This document discusses trauma life support practices from Egypt to Ghana. It outlines the high rates of trauma deaths and costs in the UK and US, as well as trauma statistics in Egypt. It then covers mechanisms of injury, the trimodal distribution of death after trauma, and the steps of Advanced Trauma Life Support (ATLS). It also discusses prehospital retrieval and management approaches, levels of trauma centers, management in the hospital, the trauma team workflow and call-out criteria. It concludes with information on triage procedures and a proposed Facebook group for Egyptian and Ghanaian healthcare professionals.

1. INTRODUCTION
Trauma life support from Egypt to Ghana

3. INTRODUCTION
UK - > 18, 000 deaths annually.
> 60, 000 hospital admission.
> Costing 2.2 billion pounds.
USA > 120, 000 deaths annually.
> 100 billion dollars.
EGYPT > 13000 deaths annully
> 60,000 hospital admission.

4. MECHANISMS OF INJURY
Types of injury
• Penetrating.
• Non-penetrating blunt.
• Blast.
• Thermal.
• Chemical.
• Others - crush & barotrauma.

5. TRIMODAL DISTRIBUTION OF DEATH
Immediate death (50%)
0 to 1 hr.
Early death (30%)
1 to 3 hrs.
Late death ( 20%)
1 to 6 wks.
Golden
Hour

6. ADVANCED TRAUMA LIFE SUPPORT ( ATLS)
Main purpose of the course
Treat lethal injuries first
Reassess
Treat again

7. ATLS –STEPS
Primary survey
Identify what is killing the patient.
Resuscitation
Treat what is killing the patient.
Secondary survey
Proceed to identify other injuries.
Definitive care
Develop a definitive management plan.

8. PREHOSPITAL RETRIEVAL & MANAGEMENT
AIMS
Access of the patient
Smooth transfer
APPROACHES
Scoop & Run policy
Stay & Play policy

9. ORGANISATION OF TRAUMA CENTRES
LEVEL 1 – REGIONAL TRAUMA CENTRES
LEVEL 2 – COMMUNITY TRAUMA CENTRES
LEVEL 3 – RURAL TRAUMA CENTRES

10. MANAGEMENT IN HOSPITAL
TRAUMA CENTRE
should be adequately equipped
with
ATLS Trained Personnel

11. THE TRAUMA TEAM
4 Doctors
At least 1 Anaesthetist
1 Orthopaedician
1 General surgeon
1 Nurses
1 Radiographer

12. But no more than
6 people should
touch the patient at
one time

13. TRAUMA TEAM CALL-OUT CRITERION
• Penetrating injuries
• Two or more proximal bone fractures
• Flail chest & pulmonary contusion
• Evidence of high energy trauma
- fall from > 6ft
-changes in velocity of 32 kmph
- 35 cm displacement of side wall of car
- ejection of the patient
- roll-over
- death of another person in same car
- blast injuries

14. Who is the leader?
Most experienced.
Preferably a general surgeon.
Takes all TRIAGE decisions.
Should be familiar with each members’ skills.
Prioritise procedures.
Communicate with consultants & family members.

15. TRIAGE
TRIAGE SIEVE – to separate dead & the walking from the injured
TRIAGE SORT – to categorize the casualties according to local
protocols.
Cat 1 : critical & cannot wait.
Cat 2 : urgent – can wait for 30 mins at most
Cat 3 : less serious injuries.
Cat 4 : expectant – survival not likely.

16. How
to
triage
1. Can the patient walk?
Yes delayed
No check for breathing
2. Is the patient breathing?
No open the airway
Are they breathing now?
Yes IMMEDIATE
No DEAD
Yes count the rate
<10 & > 30 / min – IMMEDIATE
10 – 30 /min – check circulation
3. Check the circulation
Capillary refill> 2 sec- IMMEDIATE
Capillary refill < 2 secs - urgent

17. Face book
Face book group:
Egyptian Ghanian healthcare alliance
For:
friendships
Photos
Videos
Sharing knowledge

18. THANK YOU