I am very grateful for colleagues' comments on this.
It is based on a rapid primary survey of the patient: Not breathing =
dead Otherwise, if the patient is eithey tachypneic, or has a weak rapid
or no radial pulse, or does not follow simple commands = immediate.
Otherwise delayed. All three parameters (RPM for respiration, pulse,
mental) are checked simultaneusly, in 10 seconds or less.
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of s.carley
Sent: 10 August 2002 11:25
To: [log in to unmask]
Subject: Re: Grades of entrapment.
Not sure your system is any easier for the lay person, first aider or
police officer as it incorporates sieve/sort (sort being TRTS).
Simon
Simon Carley
SpR in Emergency Medicine
[log in to unmask]
Evidence based emergency medicine
http://www.bestbets.org
----- Original Message -----
From: "Victor Calland" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Saturday, August 10, 2002 10:55 AM
Subject: Grades of entrapment.
Message text written by Accident and Emergency Academic List
I've seen the e-mails and am making adjustments. The one thing I feel
about this particular strand of e-mails is that we are doing exactly
what the group is here for. This really is joining all our expertise
together to develop something new. So can all those who just watch and
don't contribute please feel free to comment. Lets use this group as an
International Think Tank.
>Vehicle.
5. All glass & SRS intact ( therefore no intrusion and Delta V less than
15mph in deployment vector) xxxxx Good point Jonathon)
4. Glass broken &/or SRS deployed but doors open
3. Doors cannot be opened without equipment (Delta V probably in excess
of 45 mph) 2. 30cm or more intrusion into the passenger compartment 1.
Opening of the passenger compartment by shearing of metal components
Person.
Simon, I'm unsure about this. I recognise that TRTS is a more
reproducible scoring system, and its very calculation gives a lot of
valuable detail for audit purposes ( and by God we need some valid audit
of pre-hospital care), but I would envisage the SES being used as a
short way of explaining a scene to Ambulance Control so that resources
can be appropriately deployed. The criteria I suggested could be gleaned
from a first-aider on a mobile phone, and certainly can be done by a
Police Officer or Fire-fighter. TRTS needs a GCS and a BP. By the time
the information has been gathered the casualty will have had Danger,
Responsiveness, Ac, B&O2, and C done, resources will be arriving and the
nature of the scene will have been communicated to Controls by Police &
Fire etc. Is there a role for system like the APGAR scale where an
analysis at 1 and 5 minutes is made? This would reveal the accident that
looks bad, and on closer investigation turns out to be non-serious as
well as the one that looks innocuous but turns out to be difficult.
4. TRTS = 15 4. Appears stable and no other casualty in
vehicle
has a serious injury
3. TRTS = 14 3. Mechanism of accident or signs suggest
potentially unstable
2. TRTS = 5-13 2. Has injuries that classify as URGENT in
either
sieve or sort
1. TRTS = 1-4 1. Has life threatening time critical injuries
Ancillary factors.
4. Uncomplicated extrication
3. Extrication complicated by environmental factors
2. Extrication will require specialist equipment ( cranes, thermal
lances
etc)
1. Extrication estimated will be in excess of two hours
<
<
Awaiting comments with interest
Vic Calland
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