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