Musculoskeletal trauma care

2020 ◽  
pp. 315-364
Keyword(s):  
Nerve Injury ◽  
Peripheral Nerve Injury ◽  
Life Support ◽  
Traumatic Injury ◽  
Injured Patient ◽  
Musculoskeletal Injury ◽  
Advanced Trauma Life Support ◽  
Crush Injuries ◽  
Musculoskeletal Trauma ◽  
General Care

This chapter provides an overview of the principles of care of the patient who has sustained a traumatic injury. It considers the physiology of trauma and trauma psychology. There is a focus on the general care of the injured patient, considering head, chest, and abdominal trauma in the patient who also has a musculoskeletal injury, as well as a section on Advanced Trauma Life Support (ATLS®). Further sections consider the principles of fracture healing and management, soft tissue and nerve injury, peripheral nerve injury, and crush injuries and traumatic amputation.

scholarly journals The ATLS® Moulage – A quick guide

2009 ◽  
Vol 7 (2) ◽  
Author(s):  
George Alex
Keyword(s):  
Health Professionals ◽  
Life Support ◽  
Real Life ◽  
Injured Patient ◽  
Initial Assessment ◽  
Advanced Trauma Life Support ◽  
Paediatric Age ◽  
Eighth Edition ◽  
Musculoskeletal Trauma ◽  
Trauma In Pregnancy

The Advanced Trauma Life Support (ATLS®) Course1 teaches a systematic, concise approach to the early care of the trauma patient. This course is vital to guiding care for the injured patient in emergency department trauma rooms as well as in the prehospital environment. Essentially, the course training provides a common language between emergency health professionals, and is designed to save lives in critical situations. On the last day of my ATLS® Course when we had to participate in a trauma moulage, I considered the feasibility and benefits of a summary guide listing the most important things to do, and the correct order in which they should be performed. The following is based on the ATLS Course Manual2 and is intended as a guide to assist both novice and expert emergency health professionals in the moulage exercise, or when faced with a real life trauma event. The eighth edition of the ATLS® Course Manual released in late 2008 has suggested changes3 in management with regards to Initial Assessment, Airway, Shock, Thoracic, Abominal, Head and Musculoskeletal trauma as well as trauma in Pregnancy and the Paediatric age group. The main changes have been incorporated in the summary below.

The injured patient

2018 ◽  
pp. 21-60
Author(s):  
Mike Perry
Keyword(s):  
Head And Neck ◽  
Life Support ◽  
Clinical Signs ◽  
Injured Patient ◽  
Signs And Symptoms ◽  
Advanced Trauma Life Support ◽  
Neck Injuries ◽  
Complex Decision Making ◽  
Clinical Signs And Symptoms ◽  
Multiply Injured Patient

This chapter gives an overview of the assessment of patients presenting to an emergency department with injuries to head or neck (above the collar bones). The Advanced Trauma Life Support® (ATLS®) programme is now widely accepted as the gold standard in trauma management, but its strict application to patients with coexisting facial injuries can result in a number of dilemmas and complex decision-making. These issues are discussed. The approach to head and neck injuries remains the same as for the multiply injured patient but those aspects related specifically to injuries to the head and neck are discussed in detail. Emergency procedures undertaken in head and neck injuries are also discussed. Useful clinical signs and symptoms indicating significant injuries are listed at the end of the chapter.

Initial Management of Life-Threatening Trauma

2018 ◽  
Author(s):  
Emily Cantrell ◽  
Jay Doucet
Keyword(s):  
Life Support ◽  
Rapid Assessment ◽  
Trauma System ◽  
Injured Patient ◽  
Initial Assessment ◽  
Advanced Trauma Life Support ◽  
Primary Survey ◽  
Field Triage ◽  
Life Threatening ◽  
Secondary Survey

Management of the critically injured patient is optimized by a coordinated team effort in an organized trauma system that allows for rapid assessment and initiation of life-preserving therapies. This initial assessment must proceed systematically and be prioritized according to physiologic necessity for survival. Beginning in the prehospital setting, coordination, preparation, and appropriate triage of the injured are crucial to facilitating rapid resuscitation of the trauma patient. Next, active efforts to support airway, breathing, circulation, and disability are performed with simultaneous intervention to treat life-threatening injuries and restore hemodynamic stability in the primary survey. With ongoing evaluation and continued resuscitation, a secondary survey provides a head-to-toe assessment of the patient allowing for further diagnosis of injuries and triage to more definitive care. This review contains 12 figures, 8 tables and 63 references Key Words: advanced trauma life support, definitive airway, FAST/eFAST, field triage, Glasgow coma scale, primary survey, 1:1:1 resuscitation, secondary survey

Initial Management of Life-Threatening Trauma

2018 ◽  
Author(s):  
Emily Cantrell ◽  
Jay Doucet
Keyword(s):  
Life Support ◽  
Rapid Assessment ◽  
Trauma System ◽  
Injured Patient ◽  
Initial Assessment ◽  
Advanced Trauma Life Support ◽  
Primary Survey ◽  
Field Triage ◽  
Life Threatening ◽  
Secondary Survey

Management of the critically injured patient is optimized by a coordinated team effort in an organized trauma system that allows for rapid assessment and initiation of life-preserving therapies. This initial assessment must proceed systematically and be prioritized according to physiologic necessity for survival. Beginning in the prehospital setting, coordination, preparation, and appropriate triage of the injured are crucial to facilitating rapid resuscitation of the trauma patient. Next, active efforts to support airway, breathing, circulation, and disability are performed with simultaneous intervention to treat life-threatening injuries and restore hemodynamic stability in the primary survey. With ongoing evaluation and continued resuscitation, a secondary survey provides a head-to-toe assessment of the patient allowing for further diagnosis of injuries and triage to more definitive care. This review contains 12 figures, 8 tables and 63 references Key Words: advanced trauma life support, definitive airway, FAST/eFAST, field triage, Glasgow coma scale, primary survey, 1:1:1 resuscitation, secondary survey

Initial Management of Life-Threatening Trauma

2018 ◽  
Author(s):  
Emily Cantrell ◽  
Jay Doucet
Keyword(s):  
Life Support ◽  
Rapid Assessment ◽  
Trauma System ◽  
Injured Patient ◽  
Initial Assessment ◽  
Advanced Trauma Life Support ◽  
Primary Survey ◽  
Field Triage ◽  
Life Threatening ◽  
Secondary Survey

Management of the critically injured patient is optimized by a coordinated team effort in an organized trauma system that allows for rapid assessment and initiation of life-preserving therapies. This initial assessment must proceed systematically and be prioritized according to physiologic necessity for survival. Beginning in the prehospital setting, coordination, preparation, and appropriate triage of the injured are crucial to facilitating rapid resuscitation of the trauma patient. Next, active efforts to support airway, breathing, circulation, and disability are performed with simultaneous intervention to treat life-threatening injuries and restore hemodynamic stability in the primary survey. With ongoing evaluation and continued resuscitation, a secondary survey provides a head-to-toe assessment of the patient allowing for further diagnosis of injuries and triage to more definitive care. This review contains 12 figures, 8 tables and 63 references Key Words: advanced trauma life support, definitive airway, FAST/eFAST, field triage, Glasgow coma scale, primary survey, 1:1:1 resuscitation, secondary survey

Sonographic Evaluation of Peripheral Sciatic Nerve Injury: A Case Study

2021 ◽  
Vol 37 (3) ◽  
pp. 276-281
Author(s):  
Kirstie Franceschina
Keyword(s):  
Peripheral Nerve ◽  
Nerve Injury ◽  
Peripheral Nerve Injury ◽  
Surgical Intervention ◽  
Traumatic Injury ◽  
Clinical Findings ◽  
Sensory Loss ◽  
Common Finding ◽  
Sonographic Examination

Traumatic peripheral nerve injury is not a common finding in the general population but is increasingly being recognized and diagnosed in trauma and emergency medicine settings. Peripheral nerve injury can cause temporary or long-term motor and sensory loss, as well as intense pain and disability, if left untreated. The cause of peripheral nerve injury is diverse and often involves soft tissue damage, fractures, and hemorrhage in cases of traumatic injury. Peripheral nerve injury does not always heal spontaneously and, depending on severity, may warrant surgical intervention and repair. Although electrodiagnosic testing and surgical exploration are considered gold standards for peripheral nerve injury, high-resolution sonographic examination supplemented by clinical findings may be of value. The use of sonography demonstrated utility in determining a strategic management timeline and the efficacy of a surgical intervention.

Trauma Resuscitation

2015 ◽  
Author(s):  
Joaquim M. Havens ◽  
Ali S. Raja
Keyword(s):  
Local Community ◽  
Life Support ◽  
Traumatic Injury ◽  
Empirical Therapy ◽  
Trauma Team ◽  
Needle Insertion ◽  
Advanced Trauma Life Support ◽  
Abdominal Sonography ◽  
Computed Tomographic ◽  
Severe Traumatic Injury

Although patients with recently sustained traumatic injuries may present at any health care setting, this review focuses on resuscitation, stabilization, and management of the trauma patient in the emergency department. Patients with potentially severe traumatic injury often present to local, community hospitals and may require transfer to a trauma center after evaluation. Nevertheless, as long as it does not delay transfer unnecessarily, the initial evaluation can be undertaken in any setting. This review discusses assessment and stabilization, including triage and preparation, trauma team management, bedside evaluation, and supportive care and empirical therapy; diagnosis, including secondary evaluation and management, laboratory testing, and additional imaging following the secondary evaluation; treatment and disposition; and outcomes. Tables describe advanced trauma life support primary evaluation, the Glasgow Coma Scale, National Emergency X-Radiography Utilization Study low-risk criteria, criteria for a positive diagnostic peritoneal lavage, bedside airway tools and rescue airway devices, and difficult airway predictors. Figures include an illustration showing immobilization of the cervical spine, a computed tomographic scan of an open book pelvic fracture, left-sided traumatic hemothorax, focused abdominal sonography for trauma examination, and the appropriate intercostal spaces of needle insertion. This review contains 5 highly rendered figures, 6 tables, and 115 references.

Initial Management of Life-Threatening Trauma

2018 ◽  
Author(s):  
Emily Cantrell ◽  
Jay Doucet
Keyword(s):  
Life Support ◽  
Rapid Assessment ◽  
Trauma System ◽  
Injured Patient ◽  
Initial Assessment ◽  
Advanced Trauma Life Support ◽  
Primary Survey ◽  
Field Triage ◽  
Life Threatening ◽  
Secondary Survey

Management of the critically injured patient is optimized by a coordinated team effort in an organized trauma system that allows for rapid assessment and initiation of life-preserving therapies. This initial assessment must proceed systematically and be prioritized according to physiologic necessity for survival. Beginning in the prehospital setting, coordination, preparation, and appropriate triage of the injured are crucial to facilitating rapid resuscitation of the trauma patient. Next, active efforts to support airway, breathing, circulation, and disability are performed with simultaneous intervention to treat life-threatening injuries and restore hemodynamic stability in the primary survey. With ongoing evaluation and continued resuscitation, a secondary survey provides a head-to-toe assessment of the patient allowing for further diagnosis of injuries and triage to more definitive care. This review contains 12 figures, 8 tables and 63 references Key Words: advanced trauma life support, definitive airway, FAST/eFAST, field triage, Glasgow coma scale, primary survey, 1:1:1 resuscitation, secondary survey

scholarly journals Single institutional experience of management of penetrating trauma chest

2021 ◽  
Vol 8 (10) ◽  
pp. 3122
Author(s):  
Niranjan Ulhasrao Jadhav ◽  
Subrata Pramanik ◽  
Ridhika Munjal ◽  
Anubhav Gupta ◽  
Anirudh Mathur ◽  
...  
Keyword(s):  
Chest Trauma ◽  
Life Support ◽  
Traumatic Injury ◽  
Penetrating Trauma ◽  
Warning Signs ◽  
Advanced Trauma Life Support ◽  
Early Evaluation ◽  
Penetrating Chest Trauma ◽  
Mammary Arteries ◽  
Operative Exploration

Chest trauma is now the second most common non-intentional traumatic injury. Chest trauma is associated with high mortality. Control of blood loss and stabilization of vital organs is of vital importance over diagnostic and therapeutic measures. Bleeding may arise from chest wall, intercostal or internal mammary arteries, great vessels, mediastinum, myocardium, lung parenchyma, diaphragm or abdomen. Modified early warning signs (MEWS) score of >9 on presentation have shown higher rate of mortality. Diagnostic modalities such as extended-focused assessment with sonography in trauma (eFAST) have been effective. The type of surgical approach alters according to the site of injury. We here presented our experience with six such patients. All the six patients involved in this study had penetrating trauma chest with various sharp weapons including dagger, ice pick, flag post. Time of presentation of all these patients were delayed due to ours being a tertiary centre. The patients were explored on the basis of eFAST findings, intercostal drainage, hemodynamics. Out of the six patients two patients succumbed and the patients who died also had high MEWS score. All the patients were approached surgically with respect to the type of injury sustained. Penetrating chest trauma present a challenging clinical situation which warrants early evaluation and intervention. The cases of chest trauma then be it blunt or penetrating should always be treated within the advanced trauma life support (ATLS) guidelines followed by the definitive management. Regardless of any penetrating object, the foreign body should be left in situ and only to be removed under vision. If in case the penetrating object has already been removed the operative intervention is decided on the amount of drainage. With blunt chest trauma, approximately 15% of the deaths result directly from intrathoracic injury, but with penetrating chest trauma, nearly 100% of the deaths result from intrathoracic injury. Hence, the operative exploration of the chest in penetrating chest trauma and should be done on emergent basis as the mechanism of injury, vital organ damage and hemodynamic status all equate to higher rate of mortality.

Sign in / Sign up

Export Citation Format

Share Document