Advanced Trauma Life Support (ATLS)
What's included in universal precautions for the trauma bay?
gowns
eye protection
face mask
gloves
boots
Triage: Multiple vs. Mass Casualties
multiple casualties: number of patients doesn't exceed the ability of the facility
-critical patients treated first
mass casualties: number of patients/severity EXCEEDS the capability of facility and staff
-triage "flips": focus on those expected to live
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Who is included in the trauma team?
team leader
,airway MD
respiratory therapist
primary assessor (Us :)
primary nurse
secondary nurse
what does the primary assessor do in a trauma team?
Calls out airway, breathing, circulation, disability, exposure
what are the ABCDE's of trauma?
A: airway with c-spine protection
B. breathing (oxygenation and ventilation)
C: circulation (pulses and hemorrhage control)
D: disability (neuro status- GCS)
E: exposure (undress) and environment (temperature control)
how do you assess "A": airway in trauma?
ALWAYS assume c-spine injury
jaw thrust chin lift (open airway while protecting c-spine)
orotracheal or nasotracheal intubation
always assume ____ in trauma
c-spine injury
pitfalls of securing the airway
foreign body (don't want to advance something down into the airway that doesn't belong)
, maxillofacial injury
trachea or laryngeal injury
c-spine trauma
when do you intubate?
unsecure airway
unstable airway
head injury w/ GCS < 8
respiratory failure
chest trauma (flail chest)
shock
combativeness
inhalation injury
why do we worry about inhalation injuries?
airway edema- can sneak up on you!
intubate when GCS is less than...
8
what's evaluated with the GCS? what's a normal GCS score?
eye opening
motor
verbal
normal = 15
what are some reasons for mental status decline?
hypoxia/hypercapnia
organ perfusion issues
hypoglycemia
meds/drugs
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