I need some clarification on the updates to the trauma arrest algorithm. With a patient with penetrating trauma in asystole with LTH less than 30 minutes are we to transport to the lead trauma hospital as we do with PEA? Also, if the lead trauma hospital is greater than 30 minutes, I am assuming we transport to the closest ED with both asystole and PEA with penetrating trauma.

Oxygen Therapy does not address patients with GI emergencies. If their Sats are within limits we cannot give O2 even though the patient may have internal bleeding and lost a lot of hemoglobin.

This is a BLS question. For management of a flail chest, most research suggests that we tape the flail segment in place with a large bulky dressing, bag of saline, Asherman chest seal, etc. I’ve been hearing from recent PCP graduates that they have been taught to use a bulky dressing, however they mention that they are being taught to do a circumferential wrap around the chest with a triangular bandage or blanket to hold the dressing in place (which I would assume is incorrect) instead of taping a bulky dressing over the flail segment. What would be the preferred method and why?

Hello, question regarding cervical collar application. The BLS states that a collar should be applied with appropriate MOI if the Pt is altered LOC – however the Canadian Cspine flow chart states that cervical collars should only be used on stable, ALERT Pts. Is this a grey area where it is expected we use our judgement in terms of when it is appropriate to apply a collar vs manual cspine management? Or is there a certain GCS where manual cspine management is preferred over applying a collar? Thank you.

Curious. Obviously, the previous standard for spinal injury was full immobilization on a spinal board. BLS v3.3 currently states that those with suspected unstable pelvis should be secured onto a spinal board or breakaway stretcher (Scoop). We are then being referred to the blunt/penetrating trauma standard. There it also states to secure onto a spinal board or breakaway stretcher, and secure the lower extremities to reduce further injury/trauma to the pelvis. My question is, what is the current acceptable standard for this immobilization as per SWORBHP. Should this be full immobilization, 4 straps, headlocks etc? I do not see this written anywhere, and just looking for clarification as no one I ask seems to know the answer. Thanks

In the Toradol protocol it simply uses term “current/active bleed” as a contraindication, the companion document provides little clarification as to how this applies to trauma pts as trauma was removed as a contraindication. Would trauma with high index of suspicion for internal bleeding (MVC, Motorcycle accident, fall from height) be a contraindication? Would multisystem trauma pts? Or would the better course of action be to treat their pain? Thanks!

You have a patient that is VSA from penetrating trauma. The bls states you transport to trauma hospital if less than 30 min. The als pcs states that if your patient VSA from trauma and a TOR does not apply (pt in PEA) you transport to closet ED. So which one is correct the BLS to trauma hospital or ALSPCS to closest ED.

Since COVID supraglottic airways are highly recommended to be placed in a VSA patient prior to CPR. Is this for medical VSAs or does this apply to traumatic as well?