ATLS Case Scenario CDEM Self Study Modules Approach to Trauma

ATLS Case Scenario CDEM Self Study Modules Approach to Trauma APPROVED BY: DEM Curriculum Home The Approach To... Specific Diseases DIEM Cases Downloads ML's Blog The Approach to Trauma WRITTEN BY: NICHOLAS E. KMAN, MD THE OHIO STATE UNIVERSITY EDITED BY: DAVID MANTHEY, MD WAKE FOREST MEDICAL SCHOOL Trauma is the leading cause of death in the first four decades of life in most developed countries. To this end, there are more than 5 million trauma-related deaths each year worldwide. Motor vehicle crashes cause over 1 million deaths per year. Injury accounts for 12% of the world's burden of disease. 1/13 "We have a motor vehicle accident 5 minutes out per EMS report." 47 year old male unrestrained driver, ejected 15 ft from car arrives via EMS. Vital Signs: BP: 100/40, RR: 28, HR: 110. He was initially combative at the scene, but now difficult to arouse. He does not open his eyes, withdrawals only to pain, and makes gurgling sounds. EMS placed a C-collar and Backboard, but could not start an IV. What do you do? CDEM Self Study Modules Approach to Trauma Objectives Upon completion of this self-study module, you should be able to: Perform an accurate rapid assessment with focus on ABCDE's Resuscitate and stabilize by priority Discuss secondary survey Head/ CNS Trauma Cervical Spine Chest Abdomen Musculoskeletal S - The Marketplace to Buy and Sell your Study Material Initial Actions Primary Survey CDEM Curriculum What initial actions should you take to care for the trauma patient? Assess the primary survey, with focus on ABCDE's Address problems with any portion of the survey before moving on Log roll the patient Xray and FAST Exam Secondary Survey Resuscitation and stabilization As with all of your patients, your assessment should always begin with addressing airway, breathing and circulation. Each problem is addressed prior to moving to the next priority (ie, manage airway prior to treating hemorrhage). A: Airway Maintenance with CERVICAL SPINE protection B: Breathing and Ventilation C: Circulation with hemorrhage control / shock assessment D: Disability: Neurological status E: Exposure/Environmental control Airway First you'll need to judge if the airway patent? Have the patient speak to you to establish patency and to evaluate for voice change and stridor Is there evidence of pooling secretions or cyanosis? While you may have an intact airway now, look for problems which may cause the patient to lose that airway in the near future. It is usually easier to act now before the airway is gone, then to deal with a patient who progressed to an inability to ventilate or oxygenate. facial injury causing obstruction or bleeding laryngeal fractures expanding hematomas GCS of 9 or less requires intubation If you feel the patient's airway isn't inta Dc ow t, nlo y a o du ed 'lb ly: n C e H e R d ISJ tA oYa | m ct a! Distribution of this document is illegal Want to earn $103 per month? Learn disposition