Trauma 1: initial management Flashcards
What types of injury are there?
soft/hard tissue: High velocity low velocity blunt explosive penetrating
what complications can arise?
Immediate: airway and haemorrage
early: infection
late: facial deformity or functional problems
Principles of trauma management
Primary survey: ABCDE and cervical spine secondary survey: whole body treat any life threatening problems stabilise transfer
c spine injuries?
3-5% occurence
less likely to die from neck injuries but more likely to if hypoxic
ASSUME ALL PATIENTS HAVE NECK INJURY UNLESS PROVED OTHERWISE
how to manage c-spine injuries?
manual immobilisation
cervical collar
boards/head blocks
What airway measures exist?
clear airway of debris and foreign material chin lift/jaw thrust oropharyngeal (guedel) airway intubation surgical airway tongue stitch
airway maintenance?
chin lift
jaw thrust
oropharyngeal airway
nasopharyngeal airway
definitive airway?
nasotracheal airway
orotracheal airway
surgical- cricoidotomy or thyroidotomy
inidications for definitive airway?
Need for airway protection:
unconcious patient
sever maxillofacial surgery
risk for aspiration: bleeding or vomiting
risk of obstruction: neck haematoma, laryngeal or tracheal injury or stridor
inidications for definitive airway?
need for ventilation:
apnoea: neuromuscular paralysis, unconscious
– Inadequate respiratory effort – Tachypnea,
hypoxia, hypercarbia, cyanosis
– Severe closed head injury with needs for
hyperventilation
effects of flail mandible?
no forward support from the mandible leading to airway obstruction from the tongue
haemorrage?
issue in neck due to great vessels
apply pressure and prompt operative intervention
first aid measure?
wound debridement
analgesia
antibiotic
wound debridement?
Irrigation • Removal of foreign bodies • Removal of necrotic tissue • DON’T THROW ANYTHING AWAY UNLESS ITS DEFINITELY DEAD! • Dress with saline or antiseptic soaked gauze.
post op wound management
warm moist state • To absorb or contain any superficial bleeding or inflamatory exudate • To protect delicate healing tissue • To apply pressure to prevent haematoma • To conceal wounds from view
