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Polytrauma
1. POLYTRAUMA WITH AIRWAY AND CIRCULATORY PROBLEMS Dr. Mansoor Khan MBBS, FCPS I, Resident, Surgical “C”, KTH Peshawar. Sep 29 th , 2009
2. “ Trauma to two or more than two systems of the body with associated signs and symptoms ”
3. Intracranial hematoma, major Thoracic/abdominal trauma Due to sepsis & multi organ failure M o R T A L I T y Within minutes Within Hours (Golden Hour) Within Days or weeks Major Vascular/neurological Trauma Medical treatment usually not helpful
5. TRIAGE White Dead P4 Sprained ankle Delayed Green Minor P3 Fracture femur Urgent Yellow Urgent P2 Tension Pneumothorax Immediate Red Life-Threatening P1 Example Treatment Colour Definition Cat
6. W alk A irway R espiratory rate P ulse rate or C apillary return T R I A G E
9. Always assume cervical spine injury If patient can talk then no airway problem If airway compromised initially attempt a chin lift and clear airway of foreign bodies Intubate or cricothyroidotomy Give 100% Oxygen Airway and cervical spine
16. Check position of trachea, respiratory rate and air entry T ension pneumothorax will need immediate relief Place venous cannula through second intercostal space in the mid-clavicular line If open chest wound seal with occlusive dressing BREATHING
23. Assess pulse, capillary return and state of neck veins Identify exsanguinating haemorrhage and apply direct pressure Place two large calibre intravenous cannulas Give intravenous fluids (c rystalloid or colloid) Attach patient to ECG monitor Circulation and haemorrhage control
27. Assess level of consciousness using AVPU method A = alert V = responding to voice P = responding to pain U = unresponsive Assess pupil size, equality and responsiveness Dysfunction
