ملخص من عمر سعد/طب تكريت
Trauma
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•Trauma is the major cause of death in the first 40 years of life.
•Trauma has three peaks of death:
1-At the time of trauma (within seconds to minutes)
2-After minutes to hours(life threatening trauma)
3-After days or weeks
•Triage: is the process of determining the priority of patients treatments based on the severity of
their condition.it comes from French word and it mean to separate!
•Management of Trauma:
1-Basic life support (information that any person should know, for example positioning of pt. with
shock, in left lateral position with legs elevation )
2-Cardiac life support ( like CPR, drugs as dopamine and other drugs in pt. with cardiac problems)
3-Advanced trauma life support (ATLS): which its divided into:
A-Primary survey(ABCDEF):
1-A: Airway patency and cervical spine stability, e.g. when the pt. lose his conciousness ,place
him in left lateral position with jaw thrust-chin lift maneuver to avoid tongue swallow.
2-B: breathing, auscultate the chest of the pt. to check breathing and if he needs chest tube in case
of pneumothorax or hemothorax.
3-C: Circulation, Check PR and BP, Put Two wide bore cannula, Give 1000 cc of Ringer lactate,
should be warm to avoid hypothermia which may cause:
a-Coagulopathy
b-Acidosis.
4-D :Disability, Do neurological exam to check for any problems, use Glasgow coma scale (from
3-15 score) or AVPU system (A; Alert, V; Verbal, P; Pain, U; Unresponsive)
5-E; Exposure and Environment, rapidly check the pt. from head to toe and keep warm
environment to avoid hypothermia.
6-F; Fracture,.
•Adjuncts to Primary survey includes(use as needed):
1-Foly`s catheter (if no urethral bleeding)
2-NG tube (if no fracture of the base of the skull)
3-Intubation either: Endotracheal tube through mouth or through opening of tracheostomy
4-Monitoring of vital signs: PR, BP and oximetry
5-Radiological investigation as X-ray (Chest, abdomen and pelvis), FAST(Focused Assessment
with Sonography in Trauma) and CT.
6-ECG and cardiac markers (Troponin I and CK-MB)in cases of suspected cardiac trauma.
ملخص من عمر سعد/طب تكريت
7-Diagnostic peritoneal lavage (examine peritoneal fluid) .
8-Diagnostic and therapeutic laparotomy or thoracotomy.
B-Secondary survey:
Examine the pt. from top to toe
Take short focused history using AMPLE mnemonic.
A; Allery
M; Medication (as steroid and aspirin)
P; Past-medical, surgical and pregnancy
L; Last meal
E; Event or environment
C-Tertiary Survey; Refer the pt. to specialized centers if needed.
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Every student who wants to start studying Emergency, should know the above things by heart
because most of them r used routinely in most of the cases its little bit long but important.
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#(Saving lives is not easy thing and therefore its is great gift)
#(Work as possible as you can, never look at the others and what they have, look at your own
capabilities and use them,you will do excellently)