Presentation on theme: "Initial Assessment and Management"— Presentation transcript:
1 Initial Assessment and Management Presented byAbdulgadir F. Bugdadi
2 ObjectiveTo have a quick overview of the principles of primary and secondary survey.
3 Adjuncts to primary survey and resuscitation PreparationTriagePrimary SurveyResuscitationSecondary SurveyReevaluationDefinitive CareAdjuncts to primary survey and resuscitationConsider need for patient transferAdjuncts to secondary survey
5 What is the quickest way to assess the patient in 10 seconds ? A = Airway maintenance with cervical spine protection.B = Breathing and ventilation.C = Circulation with hemorrhage control.D = Disability “Neurologic status”.E = Exposure/Enviromental control.
6 Airway with Cervical Spine protection Ascertain patencyCare to prevent excessive movement of cervical spine.Equally important to recognize the potential for progressive airway loss.
7 Breathing and ventilation Airway patency does not ensure adequate ventilation.Examination.Injuries that can impair ventilation in the short term …
8 Circulation with hemorrhage control Circulation issues to consider include :1. Blood volume.2. Cardiac output.3. Bleeding.Hypotension following injury; hypovolemic.Elements of clinical observation :1. Level of consciousness.2. Skin color.3. Pulse (Pitfalls).Pitfalls:Elderly.Children.athletes.
9 Disability (Neurologic evaluation) evaluation composed of :1. Level of consciousness (GCS score).2. Pupillary size and reaction.
10 Exposure / Enviromental Control Completely undress the patient.Cover the patient following examination.
19 When ? …Head-to-toe evaluation of the trauma patient (History and physical examination) + Reevaluation of the vital signs.Complete patient evaluation require repeated physical examination.
20 HistoryAMPLE history.Blunt trauma, penetrating trauma and thermal injury history.
21 Examination Head : Laceration. Contusions. Fractures. Eyes : Visual acuity.Pupillary size.Hemorrhage of the conjunctiva or fundi.Penetrating injury.Contact lenses.Dislocation of the lense.Ocular entrapment
23 Abdomen :Exam. FAST, DPL or CT scan.Perineum / Rectum / Vagina :contusions, hematomas, lacerations ,rectal and vaginal examination.Musculoskeletal system :Inspection and palpation. (don’t forget the back).hand, wrist, feet fractures may not be diagnosed in 2ndry survey.(frequent reevaluation)
31 SUMMERY Preparation Triage Primary Survey Resuscitation Secondary SurveyReevaluationDefinitive CareSUMMERYAdjuncts to primary survey and resuscitationConsider need for patient transferAdjuncts to secondary survey