History Lesson and Practice Trauma Practical

On this day in history in 1928, Sir Alexander Fleming discovered the antibiotic, penicillin. Anti is the Greek word for "against" and "bio" meaning life. So literally it means "against life," thankfully that word applies to bacteria. Fleming originally discovered it when he found that a culture of Staphylococcus aureus had been contaminated with a species of Penicillium and was inhibiting the bacterial growth. A great day in the history of medicine and in many ways, the world.

Anyway, tonight I have my practice trauma practicals. Wish me luck!

The break down as far as I can remember is like this:

• Scene Safe/BSI (Is the scene safe? And I am taking Body Substance Isolation protocols.)
• Get partner to grab C-spine (partner manually stabilizes patient's neck to prevent further injury to the spint)
• Check patient's response level (Alert, Verbal, Painful, Unresponsive)
• Check Airway
• Check Breathing (and apply oxygen if needed)
• Check Circulation (assess for rapid pulse, skin temperature, skin color, and check for/treat any major bleeding.
• Declare patient a load-and-go or stable patient.
• See if anyone is on-scene that can give SAMPLE history(signs&symptoms, allergies, medications, pertinent past history, last meal, and events leading up to injury).
• Relieve partner of C-spine stabilization (could do this earlier) by turning C-spine over to an imaginary EMT.
• Begin rapid trauma assessment beginning from head down. Get partner to take vital signs in mean time (BP, pulse, respiratory rate, pupil response).
• Check for DCAP-BTLS (deformities, contusion, abrasions, penetrations, burns, tenderness, lacerations, and swelling) while doing the rapid trauma assessment. Check every part of the bone (especially facial) and check 4 abdominal quadrants. Apply C-collar after neck is assessed. Also listen to breath sounds. Treat any life-threats as you come upon them.
• Finally check extremities, couldn't hurt to have checked the extremity you are using for vital signs before taking the vital signs.
• Assess in extremities CMS (circulation, motor function, and sensory functions).
• Log roll patient, check the back of the patient, running you fingers/hand down their spine, and pull the backboard behind patient.
• Roll patient onto backboard. Apply spiders. Then put headblocks on each side of the patient's head. Use the straps across the patient's head and under the chin.
• Recheck CMS after patient is attached to backboard.
• Transport (say it!)
• Reassess enroute (vitals) and treat any injuries that need treating. Do detailed trauma assessment. Detailed trauma assessment is almost exactly the same as the rapid trauma assessment. It is to make sure that you haven't missed anything. You redo all the steps of the rapid trauma, except now you shine the penlight in the eyes, ears, nose, and mouth of the patient to check. Check for tracheal deviation or JVD (jugular veinous distention) in the neck. Reassess CMS.
• That's pretty much it. Fill out the call sheet and you are done.