Advanced Trauma Life Support ATLS Student Course Manual 2018

373
APPENDIX G n Skills
lacerations, tenderness, deformity, and
sensation (while restricting spinal motion
in patients with possible spinal injury).
Apply a Cervical CollAR in a
Simulated Trauma Patient
STEP 1.
Place the patient in the supine position.
NEUROLOGICAL
STEP 11. Perform a neurological assessment.
STEP 1.
STEP 2.
••
Reevaluate the pupils and level of
consciousness.
••
Determine the GCS score.
••
Evaluate the upper and lower extremities
for motor and sensory functions.
••
Observe for lateralizing signs.
Reduce and Splint a
fRActure in a Simulated
tRAuma Patient
Ensure that the ABCDEs have been assessed
and life-threatening problems have
been addressed.
Completely expose the extremity and remove
all clothing.
STEP 3. Clean and cover any open wounds.
STEP 4. Perform a neurovascular examination of
the extremity.
STEP 5. Provide analgesia.
STEP 6. Select the appropriate size and type of
splint. Include the joint above and below
the injury.
STEP 7. Pad the bony prominences that will be
covered by the splint.
STEP 8. Manually support the fractured area and
apply distal traction below the fracture and
counter traction just above the joint.
STEP 9. Reevaluate the neurovascular status of
the extremity.
STEP 10. Place the extremity in the splint and secure.
STEP 11. Obtain orthopedic consultation.
STEP 2. Place your extended fingers against the
patient’s neck. Your little finger should
almost be touching the patient’s shoulder.
Count how many of your fingers it takes
to reach the jawline. Remember, sizing a
cervical collar is not an exact science; the
available sizes are limited, so make your
best estimate.
STEP 3. Find the appropriately sized collar or use an
adjustable one, if available.
STEP 4. Have another provider restrict the patient’s
cervical spinal motion by standing at head
of bed and holding either side of the head.
STEP 5. Slide the posterior portion of the collar
behind the patient’s neck, taking care not
to move the neck.
STEP 6. Place the anterior portion of the collar on
while making sure to place the patient’s
chin in the chin holder.
STEP 7. Secure the collar with the hook and loop
fasteners, making it snug enough to prevent
flexion but allowing the patient to open his
or her mouth.
Evaluate for Presence of
CompARtment Syndrome
STEP 1. Assess the degree of pain — is it greater
than expected and out of proportion to the
stimulus or injury?
STEP 2. Determine if there is pain on passive stretch
of the affected muscle.
STEP 3. Determine if there is altered sensation or
paresthesia distal to the affected compartment.
STEP 4. Determine if there is tense swelling of the
affected compartment.
STEP 5. Palpate the muscular compartments of
the extremity and compare the tension
n BACK TO TABLE OF CONTENTS