major trauma a standard approach
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Major Trauma A standard approach. Ballarat Health Services Emergency Medicine Training Hub. Trauma workshop. Objectives C-Spine assessment and collar application Primary Survey Log Roll. C-Spine Assessment. History Observe patient Head Holding Posturing Failure to tolerate collar - PowerPoint PPT PresentationTRANSCRIPT
Major Trauma A standard approach
Ballarat Health Services
Emergency Medicine Training Hub
Trauma workshop
Objectives
C-Spine assessment and collar application
Primary Survey
Log Roll
C-Spine Assessment
History Observe patient
Head Holding Posturing Failure to tolerate collar
Palpate Midline Paracervical structures
Neurological Examination Move/collar as indicated
C-Spine Assessment
History Observe patient
Head Holding Posturing Failure to tolerate collar
Palpate Midline Paracervical structures
Neurological Examination Move/collar as indicated
Sizing a collar
Use fingers, horizontally placed to assess distance from apex of trapezius to line of mandible.
Primary Survey
A Talk to the patient! Look, listen, feel, monitor Intervene as required
Oro/naso-pharyngeal BMV RSI and ETT
Primary Survey
B Spring chest and examine for injury Auscultate for air and blood
Air
Blood
Primary Survey
C Examine
Heart Rate Blood pressure CRT JVP Heart Sounds Abdomen Long bone injury
Chest, Abdomen, Pelvis, Limbs and one more – the floor
Primary Survey
D GCS Obvious neurological injury
Limb Spinal
Log Roll
5 people (4 in children) Four to roll, one to examine
• Keep your hands across your chest. • You will not fall but will feel like you might.• I will press down your spine on each bone (demonstrate on an unbroken clavicle) like this.• Say yes if it hurts, no if it doesn’t.• I will then examine your back passage/anus to check for sensation and tone#@!**.• Turn to the head person – on your call.
To say to the patient
Keep your hands across your chest. You will not fall but will feel like you might. I will press down your spine on each bone
(demonstrate on an unbroken clavicle) like this.
Say yes if it hurts, no if it doesn’t. I will then examine your back passage/anus
to check for sensation and tone#@!**. Turn to the head person – on your call.
Log Roll
Is everybody ready?We will roll on three. . .
1, 2, 3
Log Roll
Palpate down the spine, each vertebra
Do not forget to PR (if indicated) examine the back of the head, c-spine, torso
Log Roll
Is everybody ready?We will roll back on on three. . .
1, 2, 3
Summary
C-Spine assessment with Canadian C-spine rules
Primary Survey – intervene and start again at ‘A’
Log roll – team and procedure
Questions?
Thankyou