material used during final exam preparation hope benefit for all *at own risk

1. EM CIRCULATORY ANDRESUSCITATION
Gpe
Pallor
Tachypnea
AVPU
- Look pt alert/awake
- Verbal:tapshouldersiropenureyes,holdmyhands.
- Pain:pressbothshoulderontrapezius
- Unresponsiveness/unconcious
 Hands: coldand clammy,pallor,capillary refillingtime.
 Check Brachial pulse if present
 Radial pulse:rate rhythmvolume
 If brachial absent:checkcarotid
 Checkfor bp
 Connecthemodynamicmonitoring.
Checkfor source of bleeding
- External bleeding:if foundputdigitpressure orpressure dressing
o At floor
o Chest
o Abdomen
o Pelvis
o Long bone
o Drain
o Bed
- Internal bleeding
o Site internal bleeding
 Cardiac tamponade
 Intraabdominal
 Retroperitoneal
 Pelvicandlongbone
o Raised neckvenousdistension
o Chest:muffledheartsound
o Abd:abd distension, tenderness.
o Palpate pelvis tenderness
o and longbone.
o Adjunctforinternal bleeding :dofastscan
 Subxiphoid
 Morrisonpouch
 Pelvic
 Splenorenalrecess
o X ray trauma series
 Lateral cervical
 Chest

2.  Pelvic
Shockclassification
Class3 : massive transfusion protocol
Resuscitation
- Put 2 large bore iv cannulaantecubatal fossa
- Draw bloodforinvestigation: bloodgroupingcrossmatching.abg.
- Give warm ivcrystalloid1Lbolus
- Iv tranexamicacid 1g
- Give o negative blood
- Once cross mqtchingreportcame give the cross matchedblood