DEFINING TRAUMA CARE

How do you treat trauma?

When someone is involved in a traumatic event, whether car accident, burns, fall, impaled object, or cardiac event and more, the standard of care will depend on the severity of the injury or injuries.

Sometimes trauma may occur in a rural area or one where a higher skill level is not readily available. For this reason, services such as a helicopter service may be necessary to transfer the patient to a higher level of care.

Learn more about: Spinal injury

How are the four levels of trauma categorized?

Level I: Offers 24-hour services of highly skilled staff, resident doctor on call, and can absorb trauma patients around the clock. They also include research and education programs.

Level II: Trauma center usually works in conjunction with a Level I trauma center and has 24-hour services. However, this level is not required to have a resident on call or a research program.

Level III: Does not have 24-hour service but has an intensive care and a surgical suite. Patients requiring a higher level of care would have to be transported to Level I or Level II.

Level IV: Works to stabilize injured patients who are far away and there are no other services.

 

Scenario: Trauma patient was air lifted to Level I trauma center. Special trained staff assisted in the effort.

TRAUMA CARE

     Updated 6/24                                         Trauma care

Scenario: The patient in the image above, has fallen from a roof top while at work.

He lives in a rural area, where there is no Trauma 1 care available. He will be airlifted 

to a Level 1 facility.

Trained medical staff is using Resuscitative efforts to transport him.

Scenario: Nick is a 21 year old male who was
on his way to work, when he became involved
in a head on collision.

Nick is transferred to a Level 1 Trauma center by
paramedics.
Please click on the link below for the continuation
of this case study:
Nick is in the ICU

Scenario: Mark sustained a traumatic brain injury while surfing.
He had an EVD ( external ventricular device) inserted and ICP
monitoring ordered by the doctor.

Learn more about : Care planning

TRAUMA CARE FOR NURSES - Clinical Setting

Hi guys,

Typically, the holiday season brings with it, an increase in traumatic events.

To learn more about the care of the trauma patient in the clinical setting, simply click on the link:http://www.dearnurses.com/

The topics listed in the picture above, have been prepared for you:
Traumatic Brain Injury
Understanding chest, abdominal and spinal trauma
Trauma - complications and rehabilitation

Also enjoy watching the Clinical videos. Sessions 7, 8, 9, 10

Have a good week!

UPDATED 11/23

Dearnurses.com is no longer available. Please click on the link:

ICP Monitoring

TRAUMA - EYE INJURIES

A traumatic event may occur at any time. More than one part of the body may be affected.

To learn more about trama, simply click on the link: http://www.dearnurses.com/

and enjoy the TRAUMA CARE TOPICS , or click on:

http://www.dearnurses.net/the_clinical_setting_step_by_step

and enjoy the different TRAUMA topics throughout the chapters.

TRAUMA AFTERMATH (COMPLICATIONS AND REHABILITATION)

The aftermath of trauma may be very unsettling. The complications and the rehabilitation process may be long and take its toll on patient and family. To learn more about this topic, simply click on the link:

TRAUMA CARE- THE AFTERMATH (COMPLICATIONS AND REHABILITATION) and

enjoy reading.

Also enjoy watching the Clinical videos. Sessions 7, 8, 9, 10

CAN TRAUMA HAPPEN INSIDE A TRAUMA

Updated 5/24

Dear nurses,

Dear nurses.com is no longer available. New links have
been added, to make learning easy.

When a trauma patient arrives in the Emergency Room,

it takes "all hands on deck" to help with this situation.

It is not uncommon for medical staff members to be

called from other areas of the hospital to assist.

It is important to take great care while rushing to the

trauma, otherwise another trauma may happen.

Learn more: Spinal injury 

UNDERSTANDING TRAUMA OF THE CHEST, ABDOMEN AND SPINE

The holiday season may bring with it an increase in Traumatic events

(Sessions 7, 8 and 9).

To learn more, simply click on the link:

Trauma Care- Understanding Chest, Abdominal and Spinal Trauma

and enjoy learning.

You may also enjoy watching these Clinical Nursing Videos called SESSIONS, in

particular Sessions 8

TRAUMA SCENE

 Dear nurses, 

Hope you had a good week. Here is some helpful
information on trauma.

When a trauma happens it takes all hands on deck to
stabilize and transfer a patient to a trauma center.
Trauma centers may range from Level 1- 4 and the
type of care which is available will be determined
by which level the patient is transported to.
Learn more:
Nick in the ICU

Have a good weekend.
 

THE EMERGENCY ROOM

Clinical scenarios

Above are clinical scenarios that each tell their own story.
Just click on the link above for more helpful information.

Updated 1/25

                                                           Eye injury

An eye injury may occur at anytime and anywhere,
sometimes in the workplace. It is important to recognize
that quick intervention is of paramount importance.

Helpful hints:

Always lift try to lift large objects away from the eyes.
If something splashes in the eye, washing it out of the eye and
seeking medical treatment may be necessary.

Hyphema - Blood in the anterior chamber of the eye caused by
blunt trauma.(See image).

                                                             

                                                                    Spinal injury

Scenario: Jim had a few extra drinks to celebrate his birthday.
He dives into the shallow end of the pool. Unfortunately, he will
have to be taken to the Emergency Room for further treatment.

                                Emergency Room vs. Urgent Care

Recently there have been changes in the way emergencies
are handled. Some situations are minor and do not need
        a high level of care. Triage is very important in distinguishing
how to filter patients to the right facility.

Minor cuts, bruises, infection and less severe pain may be treated in 

an Urgent Care. More severe conditions like burns, head and spinal 
trauma, stroke symptoms and a cardiac event may require a higher
level of care like an Emergency Room.

EXCERPTS TAKEN FROM A MINI CASE STUDY OF TRAUMA/SEPSIS

 Dear nurses,

Hope your week is going well. I would like to
share with you excerpts from a mini case study
on trauma /sepsis. 

The goal is to give some insight into nursing
care in the ICU.

Scenario: Nick is a 21 year old male who was
on his way to work, when he became involved
in a head on collision.

 He is now being resuscitated at the trauma scene.
WHAT NEXT?

Nick is transferred to a Level 1 Trauma center by
paramedics.
Please click on the link below for the continuation
of this case study:
Nick is in the ICU

HYPOTHERMIA IN THE PACU PATIENT

                           

                                             

 In the image above, a patient has just arrived
 in the PACU. The core temperature is 95
 degrees Fahrenheit. Warm blankets or a Bair
 Hugger may be used.

Defining Hypothermia
Hypothermia is defined as a drop in core temperature
of less than 95 Fahrenheit(35 Celsius). Regardless of
the cause, it is considered to be life - threatening. 

Hypothermia increases the body's demand for oxygen. 
If left untreated, it may lead to a myocardial infarction

 (heart attack). 

Trauma Care - Part 1 is no longer available
                             

Trauma resulting in excessive blood loss,

     as well as alcohol ingestion, may also         
lead to hypothermia.Symptoms include:
shivering, blue lips, decrease in level

of consciousness and cold extremities. IV
fluids may have to be warmed. 

                                           

WHAT HAPPENS WHEN THERE IS A SPINAL INJURY

    Scenario

   Three friends are out hiking on a nature trail.Sad to say, one
    sustains a fall and subsequently injury to the spine. As they
    work to provide a safe place to rest and comfort their friend,
    they are also trying to figure out, how to get him to the hospital.

When someone is involved in a traumatic event,
whether a  car accident , burns,fall, impaled object,
or cardiac event and more, the standard of care will 
depend on the severity of the injury or injuries.

Sometimes trauma may occur in a rural area or one 
where a higher skill level is not readily available.
For this reason, services such as a helicopter may
be necessary to transfer the patient to a higher level of care.

Learn more about : Dermatomes and  Quiz question

Learn more about : Spinal cord injury

              

BLUNT TRAUMA AND BRAIN HERNIATION

Whether you work in the ER or not, you make be faced with a situation such as blunt trauma. If the patient in your care had a blow to the head, would you know what to look for? If not well managed, such a patient may be at risk for brain herniation.
To understand more, simply click on the link:

THE CLINICAL SETTING STEP BY STEP, chapter4. or

Traumatic_brain_injury or

http://www.dearnurses.com/clinical_nursing_videos_called_sessions (Sessions 7)

UNDERSTANDING THE TRAUMA SCENE

Learn more, by clicking on the link below (SESSIONS 7):

Updated 8 /25

Dear nurses,

Have you ever wondered what happens at the trauma scene?

Have you ever taken care of a patient with a head injury or

Basal Skull Fracture?

Enjoy Learning!

THE SURGICAL PATIENT

Updated 7/25

PACU ( Post Anesthesia Care Unit)

Following surgical intervention, a patient is transferred
to an area known as PACU. . Upon arrival, a nurse will
 reorient the patient to his surroundings and do an
 assessment. 

The nurse will also follow MD orders regarding: 

- monitoring vital signs and oxygen saturation,

- administer pain medication, replace IV fluids,

- check dressings at surgical sites for bleeding 

- check drainage tubes and carry out any other

  instructions.

Paralytic ileus is a postoperative complication.
It may occur in any post surgical patient. It is
caused by anesthetics.

Absent bowel sounds, abdominal pain and distention
are signs of an ileus. It is important to check for bowel
sounds in the postoperative period.

Documentation is also important. If there are no bowel
sounds, MD should be notified for further orders.The
doctor orders tests such as X-Ray and CT scan  to confirm
diagnosis. Insertion of a nasogastric tube is also ordered by MD .

DKA may lead to dehydration. Learn more : DKA

The trauma patient is at risk for dehydration.
Learn more :Trauma

ABRUPTIO PLACENTA

Updated 3/25

The image above shows, Mrs.S who is about six months pregnant.
She is relaxing at home. Suddenly, she starts to have abdominal 

and back pain. She is also beginning to experience bleeding.

The placenta is a very vascular organ that develops in the

 uterus of a woman during pregnancy. It is attached to the 

fetus by the umbilical cord and provides nourishment and
oxygen to the growing fetus.

When the placenta suddenly becomes detached from the uterus,
either by trauma , or unknown cause, it is called placenta abruptio.
Heavy vaginal bleeding , abdominal cramping and signs and
symptoms of shock may be present.

Abruptio placenta requires emergency care. Placental separation 
occurs. C-section is usually done.

The care plan for each patient , is a reflection of the

information provided about the history and MD's 

diagnosis.

For more updated topics, please click on the links below:

IV assessment and quiz

Hyperemesis Gravidarum

Blood transfusion

POST ANESTHESIA CARE / HYPOTHERMIA

WHAT IS HYPOTHERMIA?

     Hypothermia is defined as a drop in core temperature
     of less than 95 Fahrenheit (35 Celsius).Regardless of
     the cause, it is considered to be life-threatening. The
     postoperative patient is at risk for hypothermia. Fluid
     loss and exposure in the surgical suite, may predispose
      to hypothermia.

     Hypothermia increases the body's demand for oxygen
     and if left untreated can lead to a myocardial infarction
      (heart attack). Trauma resulting in excessive blood loss, 
      as well as alcohol ingestion, may also lead to hypothermia.

What are some of the signs and symptoms of hypothermia?
Symptoms include: Shivering, blue lips, decrease in level 

of consciousness and cold extremities.

Homeless people may become hypothermic,
 due to prolonged exposure to cold weather.
Alcohol ingestion may lead to hypothermia.
 This is caused by vasodilation and significant
heat loss.

Learn more about: The Operating Room

CRANIAL NERVE ASSESSMENT

Dear nurses,

Updated 4/24

Updated information can be accessed 
by clicking on the links below.

Many nurses at one time or another will be faced with the challenge of taking care of a patient who has had brain surgery or brain injury due to trauma or tumors etc. The goal is to simplify the functions of the CRANIAL NERVES so ASSESSMENT CAN BE MADE EASY. So, follow along and make assessment in the clinical setting easy!

Updated 6/23

Click on the link for updated info:

The human brain and quiz

Cranial nerves

HYDROCHLORIC ACID IN DIGESTION

Every nurse at some time or another is put in the position of taking care of a patient with an order for NPO or NG tube insertion. When ordered by the doctor, the stomach is kept empty

for example before surgical procedures or after trauma.

If a Nasogastic tube is inserted, instructions are usually given by the MD to put NG to suction to remove excess gastric contents. There are cases when suction is not ordered. Hydrochloric acid is present in gastric contents. Above is an overview.

Enjoy reading more about the Clinical Setting.

and watch  SESSIONS 14   - ENTERAL AND PARENTERAL FEEDING

IDENTIFYING RESPIRATORY DISTRESS

Updated 7/25

The heart and lungs depend on each other and have
to work together. The heart depends on the lungs
 for oxygen rich blood, and the lungs depend on
the heart to pump blood around the body. 

If the left side of the heart fails, blood will backup
 into the lungs, causing difficulty breathing.

Causes of respiratory distress include :
- Pneumonia, COPD, ARDS, trauma,
- Congestive heart failure, 
- Myocardial Infarction, and more.

Regardless of the cause, poor oxygenation to the lungs
results in anxiety. Breathing is compromised, and intubation,
mechanical ventilation, or/and a higher level of care may be 
needed to improve oxygenation to the lungs and body tissues,
during this crucial period.

Enjoy watching the videos:

Sessions 44- The patient on mechanical ventilation

Nursing Fundamentals

Learn more about: Heart facts and the EKG