337 Complete Guide Collection PDF

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Study Guides for each week of the semester. Guides include summaries, recommended readings, and questions to consolidate your learning. ...

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School of Clinical Sciences

Week 1 Study Guide Semester two, 2020 1

Approach to learning and teaching in CSB337 For the entire semester (weeks 1-13), traditional lectures will be replaced with short ‘concept’ driven pre-recorded sessions that you can revisit as you wish. During weeks 1-8, the delivery of workshops will be via zoom sessions. Where possible, the online workshops will be recorded. Please note that due to circumstances beyond our control, some zoom sessions may not capture the recording. For weeks 9, 10 & 12, workshops will be delivered face-to-face at university as ‘intensives’. Week 11 workshop will be available as a group-based case study.

Suggested options to prepare for the workshops include: • • • • • •

Taking notes Answering the ‘questions to consider for the translation of knowledge into practice’ at the end of the weekly study guide Reflecting on your clinical practice experiences and using your critical thinking skills to refine and strengthen your practice Reflecting on the type of clinical practitioner you wish to be Contemplating your own background and experience and what you bring to the care of people experiencing traumatic injury and illness Working with your peers to form study groups within workshop time

2

Topic: Introduction to trauma epidemiology, trauma systems and trauma scoring During this week, you will be introduced to concepts about the trauma system in Queensland, issues relating to epidemiology and trauma scoring.

Central themes • • •

Trauma epidemiology Trauma systems Trauma scoring

Reading • •

Read – Curtis and Ramsden, Chapter 42 – Overview of traumatic injury, p.1067. Review - Curtis and Ramsden, Chapter 10 – Scene assessment, management and rescue, p.141, Chapter 11 – pre-hospital clinical reasoning, triage and communication, p.166, Chapter 14 – patient assessment and essentials of care, p.237.

Workshop • •

Discussion about the unit and assessment items (1 & 2) Q&A with Unit Coordinator

•

Small workshop groups to review concepts from lecture and practical skills

Questions to consider for the translation of knowledge into practice • • • • • •

What is the purpose of the Queensland Trauma System? Why is epidemiology an important instrument to understand trauma? What is the role of paramedics in the trauma system and how do they work from an interprofessional perspective? What are the most significant trauma risk factors in Australia? Discuss your knowledge of ‘patterns of injury’ in Australia. What are the effects of injury on society?

3

School of Clinical Sciences

Week 2 Study Guide Semester two, 2020 1

Topic: Mechanism of injury, pattern of injury, head injury, spinal injury During this week, you will be introduced to content examining mechanism of injury, pattern of injury, head injury and spinal injury.

Central themes •

Mechanism of injury and pattern of injury

• •

Head injury Spinal injury

Reading The chapters in the Curtis and Ramsden are extensive. Please concentrate your review of the chapters on understanding the anatomy, physiology, assessments, main injuries and out of hospital treatment options (which will be highlighted in the accompanying lecture).

• • • • • •

Review – Curtis and Ramsden – Chapter 41, pg. 1160 – Mechanism of Injury Review – Curtis and Ramsden – Chapter 47, pg.1353 – Spinal trauma Review – Curtis and Ramsden – Chapter 43, pg. 1227 – Traumatic Brain Injury Review – QAS CPP’s and CPG’s in preparation for your clinical placement Listen – podcast by Wayne Loudon (PhD candidate, CCP, CSO) – available in week 2 Listen – podcast by Dr Joseph Mathew (see under week 2 content tab on blackboard)

Workshop • •

Q&A with Unit Coordinator Small workshop groups – scenarios and review manufacturer’s videos provided on blackboard: o Traction splints – Slishman o Pelvic binders – promethius, sam sling o Helmet removal o Hard collars o Combi Carrier

2

Questions to consider for the translation of knowledge into practice • • • • • • • • • • • • • • •

Explain the term kinematics and how it relates to the concepts involved in mechanism of injury. What laws are relevant to mechanism of injury – why? Define the term ‘blunt trauma’. List the essential concepts for mechanisms of injury With reference to motor vehicle collisions, list and describe the multiple phases that occur during deceleration Discuss the points of impact that can occur in motor vehicle accidents. Describe and comment on the types of injuries paramedics are likely to observe in people who have experienced a motorbike collision. Describe and comment on the types of injuries paramedics are likely to observe in pedestrians who have been struck. Describe and comment on the types of injuries paramedics are likely to observe in people who have experienced ‘other blunt’ trauma incidents Describe the clinical challenges of providing care to a person who has experienced penetrating trauma. What considerations must you take into account? Explain how traumatic brain injury (TBI) is classified using the GCS. List and discuss the two main categories of brain injury, as offered in Curtis and Ramsden. What are the most important clinical considerations paramedics should undertake when caring for a person with suspected spinal cord injury (SCI)? What is the difference between neurogenic and hypovolaemic shock? How should paramedics assess a person’s cervical spine (clinical decision rules)?

3

School of Clinical Sciences

Week 3 Study Guide Semester two, 2020 1

Topic: Chest and facial injury During this week, you will be introduced to content examining chest and facial injury.

Central themes • •

Chest injury Facial injury

Reading The chapters in the Curtis and Ramsden are extensive. Please concentrate your review of the chapters on understanding the anatomy, physiology, assessments, main injuries and out of hospital treatment options (which will be highlighted in the accompanying lecture).

•

Review – Curtis and Ramsden – Chapter 44 – Maxillofacial trauma p.1251 Review – Curtis and Ramsden – Chapter 45 – Thoracic and neck trauma p.1275 Read – https://trauma.reach.vic.gov.au/guidelines/thoracic-trauma/key-messages The Trauma Victoria Guidelines (Victorian based only) provide a step-by-step approach to thoracic trauma. Read – QAS CPG chest injuries

•

https://www.ambulance.qld.gov.au/docs/clinical/cpg/CPG_Chest%20injuries.pdf

• • •

When you are on clinical placement, you will use the above QAS guidelines. •

• •

•

Read – QAS CPP – emergency chest decompression • https://www.ambulance.qld.gov.au/docs/clinical/cpp/CPP_Emergency%20chest%20 decompression_Pneumodart.pdf Read – QAS CPP chest seal • https://www.ambulance.qld.gov.au/docs/clinical/cpp/CPP_Chest%20seal.pdf Read – QAS CPP – The Emergency Bandage • https://www.ambulance.qld.gov.au/docs/clinical/cpp/CPP_Bandaging_Emergency% 20Bandage.pdf Read - QAS CPP – Haemostatic Quickclot • https://www.ambulance.qld.gov.au/docs/clinical/cpp/CPP_Haemostatic_QuikClot.p df

2

Workshop • •

Q&A with Unit Coordinator Small workshop groups – scenarios and review manufacturer’s videos provided on blackboard: o Chest decompression and chest seal o Wound packing o Tourniquet and amputated part

Questions to consider for the translation of knowledge into practice • • • • • • • • •

What is the main cause of airway problems following maxillofacial injuries? Explain why people with maxillofacial trauma could be haemodynamically compromised. High might haemorrhage from maxillofacial trauma be controlled? Under what circumstances might a person sustain maxillofacial trauma? Name the range of maxillofacial injuries from the Curtis and Ramsden text. Explain the anatomical structures affected. What is one of the earliest signs of clinical deterioration in a patient with chest trauma? Is oxygen saturation alone reliable in determining the degree of hypoxaemia? What does the complaint of pain, chest-wall tenderness and subcutaneous emphysema indicate when a person has sustained a thoracic injury? What are lung contusions? Explain the presence of lung contusions in people who have sustained blunt chest trauma.

3

School of Clinical Sciences

Week 4 Study Guide Semester two, 2020 1

Topic: Crush injury & limb trauma, pain management, shock, and fluid resuscitation During this week, you will be applying content knowledge about crush injury, limb trauma, pain management, shock, and fluid resuscitation to the out- of-hospital environment scenarios.

Central themes Crush injury Limb trauma Pain management Shock and fluid resuscitation

• • • •

Reading The chapters in the Curtis and Ramsden are extensive. You will already have covered many of these concepts during your first year and semester one, year two. Review – Curtis and Ramsden – Chapter 10 – Shock pp. 163-171. Listen to - Podcast by Dr John Dyett – Fluid Resuscitation in Major Trauma (see under week 3 content tab on blackboard) • Review – Curtis and Ramsden – Chapter 48 – Crush injuries and compartment syndrome pp. 1415 – 1420. • •

• •

Review – Curtis and Ramsden – Chapter 48 – Fractures – pp.1398 - 1415. Review – Curtis and Ramsden – Chapter 18 – Pain Management – pp.447 – 461.

Workshop • •

Q&A with Unit Coordinator Small workshop groups – watch and discuss recorded trauma scenarios

2

Questions to consider for the translation of knowledge into practice •

What is the current clinical thinking about fluid resuscitation in the trauma patient?

• •

When you attend a patient with a known head injury, what BP are you aiming for? When you attend a patient experiencing hypovolaemic shock, what BP are you aiming for?

• • • •

Explain the pathophysiology of each category of shock. How would you treat each category of shock? Explain the aetiology and pathophysiology of crush injury. Explain the aetiology and pathophysiology of compartment syndrome.

• •

What are the adverse effects of undertreated severe acute pain? What are the barriers that can contribute to ineffective pain management?

• •

Describe the pathophysiology and major types of pain. Discuss the classification and types of fractures likely to be observed in the out- of-hospital environment. Estimate the blood loss for each type of fracture in an adult patient.

•

3

School of Clinical Sciences

Week 5 Study Guide Semester two, 2020 1

Topic: Ballistics, bangs and bombs During this week, you will be introduced to concepts about the trauma injuries related to explosions, high and low velocity penetrating injuries.

Central themes •

Injuries related to explosions

•

Injuries related to high and low velocity penetrating injuries

Reading The chapters in the Curtis and Ramsden that you have read in the last few weeks are relevant to week 5. Please review your care of people experiencing injuries consistent with explosions, high and low velocity penetrating injuries: • • •

Traumatic head injury Spinal injury Chest injuries

• •

Crush injuries and fractures Hypovolaemia

•

Cavitation wounds

Workshop • •

Q&A with Unit Coordinator Small workshop groups – watch and discuss recorded trauma scenarios

2

Questions to consider for the translation of knowledge into practice •

What are the mechanisms of blast injury?

•

List the types of injuries likely to occur in blast injuries and discuss your out-of-hospital treatment. Describe the management of blast situations.

• • • • • • • •

List the forms of high and low velocity ballistics injuries and their out-of-hospital treatment. Describe specific tissue and organ injuries to lungs and bone What are the three (3) treatment goals for ballistics injuries? What are the special concerns you will need to consider when about to enter a scene where weapons are involved? Explain the concept of ‘preventable combat wound deaths’. Describe your actions when an active armed offender is on-scene. What is ‘Tactical Emergency Casualty Care’ (TECC)?

3

School of Clinical Sciences

Week 6 Study Guide Semester two, 2020 1

Topic: Abdominal, pelvic, and genitourinary trauma During this week, you will be examining abdominal, pelvic, and genitourinary trauma.

Central themes • • •

Abdominal trauma Pelvic trauma Genitourinary trauma

Reading Read:

Curtis and Ramsden: Chapter 46 – Abdominal and genitourinary trauma, p.1315. Concentrate your reading on:

Review:

• • •

Epidemiology Anatomy Mechanism of injury

• •

Initial assessment and management Specific organ injury

• •

Genitourinary trauma Genital injuries

Curtis and Ramsden: Chapter 48 – Pelvic Fractures, pp.1410 – 1414.

Watch/read: Pelvic Trauma: https://rydestation.wordpress.com/2014/08/17/pelvic-trauma/

Read:

Abdominal trauma – primary survey https://trauma.reach.vic.gov.au/guidelines/abdominal-trauma/primary-survey Abdominal trauma – secondary survey https://trauma.reach.vic.gov.au/guidelines/abdominal-trauma/secondary-survey

Read:

Read:

QAS CPG abdominal trauma https://www.ambulance.qld.gov.au/docs/clinical/cpg/CPG_Abdominal%20trauma.pdf QAS CPG trauma/pelvic injury https://www.ambulance.qld.gov.au/docs/clinical/cpg/CPG_Pelvic%20injury.pdf 2

Workshop • •

Q&A with Unit Coordinator Small workshop groups

Questions to consider for the translation of knowledge into practice • • • • •

List the abdominal organs that are contained within the peritoneal cavity. Explain where they are contained using your knowledge of the abdominal quadrants. List the vascular structures that are contained in the abdominal cavity. List the organs contained in the genitourinary cavity. Where are they located? What are the most common mechanisms of injury that result in abdominal trauma? Name the abdominal organs that are most likely to be injured.

•

List the types of injuries that can occur from trauma to the abdomen. Why should you have a high index of suspicion for genitourinary trauma when abdominal trauma is identified? Discuss your assessment of a person who has sustained a suspected abdominal injury. What types of treatment might you consider for a person who has sustained a pelvic injury? What organ is the most injured organ in the urinary tract? Why? What are the most likely mechanisms of injury? What mechanisms of injury might result in pelvic injuries?

• •

List the types of injuries that can occur from trauma to the pelvis. List the organs contained in the pelvis.

• •

Discuss your assessment of a person who has sustained a suspected pelvic injury. What types of treatment might you consider for a person who has sustained a pelvic injury?

• • • • •

3

School of Clinical Sciences

Week 7 Study Guide Semester two, 2020 1

Topic: Trauma in speciality groups During this week, you will consider the holistic needs of people from the following populations: paediatric, obstetric, older people and people with disabilities.

Central themes • •

Paediatric patient Older person

• •

Obstetric patient People with disabilities

Reading Review:

Review:

Curtis and Ramsden: Chapter 38: The older person, p.1081 – Concentrate your reading on: • Anatomy • Physiology • Conditions often seen in older people • •

Effects of ageing on drug metabolism Tips and tools: the geriatric assessment in the emergency health setting

•

Geriatric emergencies

Curtis and Ramsden: Chapter 35: Paediatric emergencies, p.933 - Concentrate your reading on: • Anatomy & physiology (table 35.1 is very useful) • Approach to paediatrics (practice tips p.942) • •

Review:

Examination & table 35.6 (p.948) Trauma, p.993

Curtis and Ramsden: Chapter 1059: People with disabilities, p.1059 – Concentrate your reading on: • Injury mechanism • • •

Major emergency care issues for people with an intellectual disability Assessment of the person with an intellectual disability Communication with the person with an intellectual disability – particularly box 37.1

2

Interact:

Shonel Hall’s ‘obstetric trauma’ exercise: This is a wonderfully interactive learning option. Please click on the ambulance button – and you will see your case. We will work through this case during workshops, but please take the time to navigate around it before the workshop. https://www.thinglink.com/video/1347484923467923459

Read:

QAS CPP Paediatric: https://www.ambulance.qld.gov.au/docs/clinical/cpp/CPP_Paediatric.pdf QAS CGP – Resuscitation paediatric: Please note on pg. 278 – ‘reversible causes’ https://www.ambulance.qld.gov.au/docs/clinical/cpg/CPG_Resuscitation_Paediatric. pdf QAS CPG Pain Management: Please note pg.334 pain scale for paediatrics https://www.ambulance.qld.gov.au/docs/clinical/cpg/CPG_Pain%20management.pd f QAS CPP – GCS: Please note p.476 – GCS for infant and child: https://www.ambulance.qld.gov.au/docs/clinical/cpp/CPP_Glascow%20Coma%20Sc ale.pdf

Listen:

Podcast – Paediatric trauma – Trauma Victoria (on BB under ‘study guide’ folder) Podcast – Emergency management of the older person trauma Trauma Victoria (on BB under ‘study guide’ folder)

Workshop • •

Q&A with Unit Coordinator Small workshop groups

Questions to consider for the translation of knowledge into practice • • •

What are the differences between paediatric and adult anatomy/physiology? How do you assess an infant and young child’s GCS? How do you assess an infant and young child’s pain?

3

•

How would you assess a conscious infant/young child in the out-of-hospital environment? What might provide the most comfort to them? Why might infants/young children deteriorate quickly after being involved in a traumatic incident? Why are infants/young children particularly susceptible to shock?

• • •

What are the main contributing facts that can lead to traumatic injury in older people? Name some of the injury prevention activities for the older person. Why is assessing pain in the older person so important?

•

Name some of the most common traumatic injuries that occur in the person living with disability Why is it important to take time to assess people with disabilities and their experience of pain? Anxiety is commonly experienced by people living with an intellectual disability. Why is it important for paramedics to understand this experience and what can they do to support the person in a traumatic incident?

• •

• •

• •

Describe the physiological changes in the pregnant woman What is the main goal of treatment for the pregnant patient who has experienced a traumatic incident?

•

What are your priorities when providing car...