Trauma presentation
Transcription
Trauma presentation
What is trauma? Trauma assessment !" # " $%&!' " Major Trauma Trimodial distribution of death ( )* $ ! + + - , 5 # .67' $8 + + /9 + + .) ) 0 1 / 1+ + .3 + " , " $& 2*/ + *2 + ++ Body’s response to trauma ! + 7 * + $ 87 9 = + " 4 : ;< $78 9 + !%>4 &1 4 Types of injuries + + 8 8 + + + ?+ & + ; ? ++ + + + + $ > # ' + # ' 8 + + + > 8 + ( " # ' @ + 5 4 4 + 5 1 Patterns of injury Mechanism of Injury 8 $ B + + ) 1 A + : Mechanism of Injury @ Mechanism of Injury 4 $ 8 + 4 C $ 0 ; < + - Mechanism of Injury $ + Mechanism of Injury + + ! + $ + 8 + , + + -+ $ D + , 4 2 Blunt trauma caused by kinetic energy C # ' + Blunt trauma caused by kinetic energy ! 5 < + 4< E E 8 + + + 4+ # + 4 Blunt trauma caused by kinetic energy $ + ' Blunt trauma caused by kinetic energy $ 5 # 5 ' 8 Blunt trauma caused by kinetic energy $ Blunt trauma caused by kinetic energy $ + 5 + E + 4 5 4 + 3 Blunt trauma caused by kinetic energy Blunt trauma caused by kinetic energy $ 5 + 0 ++ 4 + -+ 4 + ++ + + + 4 + ++ + Blunt trauma caused by kinetic energy 5 4 Blunt trauma caused by kinetic energy ! 4 -+ + -+ , 0, Motor vehicle collision $ Head-On (Frontal) Impact + + " % 8 > + + 8 > 5 + $ 7 $+ + + + ? ( & & & % + + 1 A+ 4 Down-and-Under Pathway % Lateral Impact " + C A++ 5 5 + 8 + & ! + Rear-End Impact " 5 % ) + 5 + % > 1 F 1 + F1 8 ! G+ ++ ) E Rollover Accidents % + Rotational Impact &+ ; & + Restraint use + (+ 5 + + ! + ) + ! + + ; + 5 Considerations for Infants & Children: Restraint Injuries: ( 5 < 0 + + + + 4 + 4 % Head Injuries + ? 5 ; @ + + + + ; " H + Deceleration Injuries + 5 A + 5 + 5 + 8 + %+ ; @ # + + 5 ' @ ( Thoracic Injuries Abdominal Injuries + # A 5 ' &+ + - 6 Thoracic Injuries Abdominal Injuries ; ( + + " ? + - + + ; I ( &+ + J Other Vehicular Collisions ) ! K > ! # $" ' + 4 4 5 Motorcycle Collisions ? ) + & 5 8 ? ; > Motorcycle Collisions + & 5 4 Motorcycle Collisions ( 5 ; ! %+ 4 > 4 > 7 Personal Protective Equipment Pedestrian Injuries & + @ ( 0 ? )+ @ + 5 + 5 4 ? 7 9 L Pedestrian Injuries + 5 Adult Pedestrian 8 ! ( + + + + ? + + + $ " Child Pedestrian + Wadell’s Triad of injuries $ % + + + $ + 8 Vertical Falls 0 Falls + 8 1 @ + $+ ? 1 + + > " + + + Landing Feet First (Don Juan Syndrome) + M 1 : M C > ?+ + + M M M Landing Head First + M M M + > @ ; 8 E M M M + M 5 M Landing Arms/Hands First 8 @ E 8 > Assessment: IN + ? J $ I ! J % ! & - + + 9 Death from Injury- Peak 1 Peak 2 “The Golden Hour” 8 ) ? ;< ? # 4 + ' 5 4 7/9 + /9 + Injury kills in reproducible time frames! Peak 3 % 5 5 @ ! :- + 5 ) + B 5 + /9 B 5 B 5 8 8 5 -+ 8 + Principles of assessment Principles of assessment $ &+ + + + B + + 1 + 10 Primary Survey $ Primary Survey + + 4 $ + $ + 5 8 + + + @ ; 7 1 0-+ * / 8 B , - # Airway and C spine stabilisation 4 ' ++ Airway and C spine stabilisation + 5 + , ++ $ 0 7 , ( 5 + - ! * + 8 + B B + ! ) + + , > 0 > M M / M Airway and C spine stabilisation – cont. ( 5 # ' 4 5 7 & 4 -4 - Airway and C spine stabilisation – cont. > * + 8 / 4 M + M M M ? M 5 M M + < < + - 4 + + - , 11 Airway and C spine stabilisation Breathing and oxygenation $ % + + $ + B $ + 8 + 4 B 4 + ! K $ 0 0 E 4 4 + + + B B + 4 + Breathing and oxygenation Breathing and oxygenation – cont. 0-+ ( 58 > $ 7 ( B 4 4 + * > + ; A + : 1 > Breathing and oxygenation – cont. , @"! + ; + + Breathing and oxygenation – cont. " + + ++ ++ + 4 -) 0$$+ $ ( ( %+ + - + - 4 0$;% - 12 Circulation and control of external haemorrhage $ + Circulation and control of external haemorrhage B ( 5 4 + 4 + + ? + + + 8 % 5 ( < 5 + # + ' + ;+ + + + Circulation and control of external haemorrhage ( 8 ! + Circulation and control of external haemorrhage > 8 5 + + + + + + 4B 4 + 4 + 4 + + + Circulation and control of external haemorrhage Circulation and control of external haemorrhage + + # B 4 ' 13 Circulation and control of external haemorrhage Circulation and control of external haemorrhage 8 & ; 1 M M - M + : + M < 0 " ; /9 + M *) O M M 5 , /)7 9 % ; .9 ' 4 , 5 M ) E # ; ? + M > $ 4 Disability :brief neurological examination Circulation and control of external haemorrhage ; 8 +- > + + + @ % + 4 + + B Disability :brief neurological examination $ ++ H4 $ + + + E B "A 8 Disability :brief neurological examination $ N ; # N; ' + + 5 4 4 + + & + & + + 14 Exposure with environment control 0-+ + + ; + + E 4 % ++ $ + + + Exposure with environment control + 4 01 4 + ++ 4 B + 4 E + C + 4 + 4+ Secondary Survey + Secondary Survey ) ) % + % 0 + + 5 + 5 1 + + + + F = Full set of vital signs/five interventions G = Give comfort measures + 4 8 " $ ; A N ( > # +% ' # ' + 15 H = History H = head – to – toe assessment ! ( 5 ; ! (0 4 4 4 4 4 H 4 4 ++ ! + & 4 5 ? + > : 4 4 + +) ) + H = head – to – toe assessment " ! $ # " ! ! H = head – to – toe assessment ! ( 5 + + 4 4 + + 5! + 4 + -+ ( + ( 5 > 0 + + 4 4 + 4 + A 4 % - 4 + 4 + 4 + + 4 4 & H = head – to – toe assessment ! 4 4 ! + > $# + ' 1 (# ' + + + 4 + + ! & 4 0 ;$ ! 4 ++ - 4 4 + # + ' + > 4 + # ( 5 B B 4 + + B - + + + ( > + + 4 4 4 + H = head – to – toe assessment ( 5 4 > 4 5 4 + + + + + + 4+ + + 4 + + + + 16 H = head – to – toe assessment ' & H = head – to – toe assessment ! ; 5+ ++ + ( 5 # - 4+ 4 4 4 4 4 1 ; 5 H 4 + ; B + 8) + 4+ + > + 4 - 4 + 4+ 4+ 4 4+ + + 4 # + ' Tertiary Survey Tertiary Survey ) ) - 4 4 - + + E : 4 ;A $ + + ( 5 + > ! + ; + ++ + 4 ! # ! 4 + + + B E + ++ * 4 + + + K + + ++ ) References $ 5 41 .67D$ 8 6)7/ ; 4 4= %E& 4N # .' $ ; 4N K 54 ! C 4( ! 4 = @ 4 # 7 '4# +O6) 2*' 8; ( N 4C # 2' 0 + C; ; & 4= K > +# 0 '40 4# +2 O)27 ' 8! > 4N # 0 ' # 6' 0 $ + + + # * '4 8; ( 0 ! 4< 4> 4 4= 4K # 0 ' # 7' ?$( @ + + ++ # / ' ( 8! 0 @ +8: : " : $ : 4K4= +# 0 41 4 5 '4; ; 4C 4& + > 0 4$ # 2' ! '40 4( = ; 4 # 0 '# 4! 0 4; = ( 4@ # 0 '# ; 8! 0 C; 4# +O.7)2 /' ' ;;;<E ; ; & 4= K 8! # '0 17