I have given some of the content in Red useful for general public and if you are not a doctor and do not want to know all these, at least go to the end of the blog and read the sentence in red and see if you can do it!
Initial
Assessment and Management
Roadside
12
year old girl with headache and arm pain
65
year old grandfather with bilateral shoulder and arm pain
38
year old mother screaming in agony
45
year old father dead on arrival to a local hospital
A
Middle aged man
History
of RTA
Brought
with
Pulse
90/mt
BP
140/90mm Hg
RR
25/mt
The
sixteen year old
RTA
in Vayalur Road
Rings
his parents at 5 PM
Taken
to few hospitals before
Brought
to Kauvery
Not
very alert
Initial management of Trauma
is different
to
what we learn in our Medical Schools where we are taught to take a detailed history, do examination and investigate and then come to a diagnosis before treating a patient
Why
Multiple
casualties
Do
not want to miss Important injuries
Do
not want to miss important injury until it is too late
Do
know how to be safe to yourself
It
is OK to Call for Help
Standard
Precautions
Cap
Gown
Gloves
Mask
Shoe
covers
Goggles/face
shields
The following is a synopsis of what you do in an emergency of trauma
The
quick ten second assessment for anyone to follow on the roadside and at initial contact
I
am " " and
What
is your name
Tell
me what happened
If you get answers to the two questions, we can relax a bit as the airway is ok at present and not in severe shock or head injury
If you get answers to the two questions, we can relax a bit as the airway is ok at present and not in severe shock or head injury
Airway
and Cervical Spine
worry about the airway if
Patient
is not talking
Noisy
breathing
Secretions,
FB, Loose tooth
The
Chest is not moving
Get the airway sorted out first by
Establishing
A Patent Airway
or
or
Securing a Patent Airway
And How?
Establish
a patent Airway by Clearing
of Secretions and blood, ensure that theTongue
not falling back by pulling the chin forward but do not bend the neck backwards, and the safer method would be to do jaw thrust
Give
Oxygen
Adjuncts
B
for
And
the
Muscles
and nerves to control
How
to assess by looking for the
Symmetry
of chest movement
Respiratory
rate
Tracheal position
Percuss
and auscultate
Manage
B:what do you do
If
chest is not moving at all?
If
Chest is moving unequally?
If
Hyperresonant or dull to percuss and no air entry to one side?
C
for
Heart
Major
Vessels
Organs:
Brain, Heart, Kidney, skin
How
to assess
Heart
Rate
Blood
Pressure
Skin:
Colour, Sweating
Conscious
level
Manage
C
Restore
Volume and Control
Hemorrhage
IV
Access
Fluids
Blood
Put it all together
A-----------------------------With
----Cervical spine protection
B------------------------------
C------------------------------
Reassess
Be
ware in Children, pregnant women and Elderly
Be
ware of Pulse oximetry reading BP
D
Disability
D
for
Neurological
Evaluation
GCS
Pupils
Localizing
Neurological Signs
Serially
Assess for deterioration
E
for Exposure
/ Environment
Watch
for Hypothermia
Get the history as below
Get the history as below
A
Allergies
M
Medications
P
Past Medical/Surgical History/Pregnancy
L
Last meal
E
Events/Environment related to injury
Detailed assessment
History
Complete
head-to-toe examination
“Tubes
and Fingers in every orifice”
Complete
Neuro exam
Special
diagnostic tests
Reevaluation
Head
To Toe Examination
Head
Neck
Chest
Abdomen
and Pelvis and Perineum
Extremities
Spine
and Neurological examination
Communicate
with patient and others
Pain
management
Maintain
Records
Before
transfer
To
X ray
To
CT scan
To
theatre
To
ICU/Ward
Summary
Quick
Assessment and primary survey, use adjuncts
Treat
to correct the problem as you find
Complete
detailed assessment
Hope you found the above synopsis useful
Remember there are two life saving drugs in trauma, one is oxygen and the other is blood and both are available or should be made available widely. Oxygen is outside
but
Donate your blood and Do it today
Thank You
Warm Regards, Chockalingam
