TRAUMATIC
EMERGENCIES Trauma can be defined as an injury or wound to the body caused by an external force. We usually think of trauma from crashes, falls or violence. Trauma can occur from environmental factors such as bites, stings or prolonged exposure to the elements as well.
Trauma can be the most shocking and emotionally charged of all first aid emergencies. Important things to remember when treating any trauma are your personal safety, scene management, identifying the mechanism of injury and preventing further injury to yourself and others around you.
A concept in the care of trauma was introduced decades ago. It gives seriously injured patients the best chance of survival. It is called “The Golden Hour.” It is the one hour in which the lives of a majority of critically injured trauma patients can be saved if definitive intervention is provided. That gives only 60 minutes from the moment of injury to begin immediate patient care, transport the patient to a hospital, summon the appropriate surgical and support staff and perform the necessary life-saving treatment. It takes a well- coordinated effort to accomplish this on the ground. Imagine how finely tuned your crew will need to be to accomplish this quality of care in the air.
Treating trauma takes an active commitment on the part of the rescuer as well. Things you will see and experience are less than pleasant. Keep in mind the real reason you are helping. Observe the scene for any potential dangers. Look for things such as leaking fuel, downed power lines, fire or a person brandishing a weapon. Remember, your personal safety is the number one priority.
Another important part of trauma care is reassuring the patient and other passengers. Stay calm and speak without yelling. When possible, identify tasks for ABPs to help with. Specific commands are more effective than general directions.
TRAUMA CARE
PRIORITIES Your initial priorities when caring for the trauma patient are nearly the same as with any other patient. Always begin with your assessment of the CABDs, which means CIRCULATION/COMPRESSIONS, AIRWAY, BREATHING and DISABILITY. The initial assessment
is a quick and orderly check for life-threatening emergencies.
Along with airway and breathing problems, the trauma patient may be at risk for life-threatening bleeding and a spinal injury. Keeping this in mind, the initial assessment of the injured patient is as follows:
Determine responsiveness Assess breathing Check for major bleeding
If the patient is not breathing or only gasping:
C | Chest compressions - 30 A | Airway - Open the airway B | Breathing - Give 2 breaths D | Disability - Assess for spinal injury
Always notify the PIC when any cabin trauma has occurred. When possible, have another crewmember contact Aircare Access so you can focus on the patient.
ARTERIAL BLEEDING
Bleeding is a common problem encountered during trauma. External bleeding is visible outside the body and identified by the type of blood vessel injured. Arterial bleeding is bright red in color and spurts out of the wound every time the heart beats. Because of the pressure of the heartbeat, arterial bleeding is almost always serious and must be treated immediately.
VENOUS BLEEDING
Venous bleeding is usually darker in color than arterial and appears as a slow, continuous flow. Venous bleeding is usually less serious than arterial bleeding, but must be treated nonetheless.
CAPILLARY BLEEDING
Capillary bleeding is the least serious type of bleeding. This is usually more of a nuisance than a life threat. Capillary bleeding is generally present with minor skin wounds and often requires no treatment, as the body stops the bleeding in just a few minutes.
The body’s normal response to any type of bleeding is to make the injured blood vessel constrict. This blood vessel constriction causes clotting, which helps minimize bleeding. However, large or more serious injuries may not be able to clot. The body has a difficult time clotting an arterial bleed.
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