Trauma Call. Primary Survey “ABC’s” Airway Maintenance Maintain C-spine protection Verbal or Non-verbal Altered mental state: most common cause of intubation.

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Presentation transcript:

Trauma Call

Primary Survey “ABC’s” Airway Maintenance Maintain C-spine protection Verbal or Non-verbal Altered mental state: most common cause of intubation. GCS < 8. Rapid sequence intubation OK vs Intubation vs cricothyroidotomy

Breathing Chest Inspection Auscultation and percussion Hypoxia or Hypercarbia, check ABG Intervention: O 2, chest tube

Circulation Clinical Assessment: level of consciousness, skin color, pulse then BP Bleeding = direct pressure Hypotension = hypovolemia 2 large bore IV’s give 1L of LR x 2 (peds 20cc/kg x 3)

Disability Neurologic assessment Level of consciousness: Alert, Vocal Stimuli, Painful stimuli, Unresposive or GCS Motor or sensory deficits Deterioration

Exposure/Environmental Control Trauma shears Warm Blankets Adjuncts EKG, Catheters, Monitors, X-ray, Radiology

Secondary Survey History Allergies Medications Past medical/surgical hx, Pregnancy Last meal Events leading to injury

Physical Exam Head: scalp, ocular mobility and acuity, ears, CN’s Face: maxillofacial fractures, malocclusion C-spine: dual examiner assessment, x- rays and CT Chest: clinical, x-rays, tube check, mediastinum Abdomen: clinical, FAST, DPL, CT

Head: scalp, ocular mobility and acuity, ears, CN’s Back: stepoffs, tenderness, rectal exam, prostate, perineum, genitalia Pelvis: stable vs unstable Musculoskeletal: contusions, deformity, pulses (ankle-brachial index), consider blood loss Neurologic assessment