- ansPrehospital shock index pg. 85
.. activation: .... are found in the carotid sinus and along the aortic arch, are sensitive to
the degree of stretch in the arterial wall. When the receptors sense a decrease in
stretch, they stimulate the sympathetic nervous system to release Epi, norepi, causing
stimulation of cardiac activity and constriction of blood vessels, which causes a rise in
heart rate and diastolic blood pressure - ansBaroreceptors:
1. A- airway and Alertness with simultaneous cervical spinal stabilization
2. B- breathing and Ventilation
3. circulation and control of hemorrhage
4. D - disability (neurologic status)
5. F - full set of vitals and Family presence
6. G - Get resuscitation adjuncts
L- Lab results (arterial gases, blood type and crossmatch)
M- monitor for continuous cardiac rhythm and rate assessment
N- naso or orogastric tube consideration
O- oxygenation and ventilation analysis: Pulse oxygemetry and end-tidal caron dioxide
(ETC02) monitoring and capnopgraphy
H- History and head to toe assessment
I- Inspect posterior surfaces - ansABCDEFGHI
1. Apnea
2. GCS 8 or less
3. Maxillary fractures
4. Evidence of inhalation injury (facial burns)
5. Laryngeal or tracheal injury or neck hematoma
6. High risk of aspiration and patients inability to protect the airway
7. Compromised or ineffective ventilation - ansFollowing conditions might require a
definitive airway
1. bony fractures and possible rib fractures, which may impact ventilation
2. palpate for crepitus
3. subcutaneous emphysema which may be a sign for a pneumothorax
4. soft tissue injury - ansPalpate the chest for
1. Check the presence of adequate rise and fall of the chest with assisted ventilation
2. Absence of gurgling on auscultation over the epigastrium
3. Bilateral breath sounds present on auscultation
4. Presence of carbon dioxide (CO2) verified by a CO2 device or monitor - ansIf the pt
has a definitive airway in what should you do?
1. Dyspnea
2. Tachycardia
3. Decreased or absent breath sounds on the injured side
4. CP - ansSimple Pneumo assessment:
, 1. equal breath sounds bilaterally at the second intercostal space midclavicular line and
the bases for fifth intercostal space at the axillary line - ansAuscultate the chest for:
1. Get a CT
2. Consider ABG 's if decreased LOC
3. Consider glucose check - ansD Interventions
1. Hypotension
2. JVD
3. Muffled heart sounds - ansBecks Triad:
1. open the airway, use jaw thrust
2. insert an oral airway
3. assist ventilations with a bag mask
4. prepare for definitive airway - ansIf breathing is absent..
1. pain - hallmark sign, early sign
2. pressure - early sign
3. pallor, pules, paresthesia, paralysis - late sign - ansSix P's of compartment
syndrome:
1. Preparation
2. Preoxygenation
3. Pretreatment
4. Paralysis and Induction
5. Protecting and positioning - v
6. Placement of proof - secure the tube
7. Post intubation - secure ETT Tube, get X-ray for placement - ansSteps of Rapid
Sequence Intubation
1. Preparation and Triage
2. Primary Survery (ABCDE) with resuscitation adjuncts (F,G)
3. Reevaluation (consideration of transfer)
4. Secondary Survey (HI) with reevaluation adjuncts
5. Reevaluation and post resuscitation care
6. Definitive care of transfer to an appropriate trauma nurse - ansInitial Assessment
1. Suction the airway
2, Use care to avoid stimulating the gag reflex
3. If the airway is obstructed by blood or vomitus secretions, use a rigid suction device
If foreign body is noted, remove it carefully with forceps or another appropriate method -
ansIf Airway is not patent
1. The tongue obstructing the airway
2. loose or missing teeth
.. activation: .... are found in the carotid sinus and along the aortic arch, are sensitive to
the degree of stretch in the arterial wall. When the receptors sense a decrease in
stretch, they stimulate the sympathetic nervous system to release Epi, norepi, causing
stimulation of cardiac activity and constriction of blood vessels, which causes a rise in
heart rate and diastolic blood pressure - ansBaroreceptors:
1. A- airway and Alertness with simultaneous cervical spinal stabilization
2. B- breathing and Ventilation
3. circulation and control of hemorrhage
4. D - disability (neurologic status)
5. F - full set of vitals and Family presence
6. G - Get resuscitation adjuncts
L- Lab results (arterial gases, blood type and crossmatch)
M- monitor for continuous cardiac rhythm and rate assessment
N- naso or orogastric tube consideration
O- oxygenation and ventilation analysis: Pulse oxygemetry and end-tidal caron dioxide
(ETC02) monitoring and capnopgraphy
H- History and head to toe assessment
I- Inspect posterior surfaces - ansABCDEFGHI
1. Apnea
2. GCS 8 or less
3. Maxillary fractures
4. Evidence of inhalation injury (facial burns)
5. Laryngeal or tracheal injury or neck hematoma
6. High risk of aspiration and patients inability to protect the airway
7. Compromised or ineffective ventilation - ansFollowing conditions might require a
definitive airway
1. bony fractures and possible rib fractures, which may impact ventilation
2. palpate for crepitus
3. subcutaneous emphysema which may be a sign for a pneumothorax
4. soft tissue injury - ansPalpate the chest for
1. Check the presence of adequate rise and fall of the chest with assisted ventilation
2. Absence of gurgling on auscultation over the epigastrium
3. Bilateral breath sounds present on auscultation
4. Presence of carbon dioxide (CO2) verified by a CO2 device or monitor - ansIf the pt
has a definitive airway in what should you do?
1. Dyspnea
2. Tachycardia
3. Decreased or absent breath sounds on the injured side
4. CP - ansSimple Pneumo assessment:
, 1. equal breath sounds bilaterally at the second intercostal space midclavicular line and
the bases for fifth intercostal space at the axillary line - ansAuscultate the chest for:
1. Get a CT
2. Consider ABG 's if decreased LOC
3. Consider glucose check - ansD Interventions
1. Hypotension
2. JVD
3. Muffled heart sounds - ansBecks Triad:
1. open the airway, use jaw thrust
2. insert an oral airway
3. assist ventilations with a bag mask
4. prepare for definitive airway - ansIf breathing is absent..
1. pain - hallmark sign, early sign
2. pressure - early sign
3. pallor, pules, paresthesia, paralysis - late sign - ansSix P's of compartment
syndrome:
1. Preparation
2. Preoxygenation
3. Pretreatment
4. Paralysis and Induction
5. Protecting and positioning - v
6. Placement of proof - secure the tube
7. Post intubation - secure ETT Tube, get X-ray for placement - ansSteps of Rapid
Sequence Intubation
1. Preparation and Triage
2. Primary Survery (ABCDE) with resuscitation adjuncts (F,G)
3. Reevaluation (consideration of transfer)
4. Secondary Survey (HI) with reevaluation adjuncts
5. Reevaluation and post resuscitation care
6. Definitive care of transfer to an appropriate trauma nurse - ansInitial Assessment
1. Suction the airway
2, Use care to avoid stimulating the gag reflex
3. If the airway is obstructed by blood or vomitus secretions, use a rigid suction device
If foreign body is noted, remove it carefully with forceps or another appropriate method -
ansIf Airway is not patent
1. The tongue obstructing the airway
2. loose or missing teeth
