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Evaluation of Trauma Patients in Emergency and Orthopedic Settings

Learn the ABCs of assessing trauma patients with an emphasis on airway, breathing, circulation, and exposure. Understand primary and secondary survey techniques, airway and C-spine control, breathing assessment, and circulation management. Gain insights into managing disabilities, pneumothorax, shock classes, and assessing consciousness. Developed by residents in the orthopedics department supervised by Dr. Bashar Mirali. Disclaimer: This lecture series is for educational purposes and any errors are not the responsibility of the website.

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Evaluation of Trauma Patients in Emergency and Orthopedic Settings

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  1. ABCs Evaluation of Trauma Patient By Dr. Mahmoud Shehadah Al hariri Emergency Medicine Orthopedic surgery

  2. Primary Survey • Airway & C-spine • Breathing • Circulation • Exposure • Disability

  3. Secondary Survey • Mechanism of the injury • Systemic evaluation • Definitive treatment

  4. Airway and C-spine control Assessment • Ascertain patency • Immobilization of C-spine ; hard collar sand bags tape

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

  6. Collar application

  7. A & C ;patency

  8. A & C ;FB

  9. A & C ;airways

  10. A & C NASO ORO

  11. A & C ; Laryngeal mask

  12. A & C;Tracheal Intubation

  13. A & C; Surgical Cricothyroidotomy

  14. A & C; NeedleCricothyroidotomy

  15. 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

  16. 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

  17. B

  18. End-tidal CO2 Qualitative Quantitative

  19. Haemothorax Management • Chest tube • Indication of surgery 1500 ml once 200 ml/h

  20. Flail chest

  21. Flail chest Management • Stabilization • Observation • Mechanical ventilation

  22. Pneumothorax

  23. Pneumothorax Management • Simple ; observe • Tension ; needle insertion chest tube 3-side patch (for 0pen,sucking)

  24. Circulation Assessment • Pulse: presence, quality, rate, regularity, paradox • Identify source of external hemorrhage • Skin color ( extremities ) • Blood pressure ( shock )

  25. C ; compession

  26. 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

  27. Classes of Shock

  28. Traumatic Types of Shock • Hypovolemic ( low CVP ) • Cardiogenic ( high CVP ) • Neurogenic ( low HR )

  29. Disability Assessment • Determine the level of consciousness using AVPU • Assess the pupils for size, equality and reaction

  30. Exposure • Completely undress the patient • Prevent hypothermia

  31. Revised trauma score

  32. تعليمات الوقاية من الكزاز

  33. THANKS…..

  34. 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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