Fear Factor Trauma

5/16/2011

Fear Factor Trauma

Corrie Alvarez, CPC, CPC-I, CEDC

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Agenda

? Overview of Trauma Centers ? Glasgow Coma Scale (GCS) ? Critical Care Guidelines ? Traumatic Brain Injuries (TBI's) ? Gunshot Wounds ? Fractures ? Common Modifier Usage ? ICD-9-CM Guidelines Ch.17 and Ch. 19

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What is a Trauma Center

? The Level Matters Level I-IV American College of Surgeons (ACS) State Designation

? CDC Statistics For the severely injured, care at a Level 1 trauma center, lowers death risk by 25%.

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Leading Causes of Death in US

? Accidents are leading causes of death in US for ages 1-44

? 50% of EMS are due to injuries ? Unintentional injuries are 5th leading cause

of death over-all. ? Top 3: Falls, MVAs, Unintentional

poisoning

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Emergency Medical Service Team

? The Decision Scheme ? National Trauma Triage Protocol

It starts in the field

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Glasgow Coma Scale

? Developed in 1974 at Glasgow University in Scotland by Doctors Teasdale and Jennett

? Evaluates the degree of consciousness ? Scale 3-15 ? Visual ability, verbal responsiveness, and motor

skills

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1

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3

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5

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Visual

Eyes

Pain causes

Voices cause Eyes open N/A

N/A

Response Remain eyes to open

eyes to open randomly

Closed

Verbal ability

Motor Skills

Silence

Minimal indistinghable Sounds

Mumbles

Incoherent Normal

N/A

rambling

Conver-

sation

Immobile

Pain causes

Pain causes

extension mvmts flexion mvmts

Pain causes Mvmt away from stimulus

Compl Mvmt in response to pain

Moves on command

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GCS Examples

? Fully conscious patient:

Visual: Eyes open randomly = 4 Verbal: Normal conversation = 5 Motor: Moves on command = 6

Total GCS: 15

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GCS Examples

? Fully Comatose Patient

Visual: Eyes remain closed

= 1

Verbal: No verbal ability

= 1

Motor: Immobile

= 1

Total GCS: 3

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