kinetic energy
the energy an object has due to its motion
principle
a fundamental scientific or evidence based tent for pt improvement or
... [Show More] survival
preference
how the specific prehospital care provider achieves the principle
preference used to accomplish depends on several factors
situation that exists
condition of the pt
fund of knowledge, skills, and experience of the prehospital care provider
local protocols
equipment available
situation involves all of the factors
hazards on scene
number of pt involved
location of the pt
postion og the vechile
contamination or hazardous materials concerns
potential for fire
weather
scene control and security by law enforcement
time and distance to hospital
number of providers
bystanders
transportation on scene
May change overtime on scene
condition of the pt
major question that will affect decision making is "how sick the pt is?"
factors that will facilitate this
age of the pt, physiologic factors that affect end organ perfusion (blood pressure, PULSE, VENTILATORY RATE, SKIN, TEMP), causes of trauma, the pt medical condition prior to the event, medication, alcohol and drug use
fund of the knowledge of the prehospital care provider
comes from several sources including initial training, cme course, local protocols, overall experience, and skill
comfort level of performing a skill depends on the frequency which it has been performed
local protocols
define what a phtls provider is credentialed to do in the field, they are intended to guide the approach to pt in a way that is systematic and consistent with the best practice levels
equipment available
experience of prehospital care provider does not matter if he or she dose not have the right equipment q
components critical thinking in emergency medical care
1.asses the situation
2.asses the pt
3.asses the available resources
4.analyze the possible solutions
5. select the best answer to manage the situation and pt
6.develop the plan of action
7. initiate the plan action
8.ressess the response of the pt to the plan of action
9. make any needed adjustments or changes to plan of action
10. continue with steps 8 and 9 until this phase of care is completed
steps in critical thinking assessment
analysis
construction of a plan
action
reassessment
changes along the way
using critical thinking to control biases
1) Assume the worst case scenario until proven other wise
2)uphold the Hippocratic oath "primum non nocere" or first do no harm
Ethics principles
...
ethics
is using a set of moral principles to assist in determining what the right thing to do
ethical decision making includes
autonomy nonmaleficence, beneficence, and justice
autonomy is greek word for
"self rule", In medicine it refer to the pt right to direct his or or her own health care free from interference or under influence
The management of posthospital trauma must reflect
1. gain access to the pt
2.identify and treat life threating inquires
3.package and transport the pt to the closest appropriate facility in the least amount of time
compensated shock
agitation, anxiety, restlessness, weak rapid thready pulse, clammy cool skin, pallor, shallow breathing, thirst
uncompensated shock
A stage of shock that occurs when the body is no longer able to maintain systemic blood pressure
hypovolemic shock
Acute blood loss from hemorrhage, or fluid volume
hypovolemic shock causes
Hemorrhage, Vomiting and Diarrhea, Dehydration, Third-space loss, Burns, heat emergences
hypovolemic shock s/s
tachycardia, silent tachypnea, sunk frontals, sunken eyes, hypotension, pale, cool, clammy skin
Hypovolemic shock tx
fluid replacement, 02, warm, stop bleeding
cardiogenic shock
failure for the heart to pump
cardiogenic shock causes
CHF, MI, dysrthisma, valvular disease
cardiogenic shock s/s
Tachycardia
Hypotension
Tachypnea
Oliguria
cool, pale skin
low CO, PAP/PAWP, SVO2
Increase in Vasc resistance
cardiogenic shock tx
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Distributive neurogenic shock
high mechanism of trauma
neurogenic shock
Circulatory failure caused by paralysis of the nerves that control the size of the blood vessels, leading to widespread dilation; seen in patients with spinal cord injuries.
T-7
neurogenic shock s/s
pale skin above the injurie and pink warm and dry below the site, hypotension, bradycardia
neurogenic shock tx
spinal immobilization [Show Less]