategies, and other management described by local protocol.

 

 

 

 

Perform management of a radiation exposure, including airway and ventilation, circulation, pharmacological, non-pharmacological, transport considerations, psychological support/ communication strategies, and other management described by local protocol.

 

 

 

HEAD/FACIAL INJURIES

4

0

0

 

Describe the incidence, morbidity, and mortality of facial injures. 

 

 

 

 

Explain facial anatomy and relate physiology to facial injuries. 

 

 

 

 

Predict facial injuries based on mechanism of injury. 

 

 

 

 

Predict other injuries commonly associated with facial injuries based on mechanism of injury. 

 

 

 

 

Differentiate between the following types of facial

injuries, highlighting the defining characteristics of

each: 

  1. Eye

2.      Ear

3.      Nose

4.      Throat

      5.   Mouth

 

 

 

 

Integrate pathophysiological principles to the assessment of a patient with a facial injury. 

 

 

 

 

Differentiate between facial injuries based on the assessment and history. 

 

 

 

 

Formulate a field impression for a patient with a facial injury based on the assessment findings. 

 

 

 

 

Develop a patient management plan for a patient with a facial injury based on the field impression. 

 

 

 

 

Explain the pathophysiology of eye injuries. 

 

 

 

 

Relate assessment findings associated with eye injuries to pathophysiology. 

 

 

 

 

Integrate pathophysiological principles to the assessment of a patient with an eye injury. 

 

 

 

 

Formulate a field impression for a patient with an eye injury based on the assessment findings. 

 

 

 

 

Develop a patient management plan for a patient with an eye injury based on the field impression.  

 

 

 

 

Explain the pathophysiology of ear injuries. 

 

 

 

 

Relate assessment findings associated with ear injuries to pathophysiology. 

 

 

 

 

Integrate pathophysiological principles to the assessment of a patient with an ear injury. 

 

 

 

 

Formulate a field impression for a patient with an ear injury based on the assessment findings. 

 

 

 

 

Develop a patient management plan for a patient with an ear injury based on the field impression. 

 

 

 

 

Explain the pathophysiology of nose injuries. 

 

 

 

 

Relate assessment findings associated with nose injuries to pathophysiology. 

 

 

 

 

Integrate pathophysiological principles to the assessment of a patient with a nose injury. 

 

 

 

 

Formulate a field impression for a patient with a nose injury based on the assessment findings. 

 

 

 

 

Develop a patient management plan for a patient with a nose injury based on the field impression. 

 

 

 

 

Explain the pathophysiology of throat injuries.  

 

 

 

 

Relate assessment findings associated with throat injuries to pathophysiology. 

 

 

 

 

Integrate pathophysiological principles to the assessment of a patient with a throat injury.