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1 Early Management of Trauma Patient in The Hospital
1 Early Management of Trauma Patient in The Hospital
Triage categories
Red ( critical) Yellow(semi critical) Green(non critical) Black
Red
Major trauma Life threatening conditions Shock states Airway compromise Severe respiratory distress Seizuring patient
Coma Head injury Severe crush injuries to limbs Burn to more than 25% BSA Gun-shot wound
Yellow
Altered conscious level Head injury Fractures Dislocation of major joints Spine injuries Eye injuries
Limb amputation Burn 15% - 25% of BSA Vascular injuries Uncontrollable major bleeding Severe pain
Green
Close fracture of upper limbs or ankle Dislocations of small joints Burns <15% of BSA Head injury Bruises Simple lacerations or cuts Controllable bleeding
Trauma team
Trauma team leader Primary resuscitator Airway manager Respiratory technician Assistant Trauma nurse Recorder
Primary Survey
A B C D E
Airway
Suctioning/Mechanical removal Chin lift/jaw thrust maneuver Oropharyngeal/Nasopharyngeal airway Endotracheal intubation Surgical airway Tracheostomy
Breathing
Inspection Palpation Percussion Auscultation
Circulation
External haemorrhage-direct pressure Internal haemorrhage-skin colour, pulse, blood pressure 2 large bore IV lines Fluid resuscitation
Disability
Level of consciousness-GCS -Eye opening(4) -Best verbal respone(5) -Best motor response(6) Pupillary response Movement
Exposure
Radiographs
Lateral cervical spine x-ray Anteroposterior chest x-ray Anteroposterior pelvic x-ray Extremity x-ray
Imaging
FAST CT angiogram CT scan of head CT scan of abdomen CT chest
Secondary Survey
History-A M P L E Head to toe examination
References
The trauma manual-trauma and acute care surgery, Lippincott Williams and Wilkins 3rd edition Bailey and Loves Short Practice of Surgery 25th edition Sabiston 18th edition, volume 1 Emergency Medicine News September 2010 www.medscape.com/emedicine