basic rapid trauma assessment

Alton Police Department Tactical Response Team

Basic Trauma

Alton Police Department Tactical Response Team

Presented By

Alton Police Department Tactical Response Team

Basic Trauma• During a tactical operation, or even training, the

risk of injury is high. Rapid Assessment can be used by team members to recognize life threatening injuries based on CPR and First Responder training.

• This process is an easy to follow outline used to evaluate the officers condition and provide basic medical care, if the team medic not immediately present, prior to transfer to EMS.

• The objective is to enhance survivability.

Alton Police Department Tactical Response Team

Basic Trauma

• Trauma, what is it?– A serious injury or shock to the body by

violence or accident.– The leading cause of death in 1-44 year age

group.– The 3rd leading cause of death in all age groups.– 60 million injuries each year in the U.S. alone.

• Remember, Only Surgeons Fix Trauma!

Alton Police Department Tactical Response Team

Basic Trauma The “Golden Hour”

Immediate(50%) minutesto one hour

Early (30%)First 4 hrs

Late (20%) 2 to5 weeks

Alton Police Department Tactical Response Team

Vest Medical Pouch• Every officer the same contents, same placement.• When treating use theirs, not yours.• Contents:

– (1) Pair Latex or vinyl gloves.– (1) Blood Stopper Dressing. – (2) Rolls of Kerlix gauze– (1) 3”x9” Petroleum gauze dressing– (1) Triangular bandage– (1) Double roll Flexwrap– (1) CPR Shield– (1) Trauma Scissors

Alton Police Department Tactical Response Team

Officer Medical Information Form

Officer Medical History

Name DSN DOB SSN Blood TypeJones, James A. 9003 1/21/1967 000-00-0000 AB-

Drug/Food Allergies Medical History Sulfa Drugs Triple By-pass

Medications Physician Additional InformationNitro-as needed Smith Has Narcolepsy

Alton Police Department Tactical Response Team

Rapid Assessment

• First course of action is to eliminate the threat and/or move downed officer to safety/cover.– Only move in necessary for safety.– Always suspect spinal injuries.

• Maintain as much in-line spinal immobilization as possible during movement.

• If threat is still present need cover officer while conducting assessment.

Alton Police Department Tactical Response Team

Rapid Assessment

• Cervical spine immobilization?• Determine Level of Consciousness (LOC).

– Is he alert? Can he speak? Does he make sense?

• Assess his airway.– If he can speak, he can breathe.– If unconscious, open the airway.

• Head tilt, chin lift• Modified jaw thrust

– Is he having difficulty breathing? What is the rate per minute?

– Normal adult 12-20 breathes per min.– <8 or >24 indicates problem, <8 assist.

Alton Police Department Tactical Response Team

Rapid Assessment

• Evaluate pulse.– What is rate and quality.

• Normal adult 80-100 bpm.• Radial pulse (wrist/thumb side).• Carotid pulse (neck).• No pulse begin CPR.

– Use AED if available.

– AED & Trauma.

Alton Police Department Tactical Response Team

Rapid Assessment

• Look head to toe for bleeding that will compromise the circulation system.– “KILLER BLEEDS”

• Large arterial or venous bleeding that could interrupt circulatory system.

• 1L is serious

• About 60-90 seconds to this point.

Alton Police Department Tactical Response Team

First Aid

• Stop the bleeding – Determine origin of injury.– Expose the injury.

• Remove and/or cut away clothing and equipment.

– Determine severity-entrance and exit wounds?– Apply concentrated or diffused pressure w/dressing.

• Cover largest/biggest bleeder 1st.

• Head trauma with possible fractures.– Cover lightly with no pressure.– Includes bleeding and fluid from ears and nose.

Alton Police Department Tactical Response Team

First Aid• Nose bleeds (no trauma)

– Ensure airway.• Lean forward to avoid swallowing blood.• Pinch fleshy portion.

– If trauma, immobilize and prepare for nausea/vomiting.

• GSW – Check for exit wound, if large may need to pack

w/gauze.– If chest wound, cover with occlusive dressing and tape

on three sides.• Lay on wounded side.• May need to “vent” dressing.

Alton Police Department Tactical Response Team

First Aid• Impaled objects

– DO NOT REMOVE!– Stabilize, dress and bandage.

• Evisceration– Abdominal injury with internal organs protruding.– Cover with sterile wet dressing to keep moist.– Do not attempt to push back in.– No Food or Drink.– Prepare for vomiting.

Alton Police Department Tactical Response Team

First Aid• Blunt Trauma to Chest

– Look for deformity/bruising– If one portion moves independently (flail chest), pad

and secure w/gauze.– Place on affected side

• Amputation– Bag and keep cool.– No direct contact with water or ice.– Do not remove partial amputation.

• Large open neck injury– Cover with occlusive dressing

Alton Police Department Tactical Response Team

First Aid

• Burns– If head or face, think airway!– Stop the burning. Nothing but water!– Remove smoldering clothing and jewelry.

• DO NOT REMOVE CLOTHING IF STUCK!

– Cover with dry sterile dressing.– Prepare for hypothermia.

Alton Police Department Tactical Response Team

Communicate• Extract the injured to or establish a safe

zone where EMS can initiate additional emergency care and prepare for transport.– Remember spinal immobilization!

• Use radio to communicate with medical support elements.– EMS– FD

Alton Police Department Tactical Response Team

Head to Toe

• Secondary survey– While waiting for support/transport (EMS, FD) conduct

secondary survey.– Re-evaluate ABC’s.– Re-evaluate for additional injuries.

– Re-evaluate treatment already done.

• Give a brief history of injuries and what you’ve done when passing patient to higher level of medical treatment (”K.I.S.S.” is the rule here).

Alton Police Department Tactical Response Team

Basic Trauma

• QUESTIONS?• EXAM• PRACTICAL

EXERCISES