critically injured patient
Download
Skip this Video
Download Presentation
Critically injured patient

Loading in 2 Seconds...

play fullscreen
1 / 25

Critically injured patient - PowerPoint PPT Presentation


  • 157 Views
  • Uploaded on

Critically injured patient. Prof Mohan de Silva. Essential words to remember. TRIMODAL distribution of deaths ATLS Primary survey Secondary survey. The Critically Injured. Trauma commonest cause of hospital admissions in Sri Lanka since 1995

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' Critically injured patient' - badu


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
critically injured patient
Critically injured patient

Prof Mohan de Silva

essential words to remember
Essential words to remember
  • TRIMODAL distribution of deaths
  • ATLS
  • Primary survey
  • Secondary survey
the critically injured
The Critically Injured

Trauma

  • commonest cause of hospital admissions

in Sri Lanka since 1995

  • commonest cause of death below the

age of 40 in many countries

the critically injured1
The critically injured
  • Majority died due to inadequate

treatment

  • Initial treatment determines the

outcome

  • Early intervention is essential
trimodal distribution of deaths
TRIMODAL DISTRIBUTION OF DEATHS
  • Immediate
  • 1st few hours
  • Few days after admission
conventional approach
Conventional approach
  • History
  • Examination
  • Investigations
  • Diagnosis
  • Treatment
slide11

New approach… A T L S

  • Initial assessment ( History,

Examination )

Resuscitation ( Treatment )

WILL BEGIN SIMALTANEOUSLY

  • Recognize and treat the most life

threatening injury first

slide12

TRAUMA KILLS ACCORDING TO A

SEQUENCE !

  • Acute airway obstruction

- The quickest killer

  • Inadequate breathing
  • Hypovolaemia
  • Expanding intra cranial

haematoma

slide13
Hypoxia and Hypovolaemia

are the main killers

  • Hypoxia kills before

hypovolaemia

slide14
PRIMARY SURVEY
  • SECONDARY SURVEY
initial assessment and resuscitation primary survey
Initialassessment and resuscitation Primary survey
  • Air way with cervical spine control
  • Breathing
  • C irculation
  • Disability (Neurological )
  • Exposure
  • Foleys catheter
airway obstruction recognition and treatment
Airway obstruction recognition and treatment
  • Identify – SPEAK TO THE PATIENT
  • establish OXYGEN
  • protect OXYGEN
  • maintain OXYGEN

10 L / minute

b reathing
B reathing
  • Inspection - wall movements,ext.

injuries etc

  • Palpation - cripitus
  • percussion - hyperesonence

or stony dullness

  • Auscultation - breath sounds

absent

RESPIRATORY RATE

c irculation
Circulation

All critically injured patients are in

hypovolaemic shockAction PULSE RATE , B P

  • 2 Big drips to Two big veins
  • 2 L of N Saline fast in
  • Blood cross matching
slide20

D isability (Neurological )

  • A V P U
  • Glasgow coma score
  • Expose the patient

Where is the scissor !

secondary survey
Secondary survey

Pulse - BP – RR -Temperature

  • Systematic examination from head

to toe

  • LOG ROLL
  • Finger to all orifices
  • Minor injuries
history a m p l e
HistoryA M P L E
  • A llergies
  • M edications
  • P ast illnesses
  • L ast meal
  • E vents leading to the injury
take home message
TAKE HOME MESSAGE
  • What is the first thing you do when you get a critically injured ?
  • What is the quickest killer of the injured?
  • What is trimodal distribution of deaths?
  • What is the difference between conventional and ATLS approach
  • What do you do in Primary and secondary surveys?
ad