Indications:
- Burns caused by electrical, thermal, or chemical injury.
- Signs: Reddening of the skin, intense pain, blisters, mottled appearance, or charred black/brown areas with severe or no pain.
BLS Care:
- Scene Safety: Extricate patient from burning vehicles/buildings when safe.
- Stop the Burning Process: Remove wet clothing, dry the patient, avoid ice packs.
- Oxygen Administration: Provide high-concentration oxygen.
- Treat Trauma: Address associated trauma.
- Burn Wound Care: Cover wounds with a clean sheet or Mylar® blanket, remove rings/jewelry.
- Chemical Burns: Brush off dry chemicals, flush with water.
- Fluid Administration: For long transports, consult for fluid recommendations.
- Destination Determination: Transport to burn centers for severe burns, trauma centers for combined injuries.
Quiz:
Which of the following should NOT be done for burn patients?
What percentage of body surface area (BSA) is represented by the patient’s hand?
Where should pediatric patients with burns be transported?
Which burn type is included in the BSA assessment?
Indications:
- Traumatic injury to the eye, including bleeding, foreign objects, or impaled objects.
BLS Care:
- Foreign Objects (Not Embedded): Flush with water or saline from the nose outward.
- Injury to the Orbits: Stabilize the head if needed, and apply Spinal Motion Restriction if indicated.
- Lacerations/Injuries: Shield the affected eye, dress the other eye to reduce movement.
- Impaled Objects: Stabilize the object, shield the affected eye, and dress the other eye.
Quiz:
What is the proper treatment for a foreign object NOT embedded in the eye?
Which of the following should NEVER be done for eye trauma?
Why is it important to elevate the head of a patient with an eye injury?
Indications:
- Traumatic injury to the eye, including bleeding, foreign objects, or impaled objects.
BLS Care:
- Foreign Objects (Not Embedded): Flush with water or saline from the nose outward.
- Injury to the Orbits: Stabilize the head if needed, and apply Spinal Motion Restriction if indicated.
- Lacerations/Injuries: Shield the affected eye, dress the other eye to reduce movement.
- Impaled Objects: Stabilize the object, shield the affected eye, and dress the other eye.
Quiz:
What is the proper treatment for a foreign object NOT embedded in the eye?
Which of the following should NEVER be done for eye trauma?
Why is it important to elevate the head of a patient with an eye injury?
Indications:
- Upper extremity injuries, including degloving, crush injuries, or suspected compartment syndrome.
- Lower extremity injuries, including amputations or significant vascular/nerve injuries.
BLS Care:
- Control Bleeding:
- Apply direct pressure.
- Use a tourniquet for uncontrolled bleeding or hypovolemic shock.
- Consider wound packing or hemostatic gauze if needed.
- Splinting:
- Splint fractures or dislocations.
- Apply gentle traction before splinting if perfusion or neurological function is compromised.
- Care for Amputated Parts:
- Place the amputated part in a sealed plastic bag (keep dry).
- Cool using ice packs (do not freeze or submerge).
Quiz:
Which of the following is a criterion for transporting an adult with a hand injury to the Curtis National Hand Center?
What is the first action for controlling bleeding in extremity trauma?
How should an amputated extremity be cared for?
Pediatric patients with lower extremity injuries should be transported to:
Indications:
- Multiple or severe traumatic injuries in patients aged 15 or older.
- Signs include suspected internal bleeding, fractures, lacerations, or shock.
BLS Care:
- Airway Management:
- Apply Spinal Motion Restriction for blunt trauma.
- Insert an NPA or OPA if needed.
- Breathing and Ventilation:
- Provide oxygen to maintain SpO₂ ≥ 94%.
- Seal open chest wounds with vented chest seals.
- Circulation and Hemorrhage Control:
- Apply direct pressure to bleeding wounds.
- Use tourniquets or hemostatic dressings for life-threatening bleeding.
- Transport Decisions:
- Transport to the nearest trauma center if criteria are met.
- Provide left lateral uterine displacement for pregnant patients >20 weeks with hypotension.
Quiz:
When should spinal motion restriction be applied in adult trauma patients?
Which of the following is the appropriate oxygen saturation goal for trauma patients?
What is the preferred method to seal open chest wounds?
Pregnant trauma patients with hypotension should receive:
Indications:
- Physical signs such as abrasions, contusions, bleeding, or petechiae.
- Signs of forcible restraint or strangulation.
- Vaginal or rectal bleeding or pain.
- Patients may also present without visible trauma.
BLS Care:
- Scene Care:
- Preserve the crime scene and clothing articles, if practical.
- Discourage patient self-treatment (e.g., showering, changing clothes).
- Injury Treatment:
- Dress wounds but do not attempt to clean them.
- Do not perform genital or rectal examinations unless required to stabilize the patient.
- Transport Decisions:
- Patients under 13 years: Transport to an MCASA-recognized pediatric facility for a SAFE exam.
- Patients ≥13 years: Transport to an MCASA-recognized facility for a SAFE exam.
Quiz:
What should you do with clothing articles of a sexual assault patient?
What is the recommended transport facility for a 12-year-old sexual assault patient?
Which of the following is NOT recommended for sexual assault patients?
EMS clinicians are legally required to report abuse of:
Indications:
- Blunt trauma with a high-energy mechanism and at least one of the following:
- Midline spinal pain, tenderness, or deformity.
- Signs of new paraplegia or quadriplegia.
- Focal neurological deficit.
- Altered mental status or disorientation.
- Distracting injury (e.g., fractures or significant discomfort).
BLS Care:
- Manual Stabilization:
- Initiate in-line cervical spine stabilization.
- Cervical Collar:
- Apply a correctly sized cervical collar to the patient.
- Full Immobilization:
- Immobilize patients with neurological deficits or GCS <15.
- Positioning:
- Ambulatory patients may lie supine with minimal movement.
- Elevate the head to 30° if there are no contraindications.
Quiz:
Which condition requires full immobilization with a cervical collar and backboard?
What is the correct position for those who are ambulatory and stable?
Backboards should primarily be used for:
When should a patient be transported to a trauma center per Maryland Trauma Decision Tree?
Indications:
- Cardiac arrest with suspected traumatic etiology in patients aged 15 years or older.
BLS Care:
- Scene Safety:
- Extricate the patient if unsafe; otherwise, initiate care on-scene.
- Resuscitation:
- Perform CPR with high-quality compressions.
- Apply an AED.
- Treat Reversible Causes:
- Open the airway and ventilate.
- Seal open chest wounds with vented chest seals.
- Control life-threatening bleeding.
Quiz:
For blunt trauma patients in cardiac arrest, when should interventions occur?
How should life-threatening external hemorrhage be managed in trauma arrest patients?
Indications:
- Cardiac arrest with suspected traumatic etiology in patients under 15 years of age.
BLS Care:
- Scene Safety:
- Extricate the patient if unsafe; otherwise, initiate care on-scene.
- Resuscitation:
- Perform CPR with high-quality compressions.
- Apply an AED.
- Treat Reversible Causes:
- Open the airway and ventilate.
- Seal open chest wounds with vented chest seals.
- Control life-threatening bleeding.
Quiz:
Which is the proper course of action for a pediatric patient in cardiac arrest with suspected trauma?
What is the initial fluid bolus amount for pediatric patients with hypoperfusion?
Where should a pediatric patient with penetrating trauma and no signs of asystole be transported if they are more than 15 minutes away from a Pediatric Trauma Center?
What should be done for a pediatric blunt trauma patient in cardiac arrest on-scene?