20
A:
ma
Re ndot ndotra ra heal heal
UL
othe otherm rmia ia
houl houl
be pr ve te
Note:
CONTROL
Stan Standa dard rd prec precau auti tion on STEP
tu e.
ON WI
MO
H AG AG E
1. Asse Assess ssme ment nt hemorrhage.
WA MA S P I N E PROTECTION STEP
WI
1. Asse Assess ssme ment nt Ascert rtai ai pate patenc ncy. y. A. Asce Rapi Rapidl dl ss ss fo ir
hemorrhage. paradox.
obst obstru ru tion tion STEP
2.
an geme gement nt site(s). rv
1) Intu Intuba bati tion on 2) Surg Surgic ical al cric cricot othy hyro roid idot otom om
rg rg
STEP
st blis blis in
airw airw y.
F.
ryst rystal allo loid id so utio utio an reve revent nt hypo hypoth th rmia rmia
lood lood repl replac ac ment ment
STEP
ft
D IS IS AB A B IL IL IT IT Y B R E F N E EU U RO R O LO LO G I EXAMINATION
~ ~ B R EA E A TH T H IN IN G : V EN E N T L AT A T IO IO N A N O XY XY G GE EN NA AT ON STEP
STEP
GCS.
1. Asse Assess ssme ment nt
STEP
OS ra he
STEP
devi deviat atio ion, n, unil unil tera tera
hyperresonance. E. us ulta ultate te th ches ches bila bilate tera ra ly 2. Mana Manage geme ment nt
an bi ater ater ry
NV RO ME
STEP
hypothermia.
RESUSCITATION STEP STEP
MA
CO
RO
21
Tor
ss in
to
DPL.
ti t' ~~
AP pelv pelvic ic x-ra x-rays ys
Sk (Als (Als
nd
ee Tabl Tabl /-1: OR
AT
C ON S D E
B: Se
MP
R EA EA S
Su
econ econda dary ry
n d M an a
NT
NE
A BC BC D
FO
AT
AN NT
R A N SF SF E
me
urve urvey) y) th
C.
N D M EC EC H N I
ti
ie
ts
O F N JU JU R Y
cros crosss-ta tabl bl preh prehos ospi pita ta
ervi ervi al spin spin x-ra x-ray. y.
pers person onne nel. l. spine.
iden identi tify fy injur injur mech mechan anism isms. s. CHEST HE
AN
M AX AX I
O FA FA C
STEP STEP 7.
ss ssme ssment nt
STEP STEP 3. Asse Assess ssme ment nt lace lacera rati tion ons, s, cont contus usio ions ns B. C.
D.
E.
ra ture tures, s,
nd ther therma ma
Injury. Reev Reeval alua uate te pupi pupils ls Re lu te CS score. Asse Assess ss ye fo hemo hemo rhag rhag pene penetr trat atin in ju it is io le pr senc senc of onta ontact ct lens lenses es Eval Evalua uate te cran crania iall-ne nerv rv func functi tion on
ur se nd bila bilate te al
espi espira rato tory ry ex ursi ursion ons. s.
hear hear soun sounds ds C.
mphy mphyse sema ma
ti tend tender erne ness ss
crep crepit itat atio ion. n.
dullness. STEP STEP 8. Mana Manage geme ment nt
leakage. cere cerebr bros ospi pina na flui fluid, d, soft soft-t -tis issu su nd loos loos te th STEP4. STEP4. Mana Manage geme ment nt ta ir in an oxyg oxyg nati nation on as indi indi ated ated B. Cont Contro ro hemo hemorr rrha hage ge Preven en seco second nd ry br in inju injury ry C. Prev ta
lace lacera rati tion ons, s, to la io
C.
is indicated.
le
STEP STEP 9. Asse Assess ssme ment nt
STEP STEP 5. Asse Assess ssme ment nt
inte intern rnal al blee bleedi ding ng
resp respir irat ator or
subc subcut ut neou neou
musc muscle les. s. it li emph emphys ysem ema, a, tr ch al devi devi tion tion
te
drai draina nage ge devi device ce
EAN
acce access ssor or
an
C.
ic
22
KI
Assessment
ON
S ec e c on o n da da r
Management
Su ve
ITEM
ESTABLISHESI
T O A SS S S ES ES S
IDENTIFIES
Consciousness
• S head head inju injury ry
CONFIRM
Seve Severe re
• G
ad inju injury ry
Moderate head head inju injury ry
9-
Re ea with with ut para paraly lyzi zing ng agen agents ts
3- 5, Mi
Pupils
Ma ffec ffec iffu iffuse se br in inju injury ry
Pres Presen enceof ceof ey inju injury ry
Op th lmic lmic inju injury ry
Reac Reacti tivi vity ty
Head
spec spec
Scal Scal inju injury ry kull kull inju injury ry
an
or lace lacera ra ions ions
Scal Scal lace lacera rati tion on
skul skul frac fractu ture re Basi Basila la skul skul frac fractu ture re
Palp Palpab able le defe defect ct
Maxillofacial
lf ne inju injury ry erve erve inju injury ry Teeth/ Teeth/mou mouth th injury injury
Neck
nj ry
Lary Laryng ngea ea inju injury ry -s in inju injury ry Vasc Vascul ular ar inju injury ry
Malocc Malocclus lusion ion lpat lpatio io fo cr
Ts it ti
Visu Visual al insp inspec ecti tion on • P Auscul Auscultat tation ion
Lary Laryng ngea ea defo deform rmit it • S
C• A Esopha Esophago gosco scopy py Laryn Laryngos goscop cop
Neur Neurol olog ogic ic defi defici ci Plat Platys ysma ma pene penetr trat atio io Pain Pain tend tender erne ness ss of c-sp c-spin in Br isin isin de ormi ormi y, parad paradoxi oxical cal motion motion
Thorax •A Pneum Pneumot othor horax! ax!
Ches Chestt-wa wall ll tend tender erne ness ss
Angiog Angiograp raphy hy
crepitation
Bronch Bronchos oscop cop
d b • P
Bron Bronch chia ia inju injury ry
TE ultr ultras asou ound nd Medi Medias asti tina na crep crepit itat atio io
Thor Thorac acic ic aort aortic ic disruption
Abdomen/Flank
Abdo Abdomi mina nall-wa wall ll inju injury ry
ever ever •V
ck
in
•A pain/tenderness
of penet penetrat ration ion
Peri Perito tone neal al irrit irritat atio io
Lapa Laparo roto tomy my
Retr Retrop oper erit iton onea ea
studies
orga orga
injury
Pelvis
ri Pelv Pelvic ic frac fractu ture re(s (s
pubi pubi fo wide wideni ning ng
Ut (hematuria)
Angiog Angiograp raphy hy lvic lvic x-ra x-ra
cf for tende tenderne rness ss st bili bility ty
ly
Rect Rectal al vagi vagina nal, l, and/ and/or or peri perine neal al inju injury ry ce
Insp Inspec ec peri perine neum um Rect Rectal al/v /vag agin inal al exam exam
Cyst Cystog ogra ra ·IVP
LS
23
CONFIRM
ESTABLISHES!
ASSESS
IDENTIFIES
b rraa l
Co mn
:F.>"'J
Unil Unilat ater eral al cran crania ia mas effect effect
to Pain Pain resp respon onse se
Cran Crania ia inju injury ry
spin spinal al Cord Cord
FINDING
Peri Periph pher eral al nerv nerve( e(s) s)
Quadri Quadriple plegia gia
injury
Para Parapl pleg egia ia
Frac Fractu ture re vers versus us dislocation
to pain pain late latera rali lizi zing ng sign sign Palp Palpat at fo te dern dern ss
Vert Verteb ebra ra inst instab abil ilit it Ne ve nj ry
lain lain spin spin x- ay
lain lain x-ra x-rays ys
Defo Deform rmit it Soft Soft-t -tis issu su
Extremities
Swel Swelli ling ng brui bruisi sing ng pallor
Visu Visual al insp inspec ecti tion on
Inju Injury ry
Bony Bony defo deform rmit itie ie Join Join abno abnorm rmal alit itie ie
Palp Palpat atio io
Spec Specif ific ic x-ra x-rays ys Dopp Dopple le exam examin inat atio io om artm artmen en ress ress re
Malali Malalignm gnment ent Pain Pain tend tender erne ness ss crepitation
Neurov Neurovasc ascula ula defects
Angio Angiogra graphy phy
Absent/dimi Absent/diminishe nishe pulses Tens Tens musc muscul ular ar compartments
lp invo involu lunt ntar ar
in
ie
for:
musc muscle le guar guardi ding ng uneq unequi uivo voca ca
B. Vagi Vagina na lace lacera rati tion on warranted. hemo hemody dyna nami mica call ll
M U SC UL O K E E TA L
TE
norm normal al
4. Asse Assess ssme ment nt
STEP10 STEP10 Mana Manage geme ment nt incl includ udin in cont contus usio ions ns deformity.
if indica indicated ted to redu redu pelv pelvic ic ol me an co trol trol hemo hemorr rrha ha from from pelv pelvic ic frac fractu ture re
P E R IN E U M /R E C T U M I V A G IN A
STEP1 STEP11. 1.
erin erinea ea
sses ssessm sm nt
sses sses fo
tend tender erne ness ss crep crepit itat atio ion, n, abno abnorm rmal al moveme movement, nt, andsen andsensat sation ion C. Palp Palpat at al pe ip eral eral puls puls fo rese resenc nce, e, abse absenc nce, e, an equa equali lity ty id an asso associ ciat ated ed hemo hemorr rrha hage ge
pati pati nts. nts. Asse Assess ss fractu fracture. re. site site as indi indica cate ted. d.
C. Bowe Bowe wall wall inte integr grit it
an
tr inju injury ry incl includ udin in cont contus usio ions ns lace lacera rati tion ons, s, tend tender erne ness ss defo deform rmit ity, y, an sens sensat atio ion. n.
B_ Lacera Laceratio tions ns C. Uret Urethr hral al blee bleedi ding ng STEP1 STEP12. 2. Re ta asse assess ssme ment nt in sele sele te for:
lace lace atio ations ns
STEP STEP 15 Mana Manage geme ment nt ly
ju
SKILL
Assessment
Management C.
C.
D.
ntir ntir
lllJury.
tien tien
E.
ON dire dire te
pe iali ialist st
syndrome.
NE EU U RO R O LO LO G
consciousness.
io ra
on os op Esop Esopha hago gosc scop op
