ATLS 10th Exam 2023

Primary survey - (A) Airway with cervical spine protection (restrict) (B) Breathing and ventilation (C) Circulation - stop the bleeding (D) Disability - neurological status (E) Exposure - undress and environment (temp control) REPEAT IF ANYTHING GOES WRONG Secondary survey - (A) Allergies (M) Medications (P) PMH and Pregnancies (L) Last meal (E) Environment and Events 3-3-2 Rule - 3 finger lengths between upper and lower incisors 3 finger lengths between hyoid and chin 2 finger lengths between thyroid notch and floor of mouth LEMON - (L) Look (visualize) (E) Evaluate 3-3-2 Rule (M) Mallampati (tongue obstruction) (O) Obstruction (N) Neck mobility MIST - (M) Mechanism (I) Injury pattern (S) Signs (T) Treatment given Rapid assessment - Initial assessment lasting 10 seconds - Touch the patient - Identify yourself - Ask the patient's name - Ask what happened Massive transfusion - - 4 units over 1 hour - 10 units over 24 hours Urine output goals - Adults - 0.5 ml/kg/hr Kids - 1.0 ml/kg/hr Infants - 2.0 ml/kg/hr Urine output goal in electrical injury - 1-1.5 ml/kg/hr in all ages Basilar skull fracture classic findings - - Rhinorrhea - Otorrhea - Hearing loss - Facial paralysis Burn fluid resuscitation formula - (2ml x ?kg x ?TSBA) ÷ 2 ÷ 8 How many people needed to log roll? - 4 Classes of hemorrhagic shock - Class 1 (0-14% blood loss) - no hemodynamic changes. - no treatment necessary. Class 2 (15-30% blood loss) - ↔/↑ HR - ↔ BP - ↔ RR - ↔ UO - Crystalloids and +/- blood