Beruflich Dokumente
Kultur Dokumente
Assessment:
- ascertain patency
- rapidly asscess for airway obstruction
Assessment:
- Expose the neck and chest and ensure immobilization of the head and neck
- determine rate and depth of the respirations
- inspect and palpate for tracheal deviation, chest movements, use of assessory
muscles or any signs of injury
- percuss of presence of any dullness or hyperesonance
- auscultate chest bilaterally
Management:
- administer high concentration of O2
- ventilate with bag-mask device (if unble to maintain saturation)
- alleviate tension pneumothorax --> needle thoracocentesis
- seal open pneumothorax
- attach CO2 monitoring device to ETT tube
- attach pulse oxymetry to patient
C. Circulation and Haemorrhage control
Assessment:
- identify source of external, exsanguinating haemorrhage
- identify potential source of external haemorrhage
- assess pulse - quality, rate, regularity and paradox.
- evaluate skin colour
- measure blood pressure if times permits
Management:
- apply direct pressure to external bleed
- consider presence of internal Hge and potential need for operative intervention
and obtain surgical consult
- TWO IV large bore branulla
- obtain blood for haematological and chemical analysis
- IV fluid theraphy (preferable 1-2 L of crystalloid) + blood replacement
- prevent hypothermia.
D. Disability:
- Determine the level of concious - GCS scoring
- Check pupil size and reaction
- Assess for laterizing signs and spinal cord injury
E. Exposure/Environmental control
- completely undress patient but prevent hypothermia
SECONDARY SURVEY:
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discussion and also the content of your discussion.
DRS ADCDE
Primary Survey:
After DRS
- GCS
- Pupils
- ABG
- ETCO2
- FAST or DPL
Secondary Survey:
- Spine x-ray
- Contrast urography
- Angiography
- Extremities x-ray
- Bronchoscopy
- Oesophagoscopy
1)Preparation
a)PPE
b)Patient
c)Equipment (M-A-L-E-S)
M-Magill Forcep,Mask,
L-Laryngoscope,LMA,Lubricating gel
S-Syringe,Suction,Stetoscope,Stylet,10cc Syringe,
2)Pre-oxygenation
3)Pre medication
-IV Fentanyl 2-3 mcg/kg
5)Protection
-Inflate cuff
-ABG
-Cardiac monitoring
-Sedation
-NG Tube
-CBD tube
-referral to icu