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Dr Indira Jayakumar
Senior Consultant
ER & PICU
Apollo Childrens Hospital
Golden Hour
Transport
Effect of trauma center designation on outcome in patients with severe traumatic brain injury.
Arch Surg 2008 Dec;143(12):1213-7
PTS < 8 – concerning !!
Protect Yourself First
Chaos to........ Calm, Confident ,Control
Team leader assigns roles
Keep Track of Events
Purpose of “ Primary Survey ”
13
Primary Survey
Airway
Breathing
Circulation
Disability
Exposure
The well practiced
trauma team should
aim to complete the
primary survey in less
than 10 minutes
Illinois EMSC 15
Assess Airway
Is the airway:
• At risk?
• Obstructed?
Cervical Spine Stabilization
• Place hands on either side of the head
18
Airway and Cervical spine
• Always assume that patient has cervical spine injury
• If patient can talk then he is able to maintain own airway
• If airway compromised , initially attempt a chin lift and do
suction with wide bore yankauer sucker .
Aims
• Support if inadequate
• Percuss , Auscultate
Tension Pneumothorax
Traumatic Hemothorax
Circulation and Haemorrhage Control
• Assess pulse, capillarycontrol
return , perfusion
• Neurogenic
•
Scalp Hematoma in infants
What is the FAST exam?
• Retroperitoneal bleeding
Unstable Stable
Hemostatic
resuscitation Damage control
surgery Conservative
Permissive
Hypotensiom
Blood Pressure in Traumatic Brain /Spinal cord Injury
• FAST