ABCs Evaluation of Trauma Patient
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By Dr. Mahmoud Shehadah Al hariri Emergency Medicine Orthopedic surgery
description
ABCs Evaluation of Trauma Patient. By Dr. Mahmoud Shehadah Al hariri Emergency Medicine Orthopedic surgery. Primary Survey. A irway & C -spine B reathing C irculation E xposure D isability . Secondary Survey . Mechanism of the injury Systemic evaluation Definitive treatment. - PowerPoint PPT Presentation
Transcript of ABCs Evaluation of Trauma Patient
By
Dr. Mahmoud Shehadah Al hariri
Emergency MedicineOrthopedic surgery
Primary Survey
Airway & C-spineBreathingCirculationExposureDisability
Secondary Survey
Mechanism of the injury
Systemic evaluation
Definitive treatment
AAirway and irway and CC-spine control-spine controlAssessment
Ascertain patency
Immobilization of C-spine ; hard collar sand bags tape
A & CManagement Chin lift Vs jaw thrust
Clear the airway of foreign bodies
Oropharyngeal or nasopharyngeal airways
Definitive airway ( intubation, LMV, Cricothyroidotomy…..)
Collar application
A & C ;patency
A & C ;FB
A & C ;airways
A & CNASO ORO
A & C ; ; Laryngeal mask
A & C;Tracheal Intubation
A & C; Surgical Cricothyroidotomy
A & C; Needle Cricothyroidotomy
BBreathingreathingAssessment
Expose the neck and chest
Rate and depth of respiration
Inspect and palpate the neck and chest
Percuss the chest
Osculate the chest bilaterally
BManagement Administer high concentrations oxygen
Ventilate with a bag-valve-mask or face-mask
Attach an end-tidal CO2 and pulse oximetery
Attention to;
Alleviate tension pneumothorax Seal open pneumothorax Flail chest
B
End-tidal CO2
Qualitative Quantitative
HaemothoraxManagement
Chest tube
Indication of surgery 1500 ml once 200 ml/h
Flail chest
Flail chestManagementStabilization
Observation
Mechanical ventilation
Pneumothorax
PneumothoraxManagement
Simple ; observe
Tension ; needle insertion chest tube 3-side patch (for 0pen,sucking)
CCirculationirculationAssessment
Pulse: presence, quality, rate, regularity, paradox
Identify source of external hemorrhage
Skin color ( extremities )
Blood pressure ( shock )
C ; compession
CManagement Direct pressure to external bleeding site
Insert two large-caliber intravenous catheters
Obtain blood for Labs; Hct , cross-match and ABGs
Start rapid IV fluid ( RL , NS )
Pneumatic splints or PASG to control hemorrhage
ECG monitor
Classes of Shock
Traumatic Types of ShockHypovolemic ( low CVP )
Cardiogenic ( high CVP )
Neurogenic ( low HR )
DDisabilityisabilityAssessment
Determine the level of consciousness using AVPU
Assess the pupils for size, equality and reaction
EExposurexposure Completely undress the patient
Prevent hypothermia
Revised trauma scoreRevised trauma score
NumberGlasgowSystolic pressure
Respiratory rate
413- 15 >8910 - 29
39 - 1276 - 89 >29
26 - 850 - 756 - 9
14 - 51 - 491 - 5
0300
تعليمات الوقاية من الكزاز >10
سنة 5-10 سنة
سنة 5> من
اخر لقاح
التمنيع غير معروف
جرعات 3>
نمط الجر
حذوفان الكزاز
نظيف ذيفان الكزاز ال شيئال شيئ صغير
ذوفان الكزاز
ذوفان الكزاز
غلوبولين ال شيئ مناعي +
ذوفان الكزاز
باقيالجرو
ح
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من • تقديمها و إعدادها تم محاضرات سلسلة من هي المحاضرة هذه , دمشق مشفى في العظمية الجراحة شعبة في المقيمين األطباء قبل
. . ميرعلي بشار د إشراف تحت• . المحاضرة هذه في الواردة األخطاء عن مسؤول غير الموقع
•This lecture is one of a series of lectures were prepared and presented by residents in the department of orthopedics in Damascus hospital, under the supervision of Dr. Bashar Mirali.
•This site is not responsible of any mistake may exist in this lecture.
كاظم. مؤيد Dr. Muayad Kadhimد
