Intro and importance of triage and prioritisation Flashcards
What are the considerations when triaging a patient?
Chance of survival
Quality of life afterwards
Resources required
What is triage?
Considering which ‘systems’ are affected to direct therapy
What factors contribute to an effective triage?
Experience/knowledge
A plan/lack of a plan
Stress/anxiety
Leadership and communication skills
Agile decision making
You are presented with a RTA with a haemoabdomen and pulmonary contusions.
What problems are there? How will they present? How will you diagnose them?
Hypovolaemia:
- Lowered rectal temperature, increased pulse rate with reduced quality, pale mucous membranes and prolonged capillary refill time.
- POCUS (point of care ultrasound)
Pulmonary contusions:
- Increased respiratory rate and total effort, cyanosis
- POCUS
Reduced perfusion with oxygenated blood:
- Neurological depression
- BP, lactate, blood gas analysis
What is GFAST assessment?
Global focused assessment - scan and assess the entire body to avoid missing pathologies
What should you check in a primary survey?
TPMR - temp, pulse, MMs, resp rate
POCUS (GFAST)
BP - how aggressive fluids need to be
Neuro assessment
Pain assessment
Why should NSAIDs be used carefully to treat pain in trauma patients?
NSAIDs are prostaglandin inhibitors in a hypovolaemic animal this could further worsen renal perfusion
What is included in a secondary survey
Further diagnostics e.g., blood glucose, ECG, Acid-base etc.
Focused exams e.g., focused neuro/spinal exam, focused ophthalmic exam (check for brain injury), focused organ ultrasound etc.
What is included in a tertiary survey
Full clinical exam
Full history
Imaging/radiography
Other diagnostics e.g., haematology, biochemistry etc.
Why are X-rays reserved for the tertiary survey
Requires physical or chemical restraint - can tip unstable patients over the edge
Only exception = GDV - always radiograph first
