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Principles of Trauma Management - Coggle Diagram
Principles of Trauma Management
Initial Management
Goals
Asses patients condition rapidly
Recussitate and stabilise
"Too sick" for this facility / doctor - transfer
Intr / Intrahospital transfer
Ensure provision of optimal care
Primary Survey ABCDE
A. Airway
B. Breathing
C. Circulation
D. Disability
Exposure and Environment
Cervical Spine Immobilization
Blood volume and Cardiac Output
Hypovolaemic Shock
Damage Control Orthopaedics
WHO
Lack of resuscitation
Bad lung status
HEad Injury
Physiologically stable but Multipl fractures
Borderline Criteria
Serum lactate > 2.5 and rising
Closed head injury unstable ICP
Body temp <32-35 C
Acidosis
Coagulopathic
Inflammatory response
OR time > 90 min
Transfusion >10 pRBCs
Open Fractures
IV antibiotics
Combined plan bone and soft tissue
Vascular injury - within 3-4 hours
Watch for compartment syndrome
Cover wound - don't wash in A+E
+/- Transfer
DEbridement - within 24h
Early definitive soft tissue cover
Compartment Syndrome
Increased pressure in a closed compartment
Absoloute valve >40mmHg
Pain out of proportion to injury
Pain on passive movement
Compartement pressure >40mmHg
Treatment
Remove Dressings
Avoid regional anaethesia
Measure compartment pressure
Urgent Fasciotomy
Primary Survey
Catheters - Urinary / gastric
Pulse Oximetry
Blood pressure
X-rays (which?)
Secondary Survey
Head to toe exam
All systems
Compelte hx and exam
AFTER Primary survey completed
Re-evauate
AMPLE Hx
A - Age
M - Meds
P - PMhx / Pregnancy
L - Last meal
E- Events / environment
Timing of Fixation
Gold Standard
EArly stabilisation of long bone freactures in multiply injured patients
