Chapter 41
Multisystem Trauma
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Objectives
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Multisystem Trauma
• Multisystem trauma
– Significant forces affect more than one
area of the body at the same time
• Examples
– Head and spinal trauma
– Chest and abdominal trauma
– Burns and extremity trauma
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Multisystem Trauma
• Greater risk of developing shock
• High frequency of serious injury and death
• Definitive care may include surgery
• Short scene times and rapid transport to the
closest appropriate facility are essential
• You must know your local trauma system
capabilities.
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Multisystem Trauma
•
•
•
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Conduct a scene size-up
Ensure your own safety because
Evaluate the mechanism of injury
Call for additional resources early
– In multisystem trauma, call for ALS
personnel right away.
– In some situations, air medical transport
may be necessary.
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Principles of Prehospital Trauma Care
• Safety of rescue personnel and patient
• Wear appropriate personal protective
equipment
• Determination of additional resources
• Assessment of mechanism of injury
• Maintain a high index of suspicion
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Principles of Prehospital Trauma Care
• Airway management while maintaining
cervical spine stabilization
• Support oxygenation and ventilation
– Oxygen saturation greater than 95%
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Principles of Prehospital Trauma Care
• Treat shock
– Maintain normal body temperature
– Splint musculoskeletal injuries
• Maintain spinal stabilization on long
backboard
• Short scene time, rapid transport to closest
appropriate facility
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Principles of Prehospital Trauma Care
• Obtain medical history
• Secondary survey after treatment of life
threats
• Accurate, legible documentation
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Blast Injuries
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Blast Injuries
• Blast injuries
– Can produce multisystem trauma
– Injuries result from pressure waves
generated by an explosion
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Blast Injuries
• Five categories:
1. Primary blast injuries
2. Secondary blast injuries
3. Tertiary blast injuries
4. Quaternary blast injuries
5. Quinary blast injuries
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Blast Injuries
1. Primary blast injury
– Occurs from the blast wave impacting the
body surface
– Organs surrounded by fluid and organs
filled with air are particularly susceptible
to primary blast injury.
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Blast Injuries
2. Secondary blast injury
– Occurs from projectiles
– Blunt and/or penetrating trauma
– Open and closed brain injury
– Extremity fractures
– Bleeding
– Shock
– Lacerations of heart and great
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Blast Injuries
3. Tertiary blast injury
– Caused by an individual flying through
the air
– Victim may be thrown to the ground or
through the air, striking other objects
– Blunt and penetrating trauma
– Fractures
– Traumatic amputations
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Blast Injuries
4. Quaternary blast injury
– All other injuries from the blast
– Burns
– Crush injuries
– Open and closed brain injuries
– Respiratory illnesses related to dust,
fumes, toxic smoke
– Worsening of chronic illnesses
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Blast Injuries
5. Quinary blast injury
– Results from absorption of toxic materials
associated with the blast
– Can include bacteria and radiation
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Blast Injuries
• Scene safety
• If an Incident Management System has been
established at the scene, report to the
Command Post
• A blast victim should be reassessed often
• Transport as soon as possible to the closest
appropriate facility
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Questions?
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