10/22/24, 1:06 <font style="vertical-align: inherit;"><font style="vertical-align:
PM inherit;">Pre…
EMERGENCY UEMAS 1
RENATA RAUBER FELKL • ATM 192
PRE-HOSPITAL TRAUMA LIFE SUPPORT (PHTLS II)
Prof. Thyago Sew
A) AIRWAYA ND O NTROL O CERVICAL
• Toguarantee permeabilityof the VA
• Chin elevation in trauma: pull jaw forward, levading with the language.
• Traction fromthe jaw node trauma: thumb positioned on each bone zygomatic. Indicator and the finger average node angle fromthe
jawthere, what is pull to up.
• Removal of blood, s organicsubstances the bodies aresnot
• Immobilization the cervical
OROPHARYNGEALCANNULA
• Indications : sick incapable of keep VA permeable or prevent that the patient intubated bite the tube trhereal.
• Contraindications: sick consciousIs or semiconsciouses.
NULLCANNONS SUPRAGLOTICAS COMMON
• Mask a laríngand
• Alternative functional à itracheal intubation
• Inserted without direct view dthe vocal chords
• Independent of the patient positionnte
• Important and in trauma victimswith difficulty dand access or suspicion ofand cervical injury.
INTUBATIONTRACHEAL ION
• Isolate the VA e allow ventilation with FiO2 of 100%
• Todecrease meanscaptivatingly the risk of aspiringaction
• Makeiteasier toaspire deep action of the trachea
• Prevent gas inflation trick
• Allow via add onal of drug administration
• Indications : inability to proprotect the VA, insufficiency ofspiratory (not able)ue oxygenate and/or ventiling).
• Complications: try atgo repeated he can to take the hypoxemia, trauma of GO causing bleeding and edema, intubation do
mainbronchus right, intubation esophagealca, injury of cervical spine.
• No trauma: sniffer position, with cervical hyperextension
• With trauma: impossible ability to realize the position of sniffer for the largest difficulty.
• Hyperfle xion of C5-C6: possibility of fracervical structures in the traumabut
• Hyperextensions ion of C1-C2: second largest possible bility of fcervical raturasais no trauma.
# Intubation Pharmacologyally Assisted
- Sedatives or Analgesics: torelax sick, without abolishing reflexos of protection and aspiration. Midazolam, etomidate, fentanyl.
- Curarization after sedationão: generates parallelisia complete of muscles, retira os reflectxos of protection and causes apnea.
- Indicationses: need VA definitive and intubationthe difficult, sick not cwork (hypoxia, traa, hypotension, intoxicity).
- Complications: aspirationions and hypotension.
# Pipe Verification Tracheal
- Capnograph: standard-gold in sick with pulse. Doebefore in PCR no produce CO2, just serving as guide to
evaluate the effectiveness of compression thoracic. One tube with position incorrect, without recognition from the team, hecan
cause severe hypoxia, brain injury and death.
- Clinical evaluationthe direct view of the proasting through the ropes pier
- Murmuro vesicular bilatgeneral, com abusence of sonsa aerialthe andm epigastro.
- Chest expansion during ventilationlation
- Fogging in the tracheal tube on expiration (ccondensation of steam).
ALTERNATIVETECHNIQUES
# Percutaneous Ventilation Transtracheal
- Levels acceptedtable of CO2 for 30 minutes
- Reference points easily rrecognizable
- Complications: hypercapniathe (elimination of CO2 notvery effective), injury of andstructures vizinhas.
# CricothyroidismSurgical omy
- Last resourceso pre-hospital
- Indicationss: trauma facial extensive , inability of control GO with measure ofs less invasive, hemorrhagethe
tracheobronchiica persistent.
- Contraindications: lesions laryngotrwhoareyou, creatences < 10 years, laryngeal disease of traumatic originco or infectionsa.
about:blan 1/
k 4
PM inherit;">Pre…
EMERGENCY UEMAS 1
RENATA RAUBER FELKL • ATM 192
PRE-HOSPITAL TRAUMA LIFE SUPPORT (PHTLS II)
Prof. Thyago Sew
A) AIRWAYA ND O NTROL O CERVICAL
• Toguarantee permeabilityof the VA
• Chin elevation in trauma: pull jaw forward, levading with the language.
• Traction fromthe jaw node trauma: thumb positioned on each bone zygomatic. Indicator and the finger average node angle fromthe
jawthere, what is pull to up.
• Removal of blood, s organicsubstances the bodies aresnot
• Immobilization the cervical
OROPHARYNGEALCANNULA
• Indications : sick incapable of keep VA permeable or prevent that the patient intubated bite the tube trhereal.
• Contraindications: sick consciousIs or semiconsciouses.
NULLCANNONS SUPRAGLOTICAS COMMON
• Mask a laríngand
• Alternative functional à itracheal intubation
• Inserted without direct view dthe vocal chords
• Independent of the patient positionnte
• Important and in trauma victimswith difficulty dand access or suspicion ofand cervical injury.
INTUBATIONTRACHEAL ION
• Isolate the VA e allow ventilation with FiO2 of 100%
• Todecrease meanscaptivatingly the risk of aspiringaction
• Makeiteasier toaspire deep action of the trachea
• Prevent gas inflation trick
• Allow via add onal of drug administration
• Indications : inability to proprotect the VA, insufficiency ofspiratory (not able)ue oxygenate and/or ventiling).
• Complications: try atgo repeated he can to take the hypoxemia, trauma of GO causing bleeding and edema, intubation do
mainbronchus right, intubation esophagealca, injury of cervical spine.
• No trauma: sniffer position, with cervical hyperextension
• With trauma: impossible ability to realize the position of sniffer for the largest difficulty.
• Hyperfle xion of C5-C6: possibility of fracervical structures in the traumabut
• Hyperextensions ion of C1-C2: second largest possible bility of fcervical raturasais no trauma.
# Intubation Pharmacologyally Assisted
- Sedatives or Analgesics: torelax sick, without abolishing reflexos of protection and aspiration. Midazolam, etomidate, fentanyl.
- Curarization after sedationão: generates parallelisia complete of muscles, retira os reflectxos of protection and causes apnea.
- Indicationses: need VA definitive and intubationthe difficult, sick not cwork (hypoxia, traa, hypotension, intoxicity).
- Complications: aspirationions and hypotension.
# Pipe Verification Tracheal
- Capnograph: standard-gold in sick with pulse. Doebefore in PCR no produce CO2, just serving as guide to
evaluate the effectiveness of compression thoracic. One tube with position incorrect, without recognition from the team, hecan
cause severe hypoxia, brain injury and death.
- Clinical evaluationthe direct view of the proasting through the ropes pier
- Murmuro vesicular bilatgeneral, com abusence of sonsa aerialthe andm epigastro.
- Chest expansion during ventilationlation
- Fogging in the tracheal tube on expiration (ccondensation of steam).
ALTERNATIVETECHNIQUES
# Percutaneous Ventilation Transtracheal
- Levels acceptedtable of CO2 for 30 minutes
- Reference points easily rrecognizable
- Complications: hypercapniathe (elimination of CO2 notvery effective), injury of andstructures vizinhas.
# CricothyroidismSurgical omy
- Last resourceso pre-hospital
- Indicationss: trauma facial extensive , inability of control GO with measure ofs less invasive, hemorrhagethe
tracheobronchiica persistent.
- Contraindications: lesions laryngotrwhoareyou, creatences < 10 years, laryngeal disease of traumatic originco or infectionsa.
about:blan 1/
k 4
