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ABCs Evaluation of Trauma Patient. By Dr. Mahmoud Shehadah Al hariri Emergency Medicine Orthopedic surgery. Primary Survey. A irway & C -spine B reathing C irculation E xposure D isability . Secondary Survey . Mechanism of the injury Systemic evaluation Definitive treatment.

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abcs evaluation of trauma patient

ABCs Evaluation of Trauma Patient

By

Dr. Mahmoud Shehadah Al hariri

Emergency Medicine

Orthopedic surgery

primary survey
Primary Survey
  • Airway & C-spine
  • Breathing
  • Circulation
  • Exposure
  • Disability
secondary survey
Secondary Survey
  • Mechanism of the injury
  • Systemic evaluation
  • Definitive treatment
a irway and c spine control
Airway and C-spine control

Assessment

  • Ascertain patency
  • Immobilization of C-spine ; hard collar

sand bags

tape

slide5
A & C

Management

  • Chin lift Vs jaw thrust
  • Clear the airway of foreign bodies
  • Oropharyngeal or nasopharyngeal airways
  • Definitive airway ( intubation, LMV, Cricothyroidotomy…..)
slide10
A & C

NASO

ORO

b reathing
Breathing

Assessment

  • Expose the neck and chest
  • Rate and depth of respiration
  • Inspect and palpate the neck and chest
  • Percuss the chest
  • Osculate the chest bilaterally
slide23
B

Management

  • Administer high concentrations oxygen
  • Ventilate with a bag-valve-mask or face-mask
  • Attach an end-tidal CO2 and pulse oximetery

Attention to;

  • Alleviate tension pneumothorax
  • Seal open pneumothorax
  • Flail chest
end tidal co 2
End-tidal CO2

Qualitative

Quantitative

haemothorax
Haemothorax

Management

  • Chest tube
  • Indication of surgery

1500 ml once

200 ml/h

flail chest1
Flail chest

Management

  • Stabilization
  • Observation
  • Mechanical ventilation
pneumothorax1
Pneumothorax

Management

  • Simple ; observe
  • Tension ; needle insertion

chest tube

3-side patch (for 0pen,sucking)

c irculation
Circulation

Assessment

  • Pulse: presence, quality, rate, regularity, paradox
  • Identify source of external hemorrhage
  • Skin color ( extremities )
  • Blood pressure ( shock )
slide34
C

Management

  • Direct pressure to external bleeding site
  • Insert two large-caliber intravenous catheters
  • Obtain blood for Labs; Hct , cross-match and ABGs
  • Start rapid IV fluid ( RL , NS )
  • Pneumatic splints or PASG to control hemorrhage
  • ECG monitor
traumatic types of shock
Traumatic Types of Shock
  • Hypovolemic ( low CVP )
  • Cardiogenic ( high CVP )
  • Neurogenic ( low HR )
d isability
Disability

Assessment

  • Determine the level of consciousness using AVPU
  • Assess the pupils for size, equality and reaction
e xposure
Exposure
  • Completely undress the patient
  • Prevent hypothermia
mokazem com
MoKazem.com
  • هذه المحاضرة هي من سلسلة محاضرات تم إعدادها و تقديمها من قبل الأطباء المقيمين في شعبة الجراحة العظمية في مشفى دمشق, تحت إشراف د. بشار ميرعلي.
  • الموقع غير مسؤول عن الأخطاء الواردة في هذه المحاضرة.
  • This lecture is one of a series of lectures were prepared and presented by residents in the department of orthopedics in Damascus hospital, under the supervision of Dr. Bashar Mirali.
  • This site is not responsible of any mistake may exist in this lecture.

Dr. Muayad Kadhim

د. مؤيد كاظم

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