Initial Management of Life-Threatening Trauma

Primary Survey ◽

Field Triage ◽

Life Threatening ◽

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

10.2310/7ccsp.2129 ◽

2018 ◽

Author(s):

Emily Cantrell ◽

Jay Doucet

Keyword(s):

Life Support ◽

Rapid Assessment ◽

Trauma System ◽

Injured Patient ◽

Initial Assessment ◽

Primary Survey ◽

Field Triage ◽

Life Threatening ◽

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

10.2310/tywc.2129 ◽

2018 ◽

Author(s):

Emily Cantrell ◽

Jay Doucet

Keyword(s):

Life Support ◽

Rapid Assessment ◽

Trauma System ◽

Injured Patient ◽

Initial Assessment ◽

Primary Survey ◽

Field Triage ◽

Life Threatening ◽

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

10.2310/surg.2129 ◽

2018 ◽

Author(s):

Emily Cantrell ◽

Jay Doucet

Keyword(s):

Life Support ◽

Rapid Assessment ◽

Trauma System ◽

Injured Patient ◽

Initial Assessment ◽

Primary Survey ◽

Field Triage ◽

Life Threatening ◽

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

A systematic approach to the injured patient

10.1093/med/9780199600830.003.0332 ◽

2016 ◽

Author(s):

Clay Cothren Burlew ◽

Ernest E. Moore

Keyword(s):

Cause Of Death ◽

Injured Patient ◽

Trauma Team ◽

Detailed Examination ◽

Simultaneous Treatment ◽

Common Cause ◽

Primary Survey ◽

Life Threatening ◽

Secondary Survey ◽

Injured Patients

Trauma remains the most common cause of death for all individuals between the ages of 1 and 44 years, and is the third most common cause of death regardless of age. It is also the leading cause of years of productive life lost. However, death rate underestimates the magnitude of the societal toll. Organized trauma systems have improved mortality by providing timely and expert care to severely-injured patients. Patient management consists of rapid primary survey, which should focus on the identification and simultaneous treatment of immediately life-threatening injuries. A classical ABC (airway, breathing, circulation) approach is recommended and is best carried out by a trained and practiced trauma team. The primary survey is followed by a more detailed examination, the secondary survey, which consists of a head-to-toe examination to identify all specific injuries. The secondary survey should be followed by investigation and definitive care.

Major trauma

10.1093/med/9780198799481.003.0015 ◽

2021 ◽

pp. 581-596

Keyword(s):

Major Trauma ◽

Life Support ◽

Head Injuries ◽

Initial Assessment ◽

Thoracic Injuries ◽

Golden Hour ◽

Secondary Survey ◽

Time Periods ◽

Second Peak

This chapter discusses the management of major trauma. Trauma is the leading cause of death in the first four decades of life, and every minute, more than nine people die from injuries and violence. Trimodal distribution of death implies death from injury occurs in one of three time periods: first peak (within seconds to minutes), second peak (within minutes to several hours), and third peak (after several days to weeks). The ‘golden hour’ refers to the period when medical care can make the maximum impact on death and disability. A systematic, rapid initial assessment is essential and this includes preparation, triage, primary survey (ABCDE), resuscitation, secondary survey, continued monitoring, and reevaluation and definitive care. The chapter then looks at the advanced trauma life support (ATLS) system. It also considers thoracic injuries, abdominal trauma, vascular injuries, and head injuries.

The ATLS® Moulage – A quick guide

Australasian Journal of Paramedicine ◽

10.33151/ajp.7.2.159 ◽

2009 ◽

Vol 7 (2) ◽

Author(s):

George Alex

Keyword(s):

Health Professionals ◽

Life Support ◽

Real Life ◽

Injured Patient ◽

Initial Assessment ◽

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.

Supervising trauma life support by telemedicine

Journal of Telemedicine and Telecare ◽

10.1258/1357633001934285 ◽

2000 ◽

Vol 6 (1_suppl) ◽

pp. 7-11 ◽

Cited By ~ 22

Author(s):

Sapal Tachakra ◽

Peter Jaye ◽

Julie Bak ◽

Jesus Hayes ◽

Alganandan Sivakumar

Keyword(s):

Emergency Department ◽

Community Hospital ◽

Life Support ◽

Trauma Management ◽

Primary Survey ◽

Resuscitation Room ◽

Accident And Emergency ◽

Secondary Survey ◽

Accident And Emergency Department

The resuscitation room in a community hospital was linked with a main hospital accident and emergency department using telemedicine equipment working at 384 kbit/s. Fifteen simulated casualties replicated the ‘moulage’ scenarios in the Advanced Trauma Life Support Course Manual of the American College of Surgeons. Each of the 15 scenarios was broken down into three main parts: the primary survey, resuscitation and the secondary survey. While a physician in the community hospital undertook each task, a senior doctor in the accident and emergency department recorded his degree of confidence in the supervision of the task on a five-point scale. There were features of the management which the supervisor found difficult, mainly related to the camera view and the use of a proxy examiner. However, supervising major trauma management by telemedicine was feasible. The average scores were mostly above 3 and often above 4 in the assessment of the primary survey and the resuscitation. The average scores were mostly above 3 for the secondary survey but were less often above 4 than for the primary survey and the resuscitation. Trials of remote trauma management with real patients appear to be justified.

Pediatric Trauma

10.1093/med/9780199918027.003.0019 ◽

2017 ◽

Author(s):

Joanna C. Lim ◽

Catherine Goodhue ◽

Elizabeth Cleek ◽

Erik R. Barthel ◽

Barbara Gaines ◽

...

Keyword(s):

Life Support ◽

Pediatric Trauma ◽

Penetrating Trauma ◽

Initial Evaluation ◽

Long Bone ◽

Initial Assessment ◽

Assessment Protocol ◽

Orderly Fashion ◽

Life Threatening

Pediatric trauma is the leading cause of death in children 1 through 14 years old. This chapter includes key information focusing on initial evaluation, triage, and stabilization of children with blunt and penetrating trauma as well as burns (and the “rule of 9s”). The authors discuss specific injuries, including those to the head (traumatic brain injury), thorax, and abdomen; genitourinary area; and orthopedic/long-bone and nonaccidental trauma. Caring for injured children is best performed using advanced trauma life support protocols during the initial assessment. Protocol-driven examination, regardless of injury mechanism, ensures clinicians consider life-threatening injuries in an orderly fashion, starting with the primary survey and moving on to the secondary survey and definitive care. After injuries are identified, priorities shift toward involving the necessary specialists. Key mnemonics in trauma care are explained: the ABCDE initial evaluation, the AMPLE history, and the AVPU categorization of neurologic status.

The injured patient

Head, Neck and Dental Emergencies ◽

10.1093/med/9780198779094.003.0002 ◽

2018 ◽

pp. 21-60

Author(s):

Mike Perry

Keyword(s):

Head And Neck ◽

Life Support ◽

Clinical Signs ◽

Injured Patient ◽

Signs And Symptoms ◽

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.