Trauma / ATLS Flashcards
ATLS
- Focus on threating the **greatest or most imminent Threat to life 1st **
- Lack of DX should not delay TX
- ABCDE approach
- Focus on second peak on the GODEN HOUR
Trimodal Distribution of Death
**Occurs on the ONE of THREE periods (or peaks ) **
First
Second
Third peak
Trimodal Distributio of DEath
First Peak
- Anticipate Death due to significan injury
Injuries happen seconds to minutes
Very few can surved
Trimodal Distributio of DEath
Second Peak
few mints to several hours
Golder hour
1st few hours
Trimodal Distributio of DEath
Third peak
days to weeks
Initial Assessment
**Primary survey **
ABCDE
Adjuncts primary survey and Resuscitation
Does pt needs transfer?
**Second Survey **
Field VS Hospital
Airway
Bleed control
Imobilization
Immediate transfer
**Communication is KEY **
Time of injury
Events leading to it
Mechanism of injury
Mecal surgical history
Multiple VS Mass Casualties
- **Multiple Casualty Incidents
> severity do not exceed facility capacity
> Priority:
Life threatening ; Multiple system injuries
**Mass Casualties
Exceed facility capacity : number and severity
> Priority :
Greates chance survival
least expenditute time and suply
PRimary Survey
Encompassing ABCDE of Trauma CARe
ABCDE can be done in 10 seconds or less
ABCDE
What is A
Airway
maitenance with Restriction of cervical Spine motion
ABCDE
B
**Breathing **and Ventilation
C
**Circulation **
Hemorrahe control
D
**Disability **
Assess neurological status
E
**Exposure **
ENviromental control
Primary survey adjuncts
Continue ECG
POx
CO2
ABG
urinary catheter: obtain retrograde urethral or perineal ecchmosis
**NGT/OGT: **decompansate
if injury place OGT
Airway Maintanance
- S/s airway obstruction
**Inspect : facial, mandibular, tracheal, laryngeal fx
**Restrict cervial spine - reassess for potential airway loss
** Intubate if GCS </= 8
B Breathing and Ventilation
> Patient airway does not guarantee proper ventilation
Monitor GAS EXchange : O2 delivery and CO2 elimination
Aduquate ventilation > proper lung function > chest wall and diaphragm in working
B Breathing
assessment
> Inspect:
Look for jvd, trachea, chest wall excursion
visual neck and chest
Ausculate :
gas flow both lungs
palpate for injury (No movements )
Percussion
C
Circulation
Assess for blood loss
Evaluate circulation with hemorrhage
Hemorrhage preventible death
Causes of shock in Trauma
Hemorrhage
Tensio pneumothorax
Tampnate
spinal and neuro shock
Tranexamic Acid
Antifibronic agent
Administered 3 hours of injury
Folow up 8 hrs if in field
