FIELD REFERENCE
Full criteria & treatment guidance
Key cautions & base contact
- A fluid threshold for general medical hypotension is not the same as the TBI threshold.
- Trauma-center designation and high hemorrhage risk are ketorolac exclusions in PR-075.
Bleeding control & transport
- Start direct pressure. If bleeding continues, consider an approved hemostatic dressing; use a tourniquet for uncontrolled extremity hemorrhage under B-010.
- Do not delay transport to establish IV access. For hypotension, the adult order starts with 250 mL saline and permits continued infusion to support perfusion.
- Base contact is required for trauma-triage criteria, hypotension, or saline needed for stabilization.
Limb injuries & impaled objects
- Splint/immobilize fractures and document distal pulses and sensation. Cold packs over a splint may improve comfort.
- Stabilize impaled objects when possible. Do not remove face/neck objects unless ventilation is compromised; avoid delays to extrication/transport.
- For qualifying pain with systolic BP above 90, options include morphine 5 mg (or 4 mg carpuject) IV/IM, fentanyl 50 mcg IV/IM, or fentanyl 100 mcg IN. Each may repeat once after 3 minutes as specified.
Suspected traumatic brain injury
- Monitor SpO₂ continuously and escalate oxygen/airway/ventilation support to maintain saturation above 90%. Use continuous ETCO₂ and target 35–45 mmHg when possible, especially during assisted ventilation.
- Check systolic BP every 5 minutes. Below 100, give 250 mL saline and continue infusion toward BP above 100. For patients 65 and older, begin below 110 and target above 110.
- At GCS 8 or below, establish an airway by the most appropriate available means. Transport to a trauma center.
Handoff
- Report mechanism, hemorrhage control, tourniquet time, neurologic findings, oxygenation/ETCO₂, BP trends, and treatment response.
- Use the complete SO-T-005 for eye injury, airbag exposure, pregnancy-positioning, and other branches beyond this focused guide.
VISUAL FIELD REFERENCE
Adult TBI: oxygenation, ventilation, blood pressure
Adult / adolescent · ALS
Suspected traumatic brain injury branch. Hemorrhage and other injuries have separate instructions.
- SpO₂ >90% · ETCO₂ 35–45
Oxygenation & ventilation
Monitor SpO₂ continuously and escalate oxygen/airway/ventilation support to maintain saturation above 90%. Use continuous ETCO₂ and target 35–45 mmHg when possible, especially during assisted ventilation.
- Recheck every 5 minutes
Blood pressure
Check systolic BP every 5 minutes. Below 100, give 250 mL saline and continue infusion toward BP above 100. For patients 65 and older, begin below 110 and target above 110.
Airway & destination
At GCS 8 or below, establish an airway by the most appropriate available means. Transport to a trauma center.
- A fluid threshold for general medical hypotension is not the same as the TBI threshold.
Selected checkpoints; read the complete guide for criteria, exclusions, doses, and ongoing care. SO-T-005 · B-010 · PR-075
UNDERSTAND THE CARE
Why the trauma report needs a treatment timeline
The mechanism, bleeding control, neurologic examination and perfusion trend help the receiving team understand the evolving injury. Record what was found before and after an intervention, including distal findings for a limb injury and application time for a tourniquet. A single final set of vital signs can conceal deterioration or the support required to maintain them.
Applying the guidance
The TBI section uses its own pressure thresholds and requires attention to oxygenation and ventilation. Keep those targets distinct from general medical hypotension. Pain treatment and splinting remain tied to the applicable injury pathway and patient conditions. Avoid delaying movement for tasks that the source says should occur en route when possible.
Putting it together
Teaching example: an injured patient’s pressure is above a familiar medical-shock cutoff but below the applicable TBI target. Use the head-injury instructions and report the neurologic and pressure trends together.
Diagram text & teaching checkpoints
- Hemorrhage
- Control and record response.
- Movement
- Coordinate prompt transport.
- TBI
- Protect oxygenation, ventilation and pressure.
- Handoff
- Mechanism, serial findings and treatment times.
Sources for this explanation
Original OCMedic teaching synthesis of the references below. Educational expansion updated ; this is not a new independent clinical-review date. Source-specific dates and limitations remain in the full guidance.
Recognize the limits of this focused trauma summary
This page concentrates on hemorrhage, limb injury and traumatic brain injury. The complete adult trauma order also contains separate branches for airbag exposure and eye injury, along with pregnancy-positioning considerations. Identify the applicable branch instead of assuming that all injuries share the same sequence.
For airbag deployment, the source distinguishes eye irritation and possible powder exposure from respiratory symptoms and blunt injury. For an eye injury, it describes protection without pressure on the globe. An apparently small local injury can therefore require a different immediate approach from the extremity bleeding example at the top of this guide. Open the full order when those branches apply.
The distinction also matters during handoff. Describe the injury pattern and the specific intervention, not merely “trauma treated.” Include distal findings for the injured limb, visible bleeding control and its timing, and serial neurologic and perfusion observations when head injury is suspected. The trauma destination and base-contact requirements continue to follow the patient’s findings; successful splinting or pain relief does not settle the destination question.
Sources: SO-T-005