- 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
Signs and Symptoms:
- Pain, swelling
- Deformity, lesions, bleeding
- Altered mental status or
- Hypotension or shock
Differential (Life threatening):
- Tension pneumothorax
- Flail chest
- Pericardial tamponade
- Open chest wound
- Intra-abdominal bleeding
- Pelvis / Femur fracture
- Spine fracture / Cord injury
- Head injury (see Head Trauma)
- Extremity fracture / Dislocation
- HEENT (Airway obstruction)
- 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.