Reference protocol
🩸 Complex traumatology
PROTOCOL FOR COMPLEX TRAUMA
Version May 20, 2022
TYPE OF TRAUMA
✂ Severed
limb
limb
🫁 Chest
wound
wound
🫀 Evisceration
📌 Impaled
object
object
🔍 Foreign body
in orifice
in orifice
🩹 Compressive dressing
on the victim's wound
on the victim's wound
🧊 Apply ice
to the injury
(with towel)
to the injury
(with towel)
🫧 Rinse the severed limb
thoroughly
thoroughly
🛍 Place the limb
in a sealed plastic bag
in a sealed plastic bag
🛍❄ Place in a second bag
containing ice or cold water
(never direct ice)
containing ice or cold water
(never direct ice)
⏱ Note the time
of the incident on the bag
of the incident on the bag
🔍 Check for absence of hemorrhagic
wound on the back
(with 2 responders)
wound on the back
(with 2 responders)
🩹 Dressing sealed
on 3 sides only
(non-occlusive — one-way valve)
on 3 sides only
(non-occlusive — one-way valve)
💨 High-flow O₂
(100% mask)
(100% mask)
🚫 Never reintroduce
the viscera into the cavity
the viscera into the cavity
🩹 Opaque moist dressing
+ plastic bag
that can contain the viscera
+ plastic bag
that can contain the viscera
💨 High-flow O₂
(100% mask)
(100% mask)
Does the victim report
pain upon removal?
pain upon removal?
YES
Leave the object
in place
in place
Sterile gauze
around it
to stabilize
around it
to stabilize
NO
Remove the object
carefully
carefully
Compressive
dressing
dressing
💨 High-flow O₂
(100% mask)
(100% mask)
Can the foreign body
be removed with fingers?
be removed with fingers?
YES
Remove the object
with fingers
with fingers
NO
Leave in place
+ sterile gauze
around it
+ sterile gauze
around it
💨 High-flow O₂
(100% mask)
(100% mask)
In all cases — Common actions
🌡 Cover the victim
warm / aluminum blanket
warm / aluminum blanket
📊 Reassess
vital signs (ABC)
vital signs (ABC)
📞 Hospital
via 911
via 911