Multi Trauma Adult




  • Time and mechanism of injury
  • Damage to structure or vehicle
  • Location in structure or vehicles
  • Others injured or dead
  • Speed and details of MVC
  • Restraints / protective equipment
  • Past medical history
  • Medications


Signs and Symptoms:


  • Pain, swelling
  • Deformity, lesions, bleeding
  • Altered mental status or
  • unconscious
  • Hypotension or shock
  • Arrest


Differential (Life threatening):


  • Chest
  • Tension pneumothorax
  • Flail chest
  • Pericardial tamponade
  • Open chest wound
  • Hemothorax
  • Intra-abdominal bleeding
  • Pelvis / Femur fracture
  • Spine fracture / Cord injury
  • Head injury (see Head Trauma)
  • Extremity fracture / Dislocation
  • HEENT (Airway obstruction)
  • Hypothermia







  • Recommended Exam: Mental Status, Skin, HEENT, Heart, Lung, Abdomen, Extremities, Back, Neuro
  • Items in Red Text are key performance measures used in the EMS Acute Trauma Care Toolkit
  • Transport Destination is chosen based on the EMS System Trauma Plan with EMS pre-arrival notification.
  • Geriatric patients should be evaluated with a high index of suspicion. Often occult injuries are more difficult to recognize and patients can decompensate unexpectedly with little warning.
  • Mechanism is the most reliable indicator of serious injury.
  • In prolonged extrications or serious trauma, consider air transportation for transport times and the ability to give blood.
  • Do not overlook the possibility of associated domestic violence or abuse.
  • Scene times should not be delayed for procedures. These should be performed en route when possible. Rapid transport of the unstable trauma patient is the goal.
  • Bag valve mask is an acceptable method of managing the airway if pulse oximetry can be maintained above 90%.
  • If a femur fracture is suspected and there is no evidence of pelvic fracture or instability, follow traction splint protocol.