Basics

Tuesday, January 24, 2023 19:25

What is trimodal destribution of trauma??

Immediate death - 50%
Occur at the site
Due to head injury , severe cardiopulmonary insult
Early deaths - 30%
Occurs from minutes to hours
This is when platinum 10 mins and golden hour is
important
Platinum 10 mins - pre hospital care should be
given
Due to failure of oxygen delivery
Respiratory failure
Cardiac failure
Late deaths - 20%
Due tp
Sepsis and MODS

ABCD approach

Wide bore cannula insertion

Responders , Transient responders and non responders

Grades of haemorrhage - Baskett classification

Ordering Blood
Group specific blood - 10 mins (for transient responders)
Cross matched blood - takes about 1 hour

ABCDE appraoch
Whats assesed in Disability
Mainly GCS and pupils

Whats checked in exposure ?

Exposure with Environmental control
"Strip , Flip , tocuh and smell"
Undress
Log roll
Minimum of 4
1 for C spine stability
2 for body rolling
1 for exmiining the spine
Perineum for injuries

What are adjuncts to primary survay ??

Portable radiographs
CXR , X Ray pelvis

FAST
If the patient is unstable - after primary survay
Otherwise after secondary survay

Bleeding - need 200 mls

Hepatorenal pouch
Around spleen
Right paracolic gutter , left paracolic gutter and
pelvis

Secondary survay
Done in stable patient after primary survay
To identify missed injuries
AMPLE hx
Head to tow examination