This document outlines the general approach and concepts for treating traumatic patients according to Advanced Trauma Life Support (ATLS) guidelines. It describes treating the greatest threats to life first using the ABCDE approach to assess the airway, breathing, circulation, disability, and exposure. The primary survey involves rapid assessment and interventions to stabilize the patient, while the secondary survey entails a full physical exam and diagnostic testing. Key interventions discussed include intubation, chest tube insertion, hemorrhage control, and use of the Focused Assessment with Sonography for Trauma (FAST) exam to evaluate for internal bleeding. Definitive care may involve transfer to the operating room or intensive care unit based on specialty consultations.
CHEST INJURY- BLUNT/ Trauma Surgery
Dear viewers,
Greetings from “Surgical Educator”
Today I have uploaded a video on CHEST INJURY- BLUNT- an important topic in trauma. Even the blunt chest trauma can turn into penetrating one because of jagged edges of the broken ribs. I haven’t talked elaborately but have included the essential minimum an undergraduate medical student should know. I have talked about pathophysiology, clinical approach, symptoms, signs, investigations, different individual types of Chest injuries and management of all the varieties of Chest injuries. My aim is, after watching this video all of you should be able to arrive at a correct working diagnosis of the type of chest injury and should also be able to institute immediate lifesaving treatment to the patients if there is a need. You can watch the video in the following links:
surgicaleducator.blogspot.com
youtube.com/c/surgicaleducator
Thank you for watching the video.
INITIAL ASSESSMENT OF TRAUMA PATIENTS....(INSPIRED FROM CTLS AND ATLS GUIDELI...Prerna Biswal
THIS PRESENTATION WAS MADE AT IMA HOUSE IN BHUBANESWAR,ODISHA, BY DR.NIBEDITA PANI,HOD ,DEPT. OF ANAESTHESIOLOGY AND DR.PRERNA BISWAL,PG,ANAESTHESIOLOGY,SCBMCH,CUTTACK,
CHEST INJURY- BLUNT/ Trauma Surgery
Dear viewers,
Greetings from “Surgical Educator”
Today I have uploaded a video on CHEST INJURY- BLUNT- an important topic in trauma. Even the blunt chest trauma can turn into penetrating one because of jagged edges of the broken ribs. I haven’t talked elaborately but have included the essential minimum an undergraduate medical student should know. I have talked about pathophysiology, clinical approach, symptoms, signs, investigations, different individual types of Chest injuries and management of all the varieties of Chest injuries. My aim is, after watching this video all of you should be able to arrive at a correct working diagnosis of the type of chest injury and should also be able to institute immediate lifesaving treatment to the patients if there is a need. You can watch the video in the following links:
surgicaleducator.blogspot.com
youtube.com/c/surgicaleducator
Thank you for watching the video.
INITIAL ASSESSMENT OF TRAUMA PATIENTS....(INSPIRED FROM CTLS AND ATLS GUIDELI...Prerna Biswal
THIS PRESENTATION WAS MADE AT IMA HOUSE IN BHUBANESWAR,ODISHA, BY DR.NIBEDITA PANI,HOD ,DEPT. OF ANAESTHESIOLOGY AND DR.PRERNA BISWAL,PG,ANAESTHESIOLOGY,SCBMCH,CUTTACK,
Approach to a trauma patient - Advanced Trauma Life SupportParthasarathi Ghosh
Approach to a trauma patient from a Critical Care Medicine perspective with basics of Advanced Trauma Life Support.
References - ATLS Manual 10th Edition
Intercostal drainage tube insertion is an emergency as well as planned procedure. In emergency it is a one of the life saving procedures. That's why it is important to learn the anatomy and physiology behind insertion of ICD and what should be the ideal procedure and post procedure care.
ATLS is two days course for those who manage trauma patients. These protocols have been followed by hospitals all over the world to treat trauma patients quickly and efficiently.
Summary and illustrations of various traumatic brain injury including primary and secondary lesions as well as limited information on indications of brain imaging in trauma
Approach to a trauma patient - Advanced Trauma Life SupportParthasarathi Ghosh
Approach to a trauma patient from a Critical Care Medicine perspective with basics of Advanced Trauma Life Support.
References - ATLS Manual 10th Edition
Intercostal drainage tube insertion is an emergency as well as planned procedure. In emergency it is a one of the life saving procedures. That's why it is important to learn the anatomy and physiology behind insertion of ICD and what should be the ideal procedure and post procedure care.
ATLS is two days course for those who manage trauma patients. These protocols have been followed by hospitals all over the world to treat trauma patients quickly and efficiently.
Summary and illustrations of various traumatic brain injury including primary and secondary lesions as well as limited information on indications of brain imaging in trauma
GEMC: Acute Pulmonary Emergencies: Pulmonary Embolism, Pulmonary Edema and Pa...Open.Michigan
This is a lecture by Dr. Michele M. Nypaver from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
Presentation by Dept of Surgery Eko Hospitals, Ikeja, Lagos Nigeria on the 1st of July 2015. Prepared by Dr. Ajayi Babajide (Junior Resident Family Medicine.)
airway management in trauma patients can be particularly challenging because of the presence of difficult airway and disrupted anatomy.
Anatomical implications, airway assessment in trauma, airway management, helpful airway devices were all mentioned in this presentation.
This is a presentation which contains basics of polytrauma management,ATLS, triage, critical decision making skills, application of Glasgow coma scale and complications of different management strategies, if not applied properly.
Polytrauma and multiple traumata are medical terms describing the condition of a person who has been subjected to multiple traumatic injuries. This will be more prevalent in our country
Successful management of Polytrauma must achieve the following goals, 1- Keep someone alive that would be dead without you 2- Prioritize treatment to prevent killing someone 3- Treat extremity injuries to return the patient to a functional life. The Priorities are 1- Life threatening, 2- Limb threatening, 3- Function threatening. The question about the best strategy in the management Polytrauma and the choice between an Early Total Care (ETC) vs. Damage Control Orthopedics (DCO) will be answered in this presentation.
Asthma Signs and Symptoms, Severity Classification, GINA and ATS Classification, Step-up Management of Chronic Asthma and Management of Acute Exacerbation of Asthma
Delayed blood transfusion reaction is a reaction too blood transfusion occurring after 24 hours. Can be divided to immune mediated and non-immune mediated. Share about the cause, symptoms, investigations and management.
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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2. Trauma
• physiological wound caused by an external
source. It can also be described as "a physical
wound or injury, such as a fracture or blow".
• E.g. MVA accidents, falls, industrial accidents,
burns, knifings, and shootings.
• Leading cause of death in productive young
man
3. Concepts of ATLS
• Treat the greatest threat to life first
• The lack of a definitive diagnosis should never
impede the application of an indicated
treatment
• A detailed history is not essential to begin the
evaluation
• “ABCDE” approach
4. Primary Survey
• Patients are assessed and treatment priorities
established based on their injuries, vital signs,
and injury mechanisms
• ABCDEs of trauma care
– A Airway and c-spine protection
– B Breathing and ventilation
– C Circulation with hemorrhage control
– D Disability/Neurologic status
– E Exposure/Environmental control
5. A- Airway
• Airway should be assessed for patency
– Is the patient able to communicate verbally?
– Inspect for any foreign bodies
– Examine for stridor, hoarseness, gurgling, pooled
secrecretions or blood
• Assume c-spine injury in patients with
multisystem trauma
– C-spine clearance is both clinical and radiographic
– C-collar should remain in place until patient can cooperate
with clinical exam
11. Breathing Interventions
• Ventilate with 100% oxygen
• Needle decompression if tension
pneumothorax suspected
• Chest tubes for pneumothorax / hemothorax
• Occlusive dressing to sucking chest wound
• If intubated, evaluate ETT position
13. C- Circulation
• Hemorrhagic shock should be assumed in any
hypotensive trauma patient
• Rapid assessment of hemodynamic status
– Level of consciousness
– Skin color
– Pulses in four extremities
– Blood pressure and pulse pressure
14. Circulation Interventions
• Cardiac monitor
• Apply pressure to sites of external hemorrhage
• Establish IV access
– 2 large bore IVs
– Central lines if indicated
• Cardiac tamponade decompression if indicated
• Volume resuscitation
– Have blood ready if needed
– Level One infusers available
– Foley catheter to monitor resuscitation
15. D- Disability
• Abbreviated neurological exam
– Level of consciousness
– Pupil size and reactivity
– Motor function
– GCS
• Utilized to determine severity of injury
• Guide for urgency of head CT and ICP monitoring
16. Disability Interventions
• Spinal cord injury
– High dose steroids if within 8 hours
• ICP monitor- Neurosurgical consultation
• Elevated ICP
– Head of bed elevated
– Mannitol
– Hyperventilation
– Emergent decompression
17. E- Exposure
• Complete disrobing of patient
• Logroll to inspect back
• Rectal temperature
• Warm blankets/external warming device to
prevent hypothermia
19. Secondary Survey
• AMPLE history
– Allergies, medications, PMH, last meal, events
• Physical exam from head to toe, including
rectal exam
• Frequent reassessment of vitals
• Diagnostic studies at this time
simultaneously
– X-rays, lab work, CT orders if indicated
– FAST exam
22. Adjuncts to Secondary Survey
Radiology
– Standard emergent films
C-spine, CXR, Pelvis
– Focused Abdominal Sonography in Trauma (FAST)
– Additional films
Cat scan imaging
Angiography
Foley Catheter
– Blood at urethral meatus = No Foley catheter
Pain Control
Tetanus Status
Antibiotics for open fractures
22
26. Abdominal Trauma
• Common source of traumatic injury
• Mechanism is important
– Bike accident over the handlebars
– Car with steering wheel trauma
• High suspicion with tachycardia, hypotension,
and abdominal tenderness
• Can be asymptomatic early on
• FAST exam can be early screening tool
27. Abdominal Trauma
• Look for distension, tenderness, seatbelt
marks, penetrating trauma, retroperitoneal
ecchymosis
• Be suspicious of free fluid without evidence of
solid organ injury
28. FAST Exam
• Focused Abdominal Scanning in Trauma
• To find free fluid (blood) around heart
(pericardiac eff.) or abdominal organ
(hemoperitoneum) after trauma
• 4 views:
– Cardiac
– RUQ (Morison’s Pouch)
– LUQ (Perispleenic Space)
– Pelvic (Pouch of Doughlas)
29. Splenic Injury
• Most commonly injured organ in
blunt trauma
• Often associated with other injuries
• Left lower rib pain may be indicative
• Often can be managed non-
operatively
30. Liver injury
• Second most common solid organ injury
• Can be difficult to manage surgically
• Often associated with other abdominal
injuries
31. Hollow Viscous Injury
• Injury can involve stomach, bowel, or
mesentery
• Symptoms are a result from a combination of
blood loss and peritoneal contamination
• Small bowel and colon injuries result most
often from penetrating trauma
• Deceleration injuries can result in bucket-
handle tears of mesentery
• Free fluid without solid organ injury is a
hollow viscus injury until proven otherwise
32. Definitive Care
Secondary Survey followed by radiographic
evaluation
– CatScan
– Consultation
Neurosurgery
Orthopedic Surgery
Vascular Surgery
Transfer to Definitive Care
– Operating Room
– ICU
– Higher level facility
32
34. Conclusion
Assessment of the trauma patient is a standard algorithm
designed to ensure life threatening injuries do not get
missed
Primary Survey + Resuscitation
– Airway
– Breathing
– Circulation
– Disability
– Exposure
Secondary Survey
Definitive Care
34
35. References
1. Bailey and Love’s Short Practice of Surgery. 25th Edition.
2. Kumar MV (2014) Clinical Companion in Surgery. 2nd
Edition
3. Davidson’s Principles and Practice of Medicine 21st Edition
4. Carmont MR (2005). "The Advanced Trauma Life Support
course: a history of its development and review of related
literature". Postgraduate Medical Journal 81(952): 87–91.
5. Styner, Randy (2012). The Light of the Moon - Life, Death
and the Birth of Advanced Trauma Life Support. Kindle
Books: Kindle Books. p. 267.
6. Committee on Trauma, American College of
Surgeons (2008). ATLS: Advanced Trauma Life Support
Program for Doctors (8th ed.). Chicago: American College
of Surgeons.