44-Hour Course

Lesson no. 16

Injured Patient Management Procedure – PHTLS

Injured Patient Management Procedure – PHTLS – Pre-Hospital Trauma Life Support

Safety & Survey

  • Safety of the responder and the patient
  • Distancing the injured person (and anyone else) to a safe place
  • Stopping life-threatening bleeding by applying a tourniquet
  • Calling for backup services (an ambulance/police/fire department)
  • Checking consciousness (AVPU)
PHTLS

Airway

  • Manual (hands) head restraint throughout the treatment if necessary (for example in a car accident or a fall from above, etc).
  • Removal of airway-obstructing material (vomit, blood, etc).
  • Opening the airway by jaw thrust if necessary, while maintaining the spinal/cervical spinal position.
  • A general impression of head condition (bruising, discoloration, lips, etc).

Breathing

  • Chest exposure and impression (fractures/bruises/bleeding/color, etc.)
  • Check breathing (note depth of breath, rhythm, regularity, symmetry of thorax)
  • Consider respiratory aid if needed (breathing above 30 or below 8 per minute)
  • Consider providing medical oxygen if needed

Circulation

  • Check peripheral pulse (rate [speed], rhythm, strength).
  • Check blood pressure (carotid-neck, femoral-by femur, radial-wrist).
  • Stop excessive bleeding.
  • Assess the skin’s condition (pale/cyanotic, body heat, dry/normal skin).
  • Capillary Fill Test: the amount of time it takes the skin’s color to return to normal from the moment it is pressed. Most often the pressure is applied to the fingertips (over 2 seconds – impaired).

Disability

  • Secondary assessment of the level of consciousness (AVPU)
  • Observation of neurological condition (normal speech, cognizant of time and place)

Exposure

  • If necessary, completely undress the injured person and check for further injuries while trying to preserve the individual’s privacy.
  • Re-cover the injured person after undressing to prevent hypothermia.

 

 During the second phase, continue with re-examination and follow-up anamnesis.

 

If necessary – evacuate to a hospital for further examination/treatment.

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