Multiply injured patient Flashcards
Femoral fractures -> what splint
Thomas splint
Trauma network vs major trauma centers.
Trauma network = all spots, pre hosp services, small and larfe treana centers and rehab. Major trauma centre = multi-speciality care to seriously injured patients. Optimised for trauma care provision. If can be there in 10 mins fab, otherwise is the golden hour.
What is the method?
Dr(ccc, catastrophic haemorrhage,call for help,c-spine)ABCDE(g-glucose). Trauma team get pre-alert, and then ATMIST handover from paramedics (Age, time of injury, mechanism of injury, Injuries sustained, Signs and symptoms, treatment)
ATLS vs BATLS
ATLS = advanced life support
BATLS = for battlefield, includes checking for cat hem beforehand.
When do we assume c spine?
If mechanism would suggest. Lowering neuro response. Unconscious/reduced conscious level, neurological signs.
Primary vs secondary survey:
primary – abc -> immediate threats to life. Secondary = injuries and more detailed history.
What do we do on breathing?
RIPPAS. Note EEE -> Effort (RR, wheeze, accessory muscles), Efficacy (tracea, percussion, air entry), effect (stats, cyanosis)
What are the signs of flailed segment?
Ribs move inwards instead of outwards when you breath in -> rib snapped in 2 .
5 spots for blood loss:
pelvis, abdo, thorax, floor, long bones (femur)
Rti -> pelvis, need to use what?
Pelvic binder
What do we do for circulation
Get IV access, HR, pulse, BP, narrowed pulse pressure, urine output, confusion. Check haemoglobin, lactate, ultrasound/ct imaging to look for blood loss. If IV is difficult can give blood IO (into bones). Hypovolaemic patients give blood not crystoloid where you ca.
What is permissive hypotension?
Giving enough fluid to perfuse vital organs but not achieving normal bp as this can disturb developing clot
reach 6 or 4 units, add what in fluids ->
clotting factors and platelets
What is the lethal triad?
Acidosis, coagulopathy and hypothermia
– What do we do in D?
AVPU
– GCS
– Pupils
– Tone and reflexes
– Log roll