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ASSESSMENT AND INITIAL
MANAGEMENT OF
TRAUMA PATIENT
Tim Diklat IRD RSSA
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OVERVIEW
- SIX STAGES OF AN AMBULANCE CALL.
- TRAUMA ASSESSMENT.
- PRELIMINARY ACTIONS AT THE SCENE
- PATIENT ASSESMENT AND MANAGEMENT
- CRITICAL INJURIES/CONDITION.- SECONDARY SURVEY
- REASSESMENT SURVEY.
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SIX STAGE OF AN
AMBULANCE CALL.
1. PREDISPATCH.
2. DISPATCH.
3. TRAVEL TO SCENE
4. ACTIONS AT THE SCENE
. TRAVEL TO THE HOSPITAL
!. ACTIONS AT THE HOSPITAL
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SCENE SURVEY
1. ASSESS FOR HA"ARDS
2. EXTRICATION RE#UIRED.
3. NOTE MECHANIMS OF INJURY.
4. NOTE NUMBER OF VICTIMS.
. RE#URIES ANY ADDITIONAL HELP NOW!
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HA"ARDS
$ LOO% BEFORE YOU LEAP $
. PAR% VEHICLE IN NEAREST SAFE PLACE.
- IS IT SAFE TO APPROCH VICTIM &
- IS SPECIAL E#UIPMENT NEEDED &
- IS IMMEDIATE MOVEMENT OF VICTIM INDICATED
&
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SAFETY FIRST
YOUR FIRST
RESPONBILITY IS TOTA%E CARE OF YOURSELF
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ESSENTIAL E#UIPMENT
1. PERSONAL PROTECTION E#UIPMENT.
2. LONG BAC% BOARD
3. CERVICAL COLLAR.
4. AIRWAY E#UIPMENT - OXYGEN
- SUCTION.
. TRAUMA BOX.
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ASSESSMENT AND INITIAL
MANAGEMENT
1. PRIMARY SURVEY - ABC'.
2. TRANSPORT DECISION AND CRITICAL
INTERVENTIONS
3. SECONDARY SURVEY
4. REASSESSMENT SURVEY.
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PRIMARY SURVEY
- RAPID HEAD -TO-FEET EXAM.
- FOCUS ON IMMEDIATE LIVE THEATENING
CONDITION.
- SHOULD TA%E NO LONGER THAN 2 MINUTE.
- STOP SURVEY ONLY FOR AIRWAY OBSTRUCTION
OR CARDIAC ARREST.
- CONTROL MAJOR BLEEDING DURING THIS TIME.
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PRIMARY SURVEY
-TOTAL OVERVIEW OF PATIENT SITUATION
WHILE YOU APPROACH.
- AIRWAY( C-SPINE CONTROL.( AND LOG ROLL.
- BREATHING.
- CIRCULATION
- CONTROL HEMORRHAGE.
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WHEN PRIMARY SURVEY
COMPLETED...
. TRANSFER PATIENT TO BAC%BOARD
- CHEC% BAC%.
- MA%E TRANSPORT AND CRITICAL DECISIONS.
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TRANSPORT DECISION
AND
CRITICAL
INTERVENTIONS.
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LOAD AND GO SITUATIONS
- TRANSPORT THESE PATIENTS IMMEDIATELY )
- ABNORMAL RESPIRATION
- ABNORMAL CIRCULATION - SHOC%.
- UNCONTROLLABLE BLEEDING
- DECREASED LOC
- TENDER ABDOMEN
- PELVIC INSTABILITY
- BILATERAL FEMUR FRACTURES
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IN $ LOAD AND GO*
SITUATIONS+..- ON-SCENE INTERVENTIONS ARE LIMITED TO
CORRECTING IMMEDIATE THREATS TO LIFE , - AIRWAY
- DECOMPRESS TENSION PNEUMOTHORAX.
-CONTROL MAJOR BLEEDING.
- ALL OTHER INTERVENTIONS SHOULD TA%E
PLACE ENROUTE TO HOSPITAL
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SECONDARY SURVEY
- DETAILED EXAM
- PROVIDES BASELINE FOR FUTURE DECISIONS- SPLINT FRACTURES
- DRESS WOUNDS
- RECORD YOUR FINDINGS.
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SECONDARY SURVEY
- VITAL SIGN
- HISTORY
- HEAD-TO-TOE EXAM
- FURTHER BANDAGING AND SPLINTING
- CONTINUALLY MONITOR
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HISTORY OF INJURY
- S YMPTOMS- A LLERGIES.
- M EDICATIONS
- P AST MEDICAL HISTORY
- L MAST MEAL
- E VENT PRECEDING THE INJURY
- SOURCES OF INFORMATION
- PERSONAL OBSERVATION.
- PATIENT BYSTANDRES
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NEUROLOGICAL EXAM
LEVEL OF CONSIOUSNESS
A - ALERT
V - RESPONSE TO VERBAL
P - RESPONSE TO PAIN
U - UNRESPONSIVE
MOTOR
SENSATION
PULSATION
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REASSESSMENT SURVEY
- PURPOSE,
- TO MONITOR FOR CHANGES IN PATIENTS
CONDITION.
- PERFORM ,
- EVERY 1 MINUTES DURING TRANSPORT
- E0 5670' 89 PATIENTS CONDITION
WORSENS
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REASSESSMENT SURVEY- LOC
- AIRWAY
- BREATHING
- RATE #UALITY
- CHEC% FOR JVD TRACHEA POSITION
- LISTEN FOR BREATH SOUNDS
- CIRCULATION
- PULSE RATE AND #UALITY
- BLOOD PRESSURE
- S%IN CONDITION
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REASSESSMENT SURVEY
. CHEC% ABDOMEN
- ASSESS ANY PERTINENT FINDING
NOTE IN PRIMARY OR SECONDARY SURVEY
- CHEC% INTERVENTIONS
- INTUBATIONS
- DRESSINGS
- SPLINTS
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COMMUNICATIONS WITH
MEDICAL DIRECTION
- EARLY CONTACT- CONCISE AND TO THE POINT
- DESTINATION AND E'7:70; 98 T0 A:<
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SUMMARY. PRELIMINARY ACTIONS AT THE SCENE
- SCENE AND PERSONAL SAFETY
- MECHANISM OF INJURY
- PATIENT ASSESSMENT AND MANAGEMENT
- PRIMARY SURVEY
- CRITICAL INJURIES/CONDITIONS
- TRANSPORT DECISION
- SECONDARY SURVEY
- REASSESSMENT SURVEY
- CONSTANT MEDICAL DIRECTION AT HOSPITAL
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THAN% YOU