Case presentation

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2005 / 09 / 22
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ATLS ???????
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ATLS 5 Steps

• Preparation
• Triage
• Primary survey (ABCDE) Resuscitation
• Adjuncts to primary survey
• Secondary survey
• Adjuncts to secondary survey
• Continued monitoring and reevaluation
• Definite care / Transfer

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Primary Survey
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• Airway C-spine protection
• Breathing R/O tension pneumothorax
• Circulation stop bleeding
• Disability (GCS) pupils MP x 4
• Exposure Environmental control

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Adjuncts to Primary Survey

• NG/OG, Foley
• X-rays Chest, pelvis, c-spine
• DPL or FAST
• Monitoring ECG, BP, SpO2, ABG, ETCO2

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Secondary Survey

• Does not begin until
• Primary survey (ABCDE) is completed
• Normalization of vital signs after resuscitation

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Secondary Survey

• Complete History
• AMPLE
• Complete PE
• Head to toes
• Finger to holes

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Secondary Survey

• History
• Allergies
• Medication
• Past illness / pregnancy
• Last meal
• Events / environment

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Adjuncts to Secondary Survey

• Specialized diagnostic tests
• CT scans
• Contrast x-rays
• Extremity x-rays
• Endoscopy and ultrasonography

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Reevaluation

• Reevaluation constantly (start with ABCDE)
• To discover new findings
• To discover deterioration
• Continuous monitoring
• Vital signs, EKG
• U/O
• ABG, SpO2
• ETCO2

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Definite Care and Transfer

• Decision during the primary survey and
  resuscitation
• D2D communication
• Transfer after life-saving resuscitation

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