Advanced Trauma Life Support (ATLS) is a system to rapidly assess and treat trauma patients. It focuses on the initial care of trauma patients, with an emphasis on the first hour known as the "golden hour." The goal of ATLS is to rapidly identify and intervene in life-threatening injuries through a primary and secondary survey, resuscitation, and stabilization of the patient for transfer to the operating room or intensive care unit if needed. ATLS aims to minimize mortality and morbidity through structured training programs for medical professionals in trauma care.
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.
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
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,
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
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,
Il politraumatizzato è un ferito in cui alle lesioni traumatiche di uno o più distretti si associa l'alterazione di una o più funzioni vitali. il trauma maggiore rappresenta la causa di morte più comune per le persone inferiori a 40 anni
Surgery in Bleeding disorders- A challenging problem to all surgeonsSelvaraj Balasubramani
Surgery in patients with bleeding disorders like hemophilia is a nightmare to any surgeon. They must have an working knowledge of how to deal these patients in this challenging situation.
Groin swellings is one of the common problems in Surgery. Common causes are Inguinal hernia, femoral hernia and Undescended testis. In this slide presentation I discuss the applied anatomy of the groin region.
Carcinoma esophagus is the common cause for dysphagia for solids. These patients usually present too late to do any definitive curative surgical procedure.
Liver is a unique organ with dual blood supply. Pyogenic, Amebic and Hydatid liver abscesses are common. Benign neoplasms like Hepatic hemangiomas, Hepatic adenomas and Focal nodular hyperplasia are common in females. Hepatoma is common in males.
Carcinoma of breast is the second common killer disease in women after carcinoma of cervix in developing countries like India whereas it is the number one killer in western world. It can also run in families associated with BRCA1 & BRCA2 genes. Early diagnosis is almost curative and that is why they are doing mass screening like mammogram to pick up this cancer early.
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.
In this presentation I am talking about the overview of So-Hum meditation- the universal mantra.
I have discussed the meaning, how to do it, it's advantages and an advanced visualisation technique.
This is a small handbook on individual surgical disease and its management . I have discussed about Acute Appendicitis and then step by step I explain both open and laparoscopic appendicectomy in this book.
The operative surgery part is very useful for surgical trainees.
POWER OF YOUTUBE IN MEDICAL EDUCATION- Surgical Educator Channel
#powerofyoutube #surgicaleducator #babysurgeon #usmle
Website Link: www.surgicaleducator.com
Dear viewers,
• Greetings from “Surgical Educator’
• In this episode, I am talking about the Power of YouTube in medical education
• I will be discussing the various benefits of using YouTube in medical education. YouTube is definitely revolutionize the way in which we are teaching our students.
• You can enjoy all my videos in the following links:
•
/ surgicaleducator surgicaleducator.com
• Thank you for watching the video.
All my videos are problem-based, because patients are coming to us with problems and not with a diagnosis.
• I have made modules for each surgical problem which consists of
many of my YouTube videos and my PPT slides
• I request you all to watch all the videos in a playlist together, so
that you will become confident in dealing with these problems.
• Links to the Playlists based on the Surgical Problems:
• Module 1: Scrotal Swellings:
https://www.youtube.com/playlist?list...
uXwt0JH0YG8m4JmzgAli9jj
https://www.slideshare.net/babysurgeo...
• Module 2: Groin Swellings:
https://www.youtube.com/playlist?list...
uVaDboG_ddw2S6xInNnB80D
https://www.slideshare.net/babysurgeo...
• Module 3: Abdominal Pain:
https://www.youtube.com/playlist?list...
uUcXb96A3tFpTrWOVa2F7j1
https://www.slideshare.net/babysurgeo...
case-based-learning-82091549
• Module 4: Abdominal Lumps:
https://youtube.com/playlist?list=PLx...
uWBKVnBkhdE4XkW-xEoiIwB
• Module 5: Obstructive Jaundice:
https://www.youtube.com/playlist?list...
uX6MsQnsCTGl8YDFN1TYiQm
https://www.slideshare.net/babysurgeo...
127314632
• Module 6: Upper GI Hemorrhage:
https://www.youtube.com/playlist?list...
uUtV67AdUQYEUKdhX9vL576
https://www.slideshare.net/babysurgeo...
227888333
• Module 7: Lower GI Hemorrhage:
https://www.youtube.com/playlist?list...
https://www.slideshare.net/babysurgeo...
• Module 8: Thyroid Pathologies:
https://www.youtube.com/playlist?list...
uWg55odQfB_7JT0NYIP8ELp
https://www.slideshare.net/babysurgeo...
benign-diseases-and-carcinoma-thyroid
• Module 9: Breast Pathologies:
https://www.youtube.com/playlist?list...
uVTLcGtam1kFBzjY4NAf7MZ
https://www.slideshare.net/babysurgeo...
diseases-and-carcinoma-breast
• Module 10: Peripheral Arterial Diseases:
https://www.youtube.com/playlist?list...
6VIbQR4g8MdOi0z
https://www.slideshare.net/babysurgeo...
106254612
• Module 11: Venous Diseases:
https://www.youtube.com/playlist?list...
uVf1aYodgILbxVpC-fkdqNo
https://www.slideshare.net/babysurgeo...
127314847
• Module 12: Dysphagia:
https://www.youtube.com/playlist?list...
4DlU1Lp
# Dear Viewers/Friends/Colleagues,
# Greetings from Surgical Educator YouTube channel
# I am sharing an E-book where you can find out the hyperlinks for all my surgery teaching videos and their PPTs
# In this E-book you will learn the purpose of my YouTube channel Surgical Educator, core clinical problems you should master, how to utilize the channel effectively, statistics and analytics for the channel, all the teaching modules with hyperlinks to all my teaching videos and their PPTs and other learning resources created by me like the android app for the channel and other E-books.
In this presentation, I discussed the various liver swellings- both cystic and solid swellings. Cystic lumps are Pyogenic liver abscess, Amebic liver abscess and hydatid cyst. Benign solid swellings are Hepatic adenoma, Focal nodular hyperplasia and Hemangioma. The malignant solid swelings are secondary carcinoma of the liver, primary Hepatocellular carcinoma and Hepatoblastoma.
In this presentation, I have shown how to do open anterior resection both high and low varieties in a step-by-step manner with clear pictures as if reading an atlas of operative surgery.
The surgical causes for jaundice in children- both in neonates and infants- are Biliary atresia, Choledochal cyst, Biliary hypoplasia, Inspissated bile syndrome, and spontaneous perforation of CBD. How to Diagnose & Treat all these causes.
I am sharing a 10 paged e-book that consists of the hyperlinks to all my surgery teaching videos and to all the PPTs used for these videos from SlideShare. You can watch these videos problem based and can become competent to deal with it. You can read this to cover the whole undergraduate curriculum.
In this presentation I discussed 5 scrotal swellings case scenarios with my MBBS students. I have shared these case scenarios prior to the PBL class and asked the students to come prepared to the class. In the class i tested the knowledge gaind by the students by watching my didactic YouTube videos on the subject by asking so many questions. So this online class was highly interactive based on flip class model.
- 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
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
4. ADVANCED TRAUMA
LIFE SUPPORT
•ATLS In US
•EMST In Australia
•PTC In UK
•Most Countries having an epidemic of trauma
•In India one of the major killer is trauma 60,000
deaths/year ; In TN5000/year
A
P
O
L
L
O
L
O
G
A
5. AATTLLSSOOBBJJEECCTTIIVVEESS
•To rapidly accurately assess trauma patients
•Early recognition timely intervention of life
threatening conditions
•To resuscitate stabilise trauma patients
•To understand the priorities in trauma management
Triage
•To organise quality trauma care in your hospital
A
P
O
L
L
O
L
O
G
A
6. TRAUMA MANAGEMENT
Six Phases
• Access Phase
• Pre hospital Triage Phase
• Early Hospital or Resuscitation Phase
• Operative Phase
• Intensive care Phase
• Rehabilitative Phase
A
P
O
L
L
O
L
O
G
A
7. ATLS TRIMODAL DEATH
By Arnold D.Trunkey
• Within Seconds to Minutes
Brainstem injury
Aortic rupture
• Within Minutes to Hours
Sub dural Hematoma
Rupture of Liver Spleen
• Within Days to Weeks
Sepsis MODS
A
P
O
L
L
O
L
O
G
A
8. AATTLLSS
• Emergency life saving precedes examination of
trauma patients
• Once immediate survival is achieved definitive
assessment treatment begins
• Priorities in management must always be salvage of
Life, Limb, Function Cosmetic
A
P
O
L
L
O
L
O
G
A
9. Pre Hospital Trauma Life Support
•Scene size up Extrication
•Primary Survey Basic Life Support
•Spinal Protection in LSB
•Splinting Extremities
•Control of External Hemorrhage
•Aim: To Stabilize the Patient Platinum 10
Minutes
•Load Go within Golden first hour
A
P
O
L
L
O
L
O
G
A
10. Field Triage- CCoolloorr CCooddiinngg
•Triage- sorting of patients by injury severity and
need for transport
•RED-most critically injured-immediate transfer to
hospital
•YELLOW-less critically injured-delayed transfer
to hospital without endangering life
• GREEN-No life/limb threatening injury- patient
ambulatory-may not need IP treatment
•BLACK- Dead patient
A
P
O
L
L
O
L
O
G
A
12. OOvveerrvviieeww ooff AATTLLSS
Primary Survey
(ABCDE's)
Resuscitation
Secondary Survey
Data / Information /
Response to Therapy
Definitive Care
A
P
O
L
L
O
L
O
G
A
13. AATTLLSSPPRRIIMMAARRYY SSUURRVVEEYY
•A- Airway Cervical Spine Control
•B-Breathing Ventilation
•C-Circulation Hemorrhage Control
•D-Disability Neurological Status
•E-Exposure Completely undress the patient
A
P
O
L
L
O
L
O
G
A
14. ATLS—PRIMARY SURVEY
Airway Cervical Spine Control
•Chin lift or Jaw Thrust
•Removal of FB,Blood Vomitus
•Oropharyngeal or Nasopharyngeal Airway
•Intubate With E T T
•Cricothyroidotomy
•Keep the neck immobilised
A
P
O
L
L
O
L
O
G
A
15. CHIN LLIIFFTT JJAAWW TTHHRRUUSSTT
A
P
O
L
L
O
L
O
G
A
18. ATLS-PRIMARY SURVEY
Breathing Ventilation
• Airway patency doesn’t assure adequate
ventilation- Look for bilateral breath sounds
• To ensure adequate oxygenation start Ambu bag
or ETT ventilation—FIO2 0.85
• Decompress Tension Pneumothorax
• Close open Chest Injury
• IPPV in large Flail Chest
A
P
O
L
L
O
L
O
G
A
19. BAG MMAASSKK VVEENNTTIILLAATTIIOONN
A
P
O
L
L
O
L
O
G
A
20. ATLS-PRIMARY SURVEY
Circulation Hemorrhage Control
•Post Traumatic Hypotension:
Hypovolemia
•Conscious PatientEnough blood for
cerebral perfusion
•Capillary Refill 2 seconds
•Pale Cold SkinBlood Volume Loss
30%
A
P
O
L
L
O
L
O
G
A
21. SURVEY
ATLSPRIMARY Circulation Hemorrhage Control
•Rapid Thready Pulse Hypovolemia
•Absent Pulse CPR
•External Exsanguinating Hemorrhage controlled
with MAST/ PASG, Never use Tourniquets
A
P
O
L
L
O
L
O
G
A
22. ATLS-PRIMARY SURVEY
Disability Neurological Status
•AVPU Describes Patient`s Level of
Consciousness
•A Alert
•V Responds to vocal stimuli
•P Responds to painful stimuli
•U Unresponsive
•GCS to be done in secondary survey
A
P
O
L
L
O
L
O
G
A
23. Common Life Threatening PPaatthhoollooggyy
A = Airway
B = Breathing
C = Circulation
Obstruction
Tension PTX or HTX
Open PTX
Flail Chest
Hypovolemic Shock
Massive hemorrhage
Spinal Shock
A
P
O
L
L
O
L
O
G
A
24. AATTLLSS--RREESSUUSSCCIITTAATTIIOONN
• Start 2 Large Bore IV Lines
• Infuse Crystalloids 2 to 3 Litres
• Then Transfuse Type Specific WB or O-ve Packed
RBCs
• Tissue Aerobic Metabolism is assured by Perfusion with
well oxygenated RBCs
• Never treat Hypovolemic Shock with Vasopressors,
Steroids or NaHco3
A
P
O
L
L
O
L
O
G
A
25. AATTLLSS --RREESSUUSSCCIITTAATTIIOONN
•CBD NGT aspiration if not contraindicated
•Careful ECG Monitoring Correction of
Arrhythmias
•Data Flow sheet of Vital Parameters to assess
effectiveness of Resuscitation
•Reevaluate Airway, Breathing and
Circulation. If needed CPR
A
P
O
L
L
O
L
O
G
A
26. Adjuncts ttoo PPrriimmaarryy SSuurrvveeyy
•Vital Signs/ECG monitoring
•ABGs
•POX/ETCO2
•Urinary/gastric catheters
•Urinary output
•Supplemental Oxygen
A
P
O
L
L
O
L
O
G
A
27. Adjuncts ttoo PPrriimmaarryy SSuurrvveeyy
•Diagnostic tools
•CXR, C-spine, Pelvis
•DPL
•Ultrasound FAST
A
P
O
L
L
O
L
O
G
A
28. SSeeccoonnddaarryy SSuurrvveeyy
•Secondary Survey does not begin until the
primary Survey( ABCDEs) is completed,
resuscitative efforts are well established, and
patient is demonstrating normalisation of vital
functions
A
P
O
L
L
O
L
O
G
A
30. ATLSSSEECCOONNDDAARRYY SSUURRVVEEYY
•Perineum/ Rectum/ Vagina
•Extremities Fractures
•Complete Neurological Exam GCS
•Appropriate X-Rays, Lab Tests and Special
Studies
•“Tubes fingers” in every orifice
A
P
O
L
L
O
L
O
G
A
31. ATLS PPaattiieenntt``ss HHiissttoorryy
•A Allergies
•M Medications Currently Taken
•P Past Illness
•L Last Meal
•E Events/ Environment related to injury
A
P
O
L
L
O
L
O
G
A
32. ATLSMechanism ooff IInnjjuurryy
• Blunt Trauma
- Front Impact Myocardial contusion,
Pneumothorax, Flail Chest, Cervical Spine#
- Side Impact.# Spleen or Liver,# Pelvis, Flail
Chest, Opposite Cervical Spine Sprain/ #
-Rear Impact Whiplash Injury Cervical Spine
-Ejection from Vehicle Multiple Injuries
• Penetrating Trauma
-Sharp objects, Missiles
A
P
O
L
L
O
L
O
G
A
36. ATLSDDeeffiinniittiivvee CCaarree
•Comprehensive Treatment of all Injuries
•Fracture Stabilisation
•Necessary Operative Intervention
•Appropriate Intensive Care
•Rehabilitation
•Stabilisation Appropriate Transfer
A
P
O
L
L
O
L
O
G
A
37. AATTLLSSTTRRIIAAGGEE
• Sorting of patients based on severity of injuries
and availability of resources
•Number of patients severity of injuries do not
exceed facility multiple casualties treat the
most critically injured first
•The same exceed the facility Mass casualties
treat as many as salvageable patients as possible
A
P
O
L
L
O
L
O
G
A
38. AATTLLSSSSKKIILLLL SSTTAATTIIOONNSS
•Airway Management
•Vascular access and Fluid Resuscitation
•ECG Monitoring CPR including defibrillation
•Pediatric Priorities
•Transport of Critically Ill Patients
•Disaster Management
A
P
O
L
L
O
L
O
G
A
41. Roles ooff tthhee TTrraauummaa TTeeaamm
Airway
Nurse
Boss
Team Member
Attending
Team Member
Nurse
A
P
O
L
L
O
L
O
G
A
42. Things to remember0
The Ideal Trauma Resuscitation
•Roles are pre-assigned Multidisciplinary team
•Clear direction communication
•Pertinent findings verbalized in proper order
•All team members know all findings
•Rapid, Efficient
•Calm Quiet!
A
P
O
L
L
O
L
O
G
A
43. OOvveerrvviieeww ooff AATTLLSS
Primary Survey
(ABCDE's)
Resuscitation
Secondary Survey
Data / Information /
Response to Therapy
Definitive Care
A
P
O
L
L
O
L
O
G
A
44.
45. CARRY HOME MESSAGE
“Joining Together is Beginning
Staying Together is Progress
Working Together is Success”
A
P
O
L
L
O
L
O
G
A