EMS Chapter 36: Multisystem Trauma & Trauma in Special Patient Populations

What special considerations should you have when immobilizing a pediatric trauma patient? A geriatric trauma patient?

-padding -have parents nearby -speak calm/slow -talk pt through everything

What are some special considerations that need to be made in assessing a pediatric trauma patient?

-smaller: more prone to multisystem trauma -fast pulse = earliest sign of hemorrhage -<3 yoa: no BP -pt <8 yoa: pad shoulders -anticipate sudden decompensation -beware tachycardia: early shock -beware bradycardia: late shock

What are some special considerations that need to be made in assessing a pregnant trauma patient?

-two patients -shock may induce premature labor -left side -injuries may be masked -fetal distress causes hypoxia/hypovolemia -anticipate vomiting

What is the PAT? At what point is this done in your assessment?

pediatric assessment triangle (appearance, work of breathing, circulation to skin) Done during General Impression

What is abruptio placentae? What type of trauma most often causes it?

premature separation of the placenta from the uterine wall Can result from traumatic incidents, most often MVC

What special consideration should you have when applying SMR to a pregnant trauma patient?

tilt patient to the left

What is your target SpO2 for a pregnant trauma patient?

100%

What is your target SpO2 for a pediatric patient? For a geriatric patient?

Both: above 94%

What is oftentimes your best source of information for a cognitively impaired patient?

Care givers

At how many weeks of gestation should you begin to consider the possibility of supine hypotensive syndrome when a pregnant patient is placed on her back?

at 20 weeks gestation

What type of injuries might be caused by shaken baby syndrome?

brain bleeding/swelling

What is the earliest sign of hemorrhagic shock for a pediatric patient?

fast pulse