Trauma Flashcards
Preparation required for trauma management? OVERVIEW
- Assemble trauma team: nursing, medical, radiography, anaesthetics
- consider type of trauma (who needs to be contacted)
- establish plan A and B
- HANDOVER: MIST
what does handover MIST stand for?
- M = Mechanism of injury
- I = injury sustained
- S = signs (vital) at the scene
- T = treatment initiated
What is the primary survey in trauma patients?
C-A-E
- Catastrophic bleeding
- Airway & C-spine
- Breathing & Ventilation
- Circulation & Haemorrhage control
- Disability (neuro & pupils)
- Exposure (keep warm)
What is the secondray survey in trauma patients ?
GHIJK
- Get a set of vitals and gadgets
o complete set vitals
o x-rays chest, pelvis
o FAST
o splinting devices
o CT Scan
- History & head to toe
o history (AMPLE) —> Allergies, medications, past medical, last meal, events surrounding injury
- Jot it down
- Koffee & debrief
Trauma: A - Airway & C spine
Causes of complications?
Causes of Complications:
- Haemorrhage
- swelling (facial #/ burns)
- Secretions (blood, vomit)
- Foreign bodies (loose teeth)
- Decreased LOC
- Displaced tongue
Trauma: A - Airway & C spine
S + S of compromise
S + S of compromise:
- Change in voice (horse)
- Noisy breathing (strider, grunt, gurgling)
- Tachypnoea, dyspnoea
- Altered LOC
Trauma: A - Airway & C spine
Management
Management:
- 02
- Techniques —> jaw thrust/ chin lift
- adjuncts e.g. oropharyngeal geudel
- advanced airway e.g. ETT
Trauma: B - Breathing
Assessment?
Assessment:
- Spontaneous
- Chest wall integrity
- colour, rate, depth, symmetry
- accessory muscles
- pain, crepitus
- air entry, position of trachea
Trauma: B - Breathing
Management
Management:
- promote 02 & ventilation
- CxR
- Removal of abnormal blood or air
- analgesia if needed
Trauma: C - Circulation
Assessment?
Assessment:
- skin colour, temp
- cap refil
- pulse - rate & quality
- BP
- external bleeding
Trauma: C - Circulation
Management
Management:
- recognise, identify cause, stop
- x2 IVC, FBC
- FAST - Focused a do sonography in trauma
- Splints (pelvis)
- consider blood products
- warm everything
Trauma: D - Disability
Assessment?
Assessment:
- pupil size, equality reaction
- AVPU
- GCS
- Consider BGL
Trauma: D - Disability
Management
Management:
- urgent CT
- early neuro intervention
- prevent secondary TBI —>
good O2, BP
Trauma: E - Exposure
E: Exposure —> remove all clothing and examine body surface
Life threatening injuries:
Breathing?
- Tension pneumothorax
- flail chest
- open chest wound
- massive haemothorax
