Atls Ppt

Powerpoint(.ppt) Medical slides Presentations: ACLS. Have a stand alone PCR for this training and submit it at the end of each month. ATLS (Advanced Trauma Life Support) Teaching Protocol. Pretest (30 min) Context of Tutorial (2 hours) General Principles. Inhospital phase clinical procedure/process. Important points/ cautions/ pitfalls. Brief discussion on traumatic shock/ blood transfusion. Thoracic Trauma. Abdominal Trauma. Answers of pretests (30 min) Skills: (1hour).

First Things First (assess & treat for the following) • Trauma is a consequence of harmful behavior that is planned or unplanned. Injury prevention starts with addressing these behaviors. • Goals of trauma patient management • Identify and treat threats to life, then limb, and then eyesight. • Prevent exacerbation of existing injuries or occurrence of additional injuries. • Return patient to a level of function as close to pre-injury as possible. • Outcomes for trauma patients are improved with a systematic, multispecialty, and interdisciplinary approach to pre-hospital, hospital, and rehabilitative care. • Principles of trauma patient management • Treat the greatest threat to life first.

• Definitive diagnosis is not immediately important. • Time matters (“golden hour” emphasizes urgency). • Do no further harm. • Assess, intervene, reassess • Did the intervention work? • Is the patient’s physiology returning to or staying normal? • Preparation • Training by discipline and as a team • Capabilities defined by established and integrated pre-hospital and hospital care protocols • Equipment maintained and ready for rapid use • Appropriate supplies available • Universal precautions enforced • Referral resources and transfer policies clearly defined • Field triage to a trauma center in four steps (from the Centers for Disease Control & Prevention expert panel with support from the National Highway Traffic Safety Administration, 2006) • Assess basic physiology.

• Systolic blood pressure 29 • Glasgow Coma Scale 1 proximal long bone fracture • Crushed, degloved, or mangled extremity • Amputation proximal to wrist and ankle • Pelvic fractures • Open or depressed skull fracture • Paralysis • Assess mechanism of injury and evidence of high-energy impact. • Falls >20 feet (6 meters) in adults and >10 feet (3 meters) or 2-3 times height in children • High-risk auto crash • Intrusion >12 inches occupant site or 18 inches any site • Ejection (partial or complete) from vehicle • Death in same passenger compartment • Vehicle telemetry data consistent with high risk of injury • Auto vs. Pedestrian/bicyclist thrown, run over, or with significant (>20 mph) impact • Assess special patient or system considerations.

• Age: older adults and children • Anticoagulation and bleeding disorders • Burns • Time-sensitive extremity injury (open fractures, vascular compromise) • End-stage renal disease requiring dialysis • Pregnancy >20 weeks • EMS provider judgment • Initial assessment • Primary survey • Resuscitation • Adjuncts to primary survey • Secondary survey • Adjuncts to secondary survey • Ongoing post-resuscitation monitoring & reevaluation • Definitive care • Tertiary survey. History & Physical (assess for the following) • Reordered in trauma to address first life-threatening physiology and then to identify and correct the anatomic injuries • These guidelines are adapted from the American College of Surgeons Advanced Trauma Life Support® program. • Primary survey and resuscitation: life-threatening conditions are identified rapidly & managed in sequence by priority A team can manage priorities in parallel. • Brief history: age, gender, mechanism of injury (what led to the injury) • Airway with cervical spine control • Upper airway (above vocal cords) managed adjunctively with chin lift/jaw thrust, suctioning, oral airway, nasopharyngeal airway, and laryngeal mask airway. The most common cause of airway obstruction in the unconscious patient is the tongue. • Lower airway managed definitively with a cuffed tube in the trachea (orotracheal intubation, nasotracheal intubation, or surgical airway—cricothyroidotomy) • Assume cervical spine injury in patients sustaining any blunt injury or penetrating injury above the chest. • Intubation is indicated for airway protection (GCS 30, hypoxia/hypercarbia).

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