Hunting Related Trauma

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Information about Hunting Related Trauma

Published on November 1, 2018

Author: RyanTrudeau1

Source: slideshare.net

1. Hunting Related Trauma Instructor Ryan Trudeau, CCEMT-P, C-NPT

2. Objectives • Identify hazards, scene safety • Review hunting related mechanism of injury • Recognize need for specialized rescue techniques • Review general trauma care • Understand injury/illness related to fall in harness • Understand treatment considerations for injury/illness caused by fall in harness • Understand cold exposure/hypothermia and treatment • Medical Protocol Review

3. Hunting Related TRAUMA • Penetrating Injuries • Blunt Injuries • Lacerations • Spinal Injuries • Hypothermia • Frostbite • Hemorrhage

4. Rescuer Safety, Hazards • Falling Objects • Trip Hazards • Loaded weapons • Sidearms/CCW • Wildlife, Insects • Weather • Other Hunters? • Other Hazards?

5. Rescue of Suspended Victim

6. Specialized Rescue • Scene Access • Rescue vs. Recovery • Self Rescue and Non-entry Techniques • Rope Rescue

7. Safety Harness • Full Body- Chest, Waist, Legs • Tethers to tree • Protects from long fall • Cheaper versions available • Usually dorsal attachment

8. Suspension Trauma Harness Hang Syndrome

9. Suspension Trauma- MEDICAL Treatment • ABCs • ACLS • Other Treatments (similar to crush protocol) • Consider Bilat LE Tourniquets • Transport Considerations • HEMS • Dialysis capable facility • IV Fluids • 0.9% NS Bolus 1-2 L IV • Pain Management • Fentanyl preferred • Sodium Bicarb 100 mEq IV Push • Albuterol • 2.5 mg NMT/Cont. • Calcium Chloride • 1 Gram Slow IVP

10. Hyperkalemia Serum Potassium (mmol/L) Predicted EKG Changes 5.5-6.5 Tall tented T waves 6.5-7.5 Loss of P wave 7.5-8.5 Widening QRS >8.5 QRS continues to widen, approaching to sine wave

11. Hyperkalemia EKG- K+ 7.1

12. Hyperkalemia EKG- K+ 8.5

13. Hyperkalemia EKG- K+ 9.9

14. Protocol Review • NRMCA Protocol – General Crush Injury

15. Cold Exposure

16. Hypothermia • Occurs when core body temp is < 35° C • Risk Factors • Age • Exposure • Drugs/Alcohol • Low Blood Sugar • Trauma

17. Hypothermia • Heat Generation • Muscle Tissue • Liver • Heat Loss • Skin (90%) • Lungs (10%) • Convection • Conduction • Radiation • Prevention • Clothing • Loose Fitting • Shelter • Fire • Caution- CO Poisoning

18. Hypothermia- Signs & Treatment Mild 32°-35° C • Shivering • Tachycardia • Mental Confusion • Passive Rewarming • Warm Drinks, Dry Clothing • Remove to Shelter • Physical Activity Moderate 28°-32° C • No Shivering? • Increased Confusion • Pale • Peripheral Cyanosis • Active Rewarming • Heating Blankets/Bair Hugger • Warmed IV Fluids • Caution- Rewarming Collapse Severe < 28° C • Bradycardia • Bradypnea • Hypotension • Major Organ Failure • Active Internal Warming • CPR • ECMO • Thoracic Lavage

19. Frostbite • Exposure to cold causes freezing of tissues • Cold/Hypothermia constricts peripheral blood vessels reducing blood flow • Risk Factors • Diabetes • Tobacco • Alcohol Use • Exposure

20. Frostbite- Windchill

21. Frostbite- Treatment • Remove wet clothing • Keep skin dry, protect from wind • DO NOT RUB • Protect from pressure, trauma • Do NOT allow thaw/refreeze • Do Not break blisters • Support/Elevate during transport • Pain Management • Per Protocol

22. Protocol Review • NRMCA Protocol- Hypothermia/Frostbite

23. Trauma Lethal Triad • Hypothermia <32°C in trauma = 100% Mortality • Normal Saline is Acidotic (pH 5.5) • Control Hemorrhage (don’t contribute to dilutional coagulopathy) MAP = 65

24. Let’s Review

25. Review Name the best rescue technique to use for a suspended victim:

26. Review Name the best rescue technique to use for a suspended victim: ______________

27. Review What are the EKG findings in hyperkalemia? Early- Progressing- Late-

28. Review What are the EKG findings in hyperkalemia? Early- Peaked T Waves Progressing- Widening QRS Late- Sine-Wave Pattern

29. Review Consider transport of harness hang syndrome patient to facility capable of ______________

30. Review Consider transport of harness hang syndrome patient to facility capable of Dialysis

31. Review Drug Dosing in Hyperkalemia Isotonic IV Fluids- Albuterol- NaHCO3- CaCl--

32. Review Drug Dosing in Hyperkalemia Isotonic IV Fluids- 1-2 Liters Albuterol- 2.5 mg/continuous NaHCO3- 100 mEq CaCl-- 1 Gram

33. Review Major hypothermia symptoms include mild shivering True / False

34. Review Major hypothermia symptoms include mild shivering False

35. Review To treat frostbite, rub skin vigorously to create friction, thereby rewarming the skin True / False

36. Review To treat frostbite, rub skin vigorously to create friction, thereby rewarming the skin False

37. Review Name the 3 part to the Trauma Lethal Triad 1 ____________ 2 ____________ 3 ____________

38. Review Name the 3 parts to the Trauma Lethal Triad Coagulopathy Acidosis Hypothermia

39. Questions?

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