Emergency Medicine Book

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Trauma EvaluationAka: Primary Trauma Evaluation, Trauma Primary Survey, ATLS

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  1. Epidemiology
    1. Trauma is the leading cause of death under age 40 years
  2. Common Pitfalls
    1. Inadequate airway maintenance
      1. Inadequate protection of Cervical Spine
      2. Airway obstruction by foreign matter (e.g. blood)
      3. Airway obstruction by Tongue or epiglottis
    2. Inadequate fluid Resuscitation in head injured child
    3. Failure to recognize and treat internal hemorrhage
  3. Primary Survey Protocol
    1. Airway maintenance with C-Spine Control
      1. See Primary Survey Airway Evaluation
    2. Breathing and Ventilation
      1. See Primary Survey Breathing Evaluation
    3. Circulation with Hemorrhage control
      1. See Primary Survey Circulation Evaluation
    4. Disability: Neurologic Status
      1. See Primary Survey Disability Evaluation
    5. Exposure and Environmental Control
      1. See Primary Survey Exposure Evaluation
    6. Trauma Diagnostic Testing
  4. Other Primary Survey measures
    1. Urinary Catheterization
    2. Gastric Catheterization
  5. Disposition
    1. Consider Patient transfer if Glasgow Coma Score <= 8
  6. Secondary Survey
    1. Obtain Trauma History
    2. Perform Trauma Secondary Survey
  7. Reference
    1. (1993) ATLS Manual, American College of Surgeons

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