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Trauma - Coggle Diagram
Trauma
Head Injury
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Cerebral contusion
-Fluffy appearanec
-Mixed hypo-hyperdense inhomogenous
-III-defined border
-Adjacent to bony prominence
Thoracic Injury
Most lift-threatening thoracic injuries can be treated with airway control or decompression of the chest with a needle,finger,or tube
Primary survey • Life threatening injury
- Airway Obstruction
- Tracheobronchial Tree Injury
- Tension Pneumothorax
- Open Pneumothorax
- Massive Hemothorax
Cardiac tamponade
Cardiac tamponade is compression of the heart by an accumulation of fluid in the pericardial sac. Cardiac tamponade most commonly results from penetrating injuries
Alrway obstruction
• Sign and symptoms
• air hunger, such as intercostal and supraclavicular muscle retractions.
• Inspect the oropharynx for foreign body obstruction Treatment
• Clearance of the blood or vomitus from the airway by suctioning. This maneuver is frequently only temporizing, and placement of a definitive airway is necessary.
Tension pneumothorax
• Immediate decompression
• Needle thoracocentesis at 5th ICS axillary line (old version 2nd ICS mid clavicular line)
• ICD Open pneumothorax
• Large injuries to the chest wall that remain open can result in an open pneumothorax, also known as a sucking chest wound . "Suction wound" : 2/3 the diameter of the trachea Treatment 3 sides dressing ICD remote from the wound as soon as possible Massive hemothorax
• The accumulation of >1500 ml of blood in one side of the che:
• one-third or more of the patient's blood volume in the chest cavity
Spinal cord injury
deficit
- Incomplete or complete paraplegia (thoracic injury)
- Incomplete or complete quadriplegia tetraplegia (cervical injury
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Brown-Sequard syndrome
- hemisection ไขสันหลัง
-มักเกิดจากการบาดเจ็บจากการเจาะ
-อาจเกิดจากรังสี myelopathy การบีบอัดไขสันหลัง Hematoma แก้ปวด,หมอนรองปากมดลูดขนาดใหญ่
Neurogenic shock
การสูญเสีย vasomotor
การบาดเจ็บที่ไขสันหลังส่วนบน (T6 ขึ้นไป) หรือทรวงอก
-Hypotension
Acute urinary retention
Physical examination
• Vital sign
• Abdomen - tender enlarged bladder with dullness to percussion above the symphysis pubis, often almost to the level of the umbilical
• Look phymosis, mental stenosis, sign of Infection
• In female - look for cystoceles, rectoceles, uterine prolapse
• PR look for enlarged prostate
• Neurological examination to detect neurogenic bladder
การซักประวัติ
• Onset and progression
• Fever
• Past medical history, neurological disease
• Ask about alcohol, constipation, low/high fluid
Management
• Acute urinary retention should be managed immediately
• Decompression by a Foley's catheter
• If the initial catheterization attempts are failed - call a doctor for advanced catheterization techniques