Trauma: Free Case Study Samples and Examples


trauma case study

A Trauma-Focused Cognitive Behavioral Therapy Case Conceptualization: From Assessment to Termination Alison Hendricks, LCSW Hendricks Consulting. Chest and Abdominal Trauma Case Studies Case #1 Scenario: EMS is dispatched to a 2-car MVC with head on collision. The posted speed limit is marked at 40 MPH. Upon EMS arrival to the scene an unrestrained adult driver is found inside the vehicle with noted + steering wheel deformity. The patient is A & O X 3 but appears restless and agitated. Mar 23,  · Our case shows that severe caution should be taken when using prior studies to make medical decisions about individual patients. Treatment of traumatic brain injuries is complex, and should continue to evolve with evidence-based by: 1.

Trauma Case 1: Stab to Left Chest » Surgery | Boston University

Make EMS1 your homepage, trauma case study. There are critical decisions made in the prehospital emergency care of unstable patients with penetrating trauma. The crew heard a "Pop, pop, pop" trauma case study, and knew it wasn't just a car backfiring. The dispatch was for "someone shot," and they were two blocks away. Law enforcement worked quickly to secure the area, and asked that EMS approach quickly. A young man was on the ground, unconscious.

He was warm. There was no blood. A rapid assessment found multiple wounds in his chest, and he would respond to painful stimuli. He had a weak pulse, and agonal respirations. The trauma protocol called for a rapid removal, and the police were nervous because a high powered automatic weapon was used and the perpetrator might still be in trauma case study area.

The patient was strapped on a backboard and moved to the ambulance, where the paramedic could do a full secondary assessment. The injured man had no head wounds, but there was blood in the mouth and coming up from the airway. The neck veins were distended. The victim was breathing in a very shallow fashion, and the paramedic noted that the right side of the chest "felt like a full balloon. He carefully removed the muscular man's shirt, making sure he did not cut through the bullet holes.

There was no air moving into that side of the chest on auscultation. He had two wounds on that side of his chest: there was an additional open wound to his left anterior chest, which caused a 4x4cm open area to be blown away.

This was covered initially with a large trauma dressing. There was an additional wound to his upper left thigh. He had no other wounds to the extremities or his back, and he withdrew trauma case study four extremities from painful stimuli.

The paramedic was able to barely palpate a carotid artery pulse, so he moved immediately to primary interventions. As the ambulance began to move on a minute transport to the trauma center, the crew communicated a "trauma alert," critical in the case of an unstable penetrating trauma patient, trauma case study. The paramedic arranged equipment for a quick set of life-saving interventions. The trauma protocol called for the paramedic to "restore perfusion," which is an important concept.

In penetrating trauma, this means performing techniques that will allow the most important organs to have adequate blood supply, but not accelerating hemorrhage or fulfilling any specific numbers for blood pressure or pulse or oxygen saturation. The important first interventions are to ventilate and secure an airway. The EMT inserted an oral airway and started bagging the patient with high flow oxygen. It was very difficult to ventilate, so the paramedic knew he would have to seal the chest wound quickly and decompress the chest.

He needed an occlusive dressing to the left chest wound that would seal it, and that would adhere to the skin despite the blood, sweat, and hair on the man's chest. A new generation of occlusive dressings is available for that purpose, and one version of the dressing is available with a pressure relief valve system that would allow air to escape from the open wound, but would not allow it to get sucked back into the chest.

These dressings have been used in recent war zones, and have been designed to be quickly applied and transparent, trauma case study, so that the trauma team can visualize the wounds once the patient arrives at the hospital. The SAM Chest Seal is the self-adherent occlusive dressing that the paramedic applied to the open left chest wound.

The hydrogel adhesive was strong and flexible, so it adhered to the skin in the presence of blood, hair, and diaphoresis. With the cap removed, the dressing functions as a valve chest seal with one-way outward flow. Trauma case study in place, the paramedic performed a needle decompression of the right chest, trauma case study, due to the EMT's ongoing difficulty trying to ventilate the patient, the lack of air trauma case study and chest wall movement on that side, and the feeling that the chest "was like a tight balloon, trauma case study.

He heard a large rush of air, followed by a "thank you" from the EMT that is was now much easier to bag the patient. The patient had a large antecubital vein in the right arm, so a large catheter was inserted and a normal saline infusion started with the bag put in a pressure infusion cuff. The paramedic then inserted an intraosseous needle into the patient's right tibia, away from the injured left leg, trauma case study.

He started another infusion of normal saline with a pressure infusion cuff. The patient continued to have blood coming up from his mouth, so the paramedic quickly performed an endotracheal intubation. The blood was coming from the patient's lungs, so the paramedic relayed that information to the trauma center, and the crew suctioned the airway on a regular basis to keep the blood from occluding the tube and compromising ventilation.

His diaphoresis disappeared, and the wound on his left thigh trauma case study to bleed more profusely. The paramedic considered applying a tourniquet, but instead started with direct pressure, and the trauma case study was controlled. The victim started to stir around a little. With these signs of improving perfusion, he takes the pressure infusers off the bags, and cuts the fluid administration rate back to about cc per hour.

The trauma team assumes care of the patient, with a plan for rapid transport to the trauma case study room, trauma case study. Decision making in cases of critical penetrating trauma There are critical decisions made in the prehospital emergency care of unstable patients with penetrating trauma.

The key assessments and interventions are summarized as:. Integrity of the body and important body portions : Penetrating wounds to the face, neck and chest create immediate and profound airway problems. Where possible, the patient should be positioned to control his or her own airway. Spine immobilization should be dictated by mechanism of injury and evidence of trauma to the spine. Many patients with penetrating wounds away from the spinal column can be managed without immobilizing the spine, and that may simplify airway management, trauma case study.

Chest and neck integrity is necessary for preventing major bleeding, and allowing the patient to both ventilate and perfuse. Loss of integrity, trauma case study, particularly with major bleeding, can be addressed by direct pressure, the new adherent dressings, or another occlusive dressing.

Airway : Where needed, airways using oral, nasal, or cricothyroid routes are lifesaving, trauma case study. With some facial injuries, before bleeding and swelling progress, the EMT can perform an oral or digital intubation to secure the airway. In some cases, the patient will need a needle or surgical cricothyrotomy, which can be performed by paramedics in some systems. Crews that are managing critical airways across long prehospital care timelines must be prepared with a number of options for airway management.

Ventilation : The chest wall must be intact for the patient to breathe, and the pleural space cannot be filled with air or blood. Filling those spaces with air creates a life threat to the patient, trauma case study the air must be removed with a needle or a chest tube. A tension pneumothorax also creates filling problems for the heart, and perfusion will decrease.

Oxygenation : Lung integrity is important for oxygenation. Supplemental oxygen is usually helpful. Perfusion is the ability of the body to provide critical oxygenation to cells and remove waste products, and the compromise of perfusion is called "shock", trauma case study. Enhancing both volume and oxygen delivery to the patient is needed to restore or maintain perfusion in the traumatized patient. Surgical intervention : EMS providers should be experienced in their work with local hospitals or the trauma center, and capable trauma case study "making the call" in a timely manner that a crisis is en route and will need to be managed at the ED, trauma case study.

James J Augustine, trauma case study, M. More EMS1 Articles. More Trauma News. More Product Listings. More Product news. More Trauma Videos. Make EMS1 your homepage Open the tools menu trauma case study your browser, trauma case study. How to buy airway management devices eBook. Nearly courses totaling hours of CE.

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Enhancing wellbeing, engagement and patient care in EMS with weak ties. How progressive EMS agencies are using advanced cellular networks to connect. Medic Mindset Podcast: Thinking about headache. Guiding choices and opening doors: Mentoring revisited. How to cultivate a culture of accountability, trauma case study. Topics Trauma. Email Print Comment. To do this, the paramedic would need to: Control the airway and ventilate using a bag-valve-mask Apply a seal to the chest wound, trauma case study, and decompress any tension pneumothorax Infuse enough fluid to restore critical perfusion To infuse fluids in a patient with open chest wounds, the paramedic would try to get intravenous access above and below the diaphragm.

This trauma case study usually done below trauma case study diaphragm using an intraosseous infusion device. Use pressure infusers to give rapid fluid boluses The important first interventions are to ventilate and secure an airway. After weeks of treatment, and multiple operations the patient was able to leave the hospital. The key assessments and interventions are summarized as: Integrity of the body and important body portions : Penetrating wounds to the face, neck and chest create immediate and profound airway problems, trauma case study.

About the author Trauma case study J Augustine, M. Tags Trauma, trauma case study. Photo of the Week: Girl meets the air-med crew who saved her life. Chaplaincy service started for Wash. Trauma prevention specialist offers tips on how to 'Stop the Bleed'. Join the discussion. You must enable JavaScript in your trauma case study to view and post comments.

EMS1 Top 5 5 errors that are giving you incorrect blood pressure readings 2 Wait a minute, you auscultated a broken bone? Trauma Photo of the Week: Girl meets the air-med crew who saved her life.


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trauma case study


"Someone's been shot": An EMS case study There are critical decisions made in the prehospital emergency care of unstable patients with penetrating trauma The crew heard a . TRAUMATIC BRAIN INJURY CASE STUDY Amy C. Szalinski, PT HealthSouth Harmarville Rehabilitation Hospital. HISTORY •Mr. N. sustained a traumatic brain injury on 8/21/ He is 46 years old and was riding his motorcycle without a helmet when he . Trauma Case 1: Stab to Left Chest Boston Medical Center – Trauma Case of the Month Case #1: Diagnostic Laparoscopy in Penetrating Chest Trauma. by Rie Aihara, M.D. and Wayne LaMorte, M.D., Ph.D., M.P.H. Pre-Hospital Data. A 17 year-old male from Michigan was visiting his cousins and friends in Boston, when he became a victim of a stabbing.