Vascular injuries
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This document discusses vascular injuries, covering their mechanisms, recognition, and management. It begins with the objectives of understanding trauma management principles, vascular anatomy, and mechanisms of injury. For management, the document outlines the ABCDE primary survey, resuscitation to control bleeding and protect airways, and secondary survey. It then details the specific mechanisms of penetrating, blunt, blast, and iatrogenic vascular injuries. The document concludes by discussing principles of vascular repairs, options for peripheral repairs, and potential complications.
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Vascular injuries and Principles of management 2021
This document discusses vascular injuries, their causes, signs, investigations, and principles of management. It focuses on surgical repair techniques including preparing the limb, assessing and trimming the injured vessel, thrombectomy, and using a reverse saphenous vein graft or direct approximation when possible. It also addresses venous injuries, combined vascular and skeletal trauma, and the role of primary amputation in extensive crush injuries. The overall aim is to resuscitate the patient, repair the injury as soon as possible with or without fasciotomy or external fixation, provide post-operative monitoring, and enable rehabilitation.
extremity Vascular trauma / injury
extremity vascular injury, arterial injury, causes of arterial injury, mechanisms of arterial injury, investigations for arterial injury, treatment of arterial injury, , extremity vascular injuryfor medical students
Vascular trauma
1. The document discusses various types of vascular injuries including sharp, blunt, transection, laceration, and contusion injuries.
2. Signs of vascular injury in the extremities include pain, pallor, pulselessness, perishing cold, paresthesia, paralysis and the "P's". Complications can include bleeding, ischemia, and complications from vascular injury.
3. Evaluation of vascular injuries involves assessment of signs like hard or soft pulses, Doppler, CT angiography, and possible urgent exploration and repair in cases of threatened limbs with paresthesia and paresis.
G03 vascular injury
Vascular injuries require prompt evaluation and treatment to prevent limb loss from hemorrhage or ischemia. Physical exam and Doppler are initial steps to detect hard signs of injury warranting arteriography or surgery. Soft signs may be managed non-operatively with serial imaging. Scoring systems help determine limb salvability in mangled extremities based on injury mechanism, ischemia time, age, and hemodynamics. Revascularization generally precedes fixation to restore blood flow, though temporary shunts allow staged procedures. Close coordination between specialties optimizes limb salvage.
Vascular trauma
This document summarizes the assessment and treatment of vascular trauma. It discusses the history of vascular surgery, mechanisms of injury, initial assessment and treatment focusing on controlling bleeding and ischemia. Signs of arterial injury are outlined. Surgical management may involve angiography, open exploration, repair, bypass or ligation. Compartment syndrome is a risk and location of injury impacts outcomes. Treatment of venous and carotid trauma is also addressed.
vascular injury
This document discusses the evaluation and treatment of vascular injuries associated with orthopedic trauma. Vascular injuries can cause irreversible tissue damage within 6 hours so rapid diagnosis and treatment is crucial. Physical exam, Doppler ultrasound, angiography, and surgical exploration are used to diagnose injuries. The type and level of injury, collateral circulation, ischemia time, and patient factors impact prognosis. Immediate treatment involves controlling bleeding, resuscitation, and splinting injuries. Urgent surgical treatment may be needed for arterial injuries or absent pulses. Ongoing monitoring of circulation and compartment pressures is important after initial treatment.
Lower Limb Vascular Trauma
This document provides an overview of lower limb vascular trauma, including:
- It accounts for 80% of all vascular trauma cases, with the lower extremities involved in two-thirds of patients.
- Presentation can include hard signs like active bleeding or soft signs like pulse deficits. Complications include thrombosis, embolization, and rupture.
- Diagnosis involves clinical examination, pulse oximetry, Doppler ultrasound, duplex ultrasound, and angiography.
- Management includes immediate hemorrhage control, volume resuscitation, operative strategies like suturing, grafting or shunting, and damage control techniques like ligation if needed. Case examples from the author's experience are also summarized.
Vascular injuries and management 2018
Vascular Injuries and Principles of ManagementVascular Surgery Workshop 2018
Joel Arudchelvam,MBBS (Col), MD (Sur), MRCS (Eng),Consultant Vascular and Transplant Surgeon Teaching Hospital Anuradhapura.
Causes, Mechanism of injury, Arterial Level injuries, Signs of vessel injury -Hard signs,Soft sign, Principles of management
Recommended
Vascular injuries and Principles of management 2021
This document discusses vascular injuries, their causes, signs, investigations, and principles of management. It focuses on surgical repair techniques including preparing the limb, assessing and trimming the injured vessel, thrombectomy, and using a reverse saphenous vein graft or direct approximation when possible. It also addresses venous injuries, combined vascular and skeletal trauma, and the role of primary amputation in extensive crush injuries. The overall aim is to resuscitate the patient, repair the injury as soon as possible with or without fasciotomy or external fixation, provide post-operative monitoring, and enable rehabilitation.
extremity Vascular trauma / injury
extremity vascular injury, arterial injury, causes of arterial injury, mechanisms of arterial injury, investigations for arterial injury, treatment of arterial injury, , extremity vascular injuryfor medical students
Vascular trauma
1. The document discusses various types of vascular injuries including sharp, blunt, transection, laceration, and contusion injuries.
2. Signs of vascular injury in the extremities include pain, pallor, pulselessness, perishing cold, paresthesia, paralysis and the "P's". Complications can include bleeding, ischemia, and complications from vascular injury.
3. Evaluation of vascular injuries involves assessment of signs like hard or soft pulses, Doppler, CT angiography, and possible urgent exploration and repair in cases of threatened limbs with paresthesia and paresis.
G03 vascular injury
Vascular injuries require prompt evaluation and treatment to prevent limb loss from hemorrhage or ischemia. Physical exam and Doppler are initial steps to detect hard signs of injury warranting arteriography or surgery. Soft signs may be managed non-operatively with serial imaging. Scoring systems help determine limb salvability in mangled extremities based on injury mechanism, ischemia time, age, and hemodynamics. Revascularization generally precedes fixation to restore blood flow, though temporary shunts allow staged procedures. Close coordination between specialties optimizes limb salvage.
Vascular trauma
This document summarizes the assessment and treatment of vascular trauma. It discusses the history of vascular surgery, mechanisms of injury, initial assessment and treatment focusing on controlling bleeding and ischemia. Signs of arterial injury are outlined. Surgical management may involve angiography, open exploration, repair, bypass or ligation. Compartment syndrome is a risk and location of injury impacts outcomes. Treatment of venous and carotid trauma is also addressed.
vascular injury
This document discusses the evaluation and treatment of vascular injuries associated with orthopedic trauma. Vascular injuries can cause irreversible tissue damage within 6 hours so rapid diagnosis and treatment is crucial. Physical exam, Doppler ultrasound, angiography, and surgical exploration are used to diagnose injuries. The type and level of injury, collateral circulation, ischemia time, and patient factors impact prognosis. Immediate treatment involves controlling bleeding, resuscitation, and splinting injuries. Urgent surgical treatment may be needed for arterial injuries or absent pulses. Ongoing monitoring of circulation and compartment pressures is important after initial treatment.
Lower Limb Vascular Trauma
This document provides an overview of lower limb vascular trauma, including:
- It accounts for 80% of all vascular trauma cases, with the lower extremities involved in two-thirds of patients.
- Presentation can include hard signs like active bleeding or soft signs like pulse deficits. Complications include thrombosis, embolization, and rupture.
- Diagnosis involves clinical examination, pulse oximetry, Doppler ultrasound, duplex ultrasound, and angiography.
- Management includes immediate hemorrhage control, volume resuscitation, operative strategies like suturing, grafting or shunting, and damage control techniques like ligation if needed. Case examples from the author's experience are also summarized.
Vascular injuries and management 2018
Vascular Injuries and Principles of ManagementVascular Surgery Workshop 2018
Joel Arudchelvam,MBBS (Col), MD (Sur), MRCS (Eng),Consultant Vascular and Transplant Surgeon Teaching Hospital Anuradhapura.
Causes, Mechanism of injury, Arterial Level injuries, Signs of vessel injury -Hard signs,Soft sign, Principles of management
Popliteal artery trauma
The popliteal artery and vein are vulnerable to injury due to their location behind the knee. Popliteal artery injuries have high amputation rates of around 30-35% due to the end artery nature with limited collaterals. Prompt diagnosis and surgical repair through a medial approach with interposition grafting can achieve limb salvage in over 85% of cases. Factors associated with higher amputation risks include delay in treatment, the presence of additional injuries, and blunt rather than penetrating mechanisms of injury.
Peripheral Vascular Injuries
This document discusses peripheral vascular injuries. Some key points:
- Peripheral injuries account for 80% of vascular trauma cases, with the lower extremities most commonly involved.
- Combined arterial and skeletal injuries in the extremities significantly increase the risk of limb loss compared to isolated injuries.
- Diagnosing and managing vascular injuries is technically challenging, as the physiology of trauma patients is complex. Damage control techniques like shunting and ligation may be necessary.
- Hard signs of vascular injury include active bleeding, pulsatile hematoma, limb ischemia. Soft signs require further investigation like Doppler or angiography to diagnose injury.
- Surgical management involves gaining proximal and distal control, investigating the injury site, and
Trauma resuscitation
1) The document discusses a case of a pedestrian hit by a car with injuries including a flail chest, unstable pelvis, and internal bleeding. The goals of treatment are to prevent death from hemorrhage through early intervention, good airway management, resuscitation, and surgical intervention.
2) It introduces the principles of damage control resuscitation (DCR) including permissive hypotension to limit blood loss, early use of blood products to replace lost volume and clotting factors, and damage control surgery to control bleeding. DCR aims to address the "lethal triad" of coagulopathy, acidosis, and hypothermia.
3) Clinical markers like thromboelastography
Damage Control in Trauma by Brohi
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Arterial trauma
This document discusses extremity vascular injuries, which can result in limb loss or death if not properly treated. The most common causes are road traffic injuries. Clinical features include signs of active bleeding, ischemia, pain, pallor, and pulse absence. Imaging like duplex scans and angiography can help diagnose the injury. Early surgical repair of damaged blood vessels is needed to restore blood flow. Complications include compartment syndrome, which requires fasciotomy to reduce pressure. Close monitoring is also needed after reperfusion to watch for systemic effects. With proper emergency treatment and surgery, many extremities can be saved from amputation.
Vastrauma mannar
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MANAGEMENT OF TRAUMA
Trauma management involves initial assessment and stabilization of airway, breathing, circulation, disability and exposure (ABCDE). The primary survey assesses life threats and guides resuscitation efforts. Key priorities include spinal immobilization, hemorrhage control, and treating tension pneumothorax. Secondary survey involves full head-to-toe examination and history to identify all injuries requiring attention or monitoring. Management requires a multidisciplinary team approach. Proper preparation and coordination of care is essential for optimal trauma outcomes.
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Acute Limb ischemia
The document discusses acute ischemia and compartment syndrome. Acute ischemia occurs when blood supply is suddenly interrupted, most commonly due to embolism or thrombosis. It can cause severe pain and irreversible tissue damage within hours. Treatment depends on the severity and includes heparin, hydration, embolectomy, and thrombolysis. Compartment syndrome is a painful emergency condition caused by increased pressure within a muscle compartment, blocking blood flow. It requires early fasciotomy to decompress the compartment if diagnosed in the first 8 hours.
ATLS- Advanced Trauma Life Support
ATLS is the protocol developed by the American College of surgeons to assess and manage all trauma patients efficiently.
Atls presentation
This document provides an overview of Advance Trauma Life Support (ATLS) principles from a presentation. It discusses the importance of the "golden hour" in trauma care. The objectives of ATLS are to prioritize patient assessment and management. It covers the basics of trauma assessment including preparation, triage, primary survey, resuscitation, secondary survey, and transfer to definitive care. The primary survey focuses on addressing life threats in order of airway, breathing, circulation, disability and exposure.
Mangled extremity
The document discusses the management of mangled extremities. It covers components of mangled injuries including soft tissue loss, fractures, vascular and nerve injuries. It discusses the assessment, decision to amputate or attempt salvage, and principles of amputation and limb salvage. Key factors in the decision include the extent of soft tissue damage, viability of nerves and blood vessels, amount of bone loss and potential for functional recovery. Serial debridement, skeletal stabilization, wound management and soft tissue coverage are also addressed.
Polytrauma part 7 (Management)
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.
Trauma scoring systems
The document discusses various trauma scoring systems used to classify and predict outcomes in trauma patients. It describes physiological scores like the Glasgow Coma Scale (GCS) and Revised Trauma Score (RTS) that assess consciousness and vital signs. Anatomical scores like the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS) evaluate specific injuries. Combined scores like the Trauma Score-Injury Severity Score (TRISS) and Acute Physiology and Chronic Health Evaluation (APACHE) integrate multiple factors. Each score has benefits for triage, prognosis, and research but also limitations in certain clinical scenarios.
Management of abdominal vascular injury
This document discusses the management of abdominal vascular injuries. It covers the epidemiology, anatomy, presentation, investigations, surgical approaches, challenges, and complications of abdominal vascular injuries. Resuscitation and damage control techniques are emphasized. Exposure and control of the aorta, inferior vena cava, and iliac vessels are described in detail. Primary repair or ligation are the main repair options, with endovascular techniques also playing a selective role. Mortality rates are high and prompt diagnosis and management are critical due to the risk of exsanguinating hemorrhage.
Vasular trauma
Vascular Trauma
Joel Arudchelvam
Consultant Vascular and Transplant Surgeon
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Extremity Vascular Injuries
causes
Signs of a vessel injury hard and soft
Mechanism of disruption of flow at arterial level
Problems with diagnosing ischaemia after trauma
Investigations
How soon we should we repair
Surgical Repair
Compartment Syndrome
FASCIOTOMY
Reperfusion effects
• Reperfusion injury
• Post perfusion syndrome
Crush injury-and-crush-syndrome
This document discusses crush injury and crush syndrome. It defines crush syndrome as muscle damage from prolonged pressure that can lead to systemic complications from the release of intracellular muscle contents. Key points include: crush syndrome is a medical emergency requiring aggressive IV fluid resuscitation and bicarbonate to prevent renal failure from myoglobinuria; complications include rhabdomyolysis, hyperkalemia, hypocalcemia, and metabolic acidosis; it commonly results from events causing mass casualties such as earthquakes.
Splenic Trauma by Doctor Saleem
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Peripheral vascular injury
This document provides an overview of peripheral vascular injuries, including anatomy, types of injuries, clinical features, evaluation, management, and disposition. It discusses major blood vessels in the upper and lower extremities that are susceptible to injury from blunt or penetrating trauma. Clinical features are separated into "hard signs" that indicate over 90% risk of arterial injury and require intervention, and "soft signs" with a 30% risk that may be managed conservatively. Evaluation involves tests like ankle-brachial index, arterial pressure index, Doppler ultrasound, and CT angiography. Management consists of direct pressure, tourniquets, permissive hypotension, surgical repair, and vasodilators. Patients generally require disposition to vascular surgery.
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Vascular
This document discusses various types of vascular injuries. It covers the basic principles of vascular injury including anatomy, type of injury, mechanisms, clinical manifestations, investigations and management. It describes different types of vascular injuries like laceration, transection, dissection, crush and thrombosis. It discusses evaluation and investigations like Doppler, duplex ultrasound, angiography, CT angiography and MRI. It covers management of vascular injuries in different body regions like neck, chest, abdomen and extremities. It provides guidelines on treatment approaches including operative versus endovascular management.
TRAUMA VASCULAR
El documento resume el tema del trauma vascular. Define el trauma vascular como una lesión traumática de los vasos sanguíneos. Explica que las lesiones vasculares ocurren con más frecuencia en hombres entre 20-40 años, y que las arterias más comúnmente afectadas son la femoral superficial y la aorta abdominal. Describe los signos y síntomas de las lesiones vasculares, así como los métodos de diagnóstico y tratamiento para diferentes regiones del cuerpo.
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Popliteal artery trauma
The popliteal artery and vein are vulnerable to injury due to their location behind the knee. Popliteal artery injuries have high amputation rates of around 30-35% due to the end artery nature with limited collaterals. Prompt diagnosis and surgical repair through a medial approach with interposition grafting can achieve limb salvage in over 85% of cases. Factors associated with higher amputation risks include delay in treatment, the presence of additional injuries, and blunt rather than penetrating mechanisms of injury.
Peripheral Vascular Injuries
This document discusses peripheral vascular injuries. Some key points:
- Peripheral injuries account for 80% of vascular trauma cases, with the lower extremities most commonly involved.
- Combined arterial and skeletal injuries in the extremities significantly increase the risk of limb loss compared to isolated injuries.
- Diagnosing and managing vascular injuries is technically challenging, as the physiology of trauma patients is complex. Damage control techniques like shunting and ligation may be necessary.
- Hard signs of vascular injury include active bleeding, pulsatile hematoma, limb ischemia. Soft signs require further investigation like Doppler or angiography to diagnose injury.
- Surgical management involves gaining proximal and distal control, investigating the injury site, and
Trauma resuscitation
1) The document discusses a case of a pedestrian hit by a car with injuries including a flail chest, unstable pelvis, and internal bleeding. The goals of treatment are to prevent death from hemorrhage through early intervention, good airway management, resuscitation, and surgical intervention.
2) It introduces the principles of damage control resuscitation (DCR) including permissive hypotension to limit blood loss, early use of blood products to replace lost volume and clotting factors, and damage control surgery to control bleeding. DCR aims to address the "lethal triad" of coagulopathy, acidosis, and hypothermia.
3) Clinical markers like thromboelastography
Damage Control in Trauma by Brohi
Damage control strategies. Karim Brohi outlines the critical concepts for the managment of the actively bleeding patient.
Arterial trauma
This document discusses extremity vascular injuries, which can result in limb loss or death if not properly treated. The most common causes are road traffic injuries. Clinical features include signs of active bleeding, ischemia, pain, pallor, and pulse absence. Imaging like duplex scans and angiography can help diagnose the injury. Early surgical repair of damaged blood vessels is needed to restore blood flow. Complications include compartment syndrome, which requires fasciotomy to reduce pressure. Close monitoring is also needed after reperfusion to watch for systemic effects. With proper emergency treatment and surgery, many extremities can be saved from amputation.
Vastrauma mannar
vascular trauma, mannar medical association, causes,Data from Teaching Hospital Anuradhapura Sri Lanka 2015 - 2016, pathology, signs and symptoms, hard and soft signs, investigations, management
MANAGEMENT OF TRAUMA
Trauma management involves initial assessment and stabilization of airway, breathing, circulation, disability and exposure (ABCDE). The primary survey assesses life threats and guides resuscitation efforts. Key priorities include spinal immobilization, hemorrhage control, and treating tension pneumothorax. Secondary survey involves full head-to-toe examination and history to identify all injuries requiring attention or monitoring. Management requires a multidisciplinary team approach. Proper preparation and coordination of care is essential for optimal trauma outcomes.
Appraoch to patient with polytrauma and Damage control orthopedics
A brief approach to patient with polytrauma, physiological response of body with trauma, the trimodal mortality, golden hour, lethal triad of trauma, two hit hypothesis, inflammatory mediators, prehospital care, primary survey, secondary survey, ABCDE approach, Adjucts are included. Besides thc concept of Damage control orthopedics, trend in fracture management , evolution , principle, indication , surgical stratergies, advantage, limitation, definitive fixation and EAC and ETC are included in breif.
Acute Limb ischemia
The document discusses acute ischemia and compartment syndrome. Acute ischemia occurs when blood supply is suddenly interrupted, most commonly due to embolism or thrombosis. It can cause severe pain and irreversible tissue damage within hours. Treatment depends on the severity and includes heparin, hydration, embolectomy, and thrombolysis. Compartment syndrome is a painful emergency condition caused by increased pressure within a muscle compartment, blocking blood flow. It requires early fasciotomy to decompress the compartment if diagnosed in the first 8 hours.
ATLS- Advanced Trauma Life Support
ATLS is the protocol developed by the American College of surgeons to assess and manage all trauma patients efficiently.
Atls presentation
This document provides an overview of Advance Trauma Life Support (ATLS) principles from a presentation. It discusses the importance of the "golden hour" in trauma care. The objectives of ATLS are to prioritize patient assessment and management. It covers the basics of trauma assessment including preparation, triage, primary survey, resuscitation, secondary survey, and transfer to definitive care. The primary survey focuses on addressing life threats in order of airway, breathing, circulation, disability and exposure.
Mangled extremity
The document discusses the management of mangled extremities. It covers components of mangled injuries including soft tissue loss, fractures, vascular and nerve injuries. It discusses the assessment, decision to amputate or attempt salvage, and principles of amputation and limb salvage. Key factors in the decision include the extent of soft tissue damage, viability of nerves and blood vessels, amount of bone loss and potential for functional recovery. Serial debridement, skeletal stabilization, wound management and soft tissue coverage are also addressed.
Polytrauma part 7 (Management)
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.
Trauma scoring systems
The document discusses various trauma scoring systems used to classify and predict outcomes in trauma patients. It describes physiological scores like the Glasgow Coma Scale (GCS) and Revised Trauma Score (RTS) that assess consciousness and vital signs. Anatomical scores like the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS) evaluate specific injuries. Combined scores like the Trauma Score-Injury Severity Score (TRISS) and Acute Physiology and Chronic Health Evaluation (APACHE) integrate multiple factors. Each score has benefits for triage, prognosis, and research but also limitations in certain clinical scenarios.
Management of abdominal vascular injury
This document discusses the management of abdominal vascular injuries. It covers the epidemiology, anatomy, presentation, investigations, surgical approaches, challenges, and complications of abdominal vascular injuries. Resuscitation and damage control techniques are emphasized. Exposure and control of the aorta, inferior vena cava, and iliac vessels are described in detail. Primary repair or ligation are the main repair options, with endovascular techniques also playing a selective role. Mortality rates are high and prompt diagnosis and management are critical due to the risk of exsanguinating hemorrhage.
Vasular trauma
Vascular Trauma
Joel Arudchelvam
Consultant Vascular and Transplant Surgeon
Teaching Hospital Anuradhapura
Extremity Vascular Injuries
causes
Signs of a vessel injury hard and soft
Mechanism of disruption of flow at arterial level
Problems with diagnosing ischaemia after trauma
Investigations
How soon we should we repair
Surgical Repair
Compartment Syndrome
FASCIOTOMY
Reperfusion effects
• Reperfusion injury
• Post perfusion syndrome
Crush injury-and-crush-syndrome
This document discusses crush injury and crush syndrome. It defines crush syndrome as muscle damage from prolonged pressure that can lead to systemic complications from the release of intracellular muscle contents. Key points include: crush syndrome is a medical emergency requiring aggressive IV fluid resuscitation and bicarbonate to prevent renal failure from myoglobinuria; complications include rhabdomyolysis, hyperkalemia, hypocalcemia, and metabolic acidosis; it commonly results from events causing mass casualties such as earthquakes.
Splenic Trauma by Doctor Saleem
Splenic Trauma ,Blunt trauma abdomen, spleen anatonmy (Ligaments blood supply accessory spleens) , Mechanism of injury, Presentation (symptoms and signs) Management ( operative vs non operative ) Imaging techniques for spleen ( FAST CT Scan abdomen Angiography ) , Grades of Splenic injury , Criteria for non operative management , Surgical Management ( Splenectomy Vs Splenorrahphy Partial Splenectomy Autotransplantation ), Post operative complications , Overwhelming Post Splenectomy Sepsis ( OPSI ) ,Follow up Care ( Vaccination )
Peripheral vascular injury
This document provides an overview of peripheral vascular injuries, including anatomy, types of injuries, clinical features, evaluation, management, and disposition. It discusses major blood vessels in the upper and lower extremities that are susceptible to injury from blunt or penetrating trauma. Clinical features are separated into "hard signs" that indicate over 90% risk of arterial injury and require intervention, and "soft signs" with a 30% risk that may be managed conservatively. Evaluation involves tests like ankle-brachial index, arterial pressure index, Doppler ultrasound, and CT angiography. Management consists of direct pressure, tourniquets, permissive hypotension, surgical repair, and vasodilators. Patients generally require disposition to vascular surgery.
Vascular Trauma The challenges for extremity vascular trauma in a resource po...
Vascular Trauma The challenges for extremity vascular trauma in a resource po...Joel Arudchelvam MBBS, MD, MRCS, FCSSL
Vascular Trauma
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Appraoch to patient with polytrauma and Damage control orthopedics
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This document discusses various types of vascular injuries. It covers the basic principles of vascular injury including anatomy, type of injury, mechanisms, clinical manifestations, investigations and management. It describes different types of vascular injuries like laceration, transection, dissection, crush and thrombosis. It discusses evaluation and investigations like Doppler, duplex ultrasound, angiography, CT angiography and MRI. It covers management of vascular injuries in different body regions like neck, chest, abdomen and extremities. It provides guidelines on treatment approaches including operative versus endovascular management.
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El documento resume el tema del trauma vascular. Define el trauma vascular como una lesión traumática de los vasos sanguíneos. Explica que las lesiones vasculares ocurren con más frecuencia en hombres entre 20-40 años, y que las arterias más comúnmente afectadas son la femoral superficial y la aorta abdominal. Describe los signos y síntomas de las lesiones vasculares, así como los métodos de diagnóstico y tratamiento para diferentes regiones del cuerpo.
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This document discusses ethanol toxicity and its effects both acutely and chronically. It covers the pharmacokinetics of ethanol including absorption, distribution, metabolism and elimination. Acute toxicity can range from mild euphoria to death depending on blood alcohol concentration. Chronic toxicity includes tolerance, withdrawal symptoms, liver damage, increased cancer risk and fetal alcohol syndrome. Management of acute toxicity focuses on supporting vital signs and increasing ethanol clearance. Chronic alcoholism treatment includes psychosocial support and nutritional supplementation.
Classification of general anaesthetics and pharmacokinetics
This document classifies general anesthetics and discusses factors that influence their potency and effects in the body. It divides anesthetics into inhalational gases/liquids and intravenous agents. It describes how minimum alveolar concentration is used to measure potency and lists concentrations for common gases. Other sections explain how pulmonary ventilation, alveolar exchange, solubility in blood and tissues, and cerebral blood flow impact the partial pressure of anesthetics in the brain.
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The document discusses the initial approach to trauma care, which consists of an initial primary assessment, rapid resuscitation, and a more thorough secondary assessment. The primary assessment focuses on identifying and treating life-threatening conditions by assessing ABCDE (airway, breathing, circulation, disability, exposure). Key interventions include controlling bleeding, treating pneumothorax, and addressing shock. A secondary assessment then provides a full head-to-toe examination to identify all injuries, with resuscitation continuing throughout. An organized team approach is emphasized to properly manage trauma in a timely manner.
Trauma part 1 1ry and 2dry survey
This document provides information on trauma management from the surgical club of Red Sea University. It discusses the phases of mortality from trauma, principles of triage, biomechanics of different injury types, and the ABCDE approach to the primary survey. For airway management, it describes techniques like chin lift, positioning, adjuncts, and definitive airways. It emphasizes controlling circulation through IV access, fluid resuscitation, and identifying/treating sources of hemorrhage in the primary survey. The goal is to recognize and stabilize life-threatening injuries in the first 10 minutes after trauma.
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The document discusses abdominal trauma, providing information on epidemiology, anatomy, classification, mechanisms of injury, signs and symptoms, diagnosis, and management. It notes that abdominal trauma can be blunt or penetrating, with the most common causes being motor vehicle accidents and assaults. Physical examination may reveal signs of internal bleeding or peritonitis, while imaging tools like ultrasound, CT scans, and diagnostic peritoneal lavage can aid in diagnosis. Resuscitation involves stabilizing the patient and controlling bleeding, while surgical intervention may be needed for injuries to hollow organs or solid organs like the liver or spleen.
Polytrauma
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
MANAGEMENT OF ABDOMINAL TRAUMA
The document discusses the principles of trauma management for abdominal and pelvic injuries, including classifications of injuries, mechanisms of injury, assessment techniques, management approaches like damage control resuscitation and surgery, and guidelines for treatment of specific injuries to the liver, spleen, and other abdominal organs. Case scenarios are presented and management strategies are outlined for various injury patterns and severity.
POLYTRAUMA
1) Polytrauma refers to multiple injuries that affect multiple body systems and can lead to organ dysfunction or failure. It requires management by a team of surgeons and physicians, including an orthopedic surgeon.
2) The priorities in managing polytrauma are life salvage, limb salvage, and salvaging total function if possible. This involves controlling hemorrhage, treating life-threatening injuries, and splinting fractures while avoiding further injury.
3) Damage control orthopedics focuses on rapidly stabilizing fractures to control bleeding and prevent further tissue injury, while delaying more definitive fixation to avoid exacerbating the body's inflammatory response in critically injured patients.
polytrauma.pdf
Polytrauma refers to multiple injuries that affect multiple body systems. An orthopedic surgeon is part of the trauma team that manages polytrauma patients. The goals of polytrauma management are to save the patient's life, salvage any injured limbs, and restore the patient's pre-injury level of function if possible. The management involves assessing and stabilizing life-threatening injuries during the primary survey before conducting a full secondary survey. This includes maintaining the airway, breathing, circulation, and disability level using ATLS protocols. Definitive treatment of orthopedic injuries may be delayed to focus on life-saving interventions during the damage control phase.
Primary trauma care
This document discusses trauma epidemiology and management. It begins by outlining the topics to be covered, including trauma epidemiology, rapid assessment of patient condition through triage, identifying life-threatening injuries, resuscitation, secondary survey, and planning further care. It then provides statistics on the burden of trauma as a leading cause of death and disability worldwide. Several principles of trauma management are covered, including the concept of the "golden hour" for early treatment. Mortality rates from trauma are shown to have decreased with advances in pre-hospital care and transportation. The document concludes with details on assessing and managing the airway, breathing, circulation and disability during the primary and secondary trauma surveys.
Abdominal trauma
1. Abdominal trauma can involve different regions including the anterior abdomen, thoracoabdominal area, flanks, and back. Blunt abdominal trauma is more difficult to diagnose than penetrating trauma and can involve multiple organs.
2. Evaluation of abdominal trauma involves primary and secondary surveys including history, physical exam, diagnostic tests like FAST, CT scans, and exploratory laparotomy if indicated. Common solid organ injuries are to the spleen and liver while the small intestine is the most common hollow viscus injury.
3. Management depends on the specific organ injured and includes non-operative management, angiographic embolization, splenectomy, splenorrhaphy, small bowel resection, and repair of
Abdominal trauma management
1) Abdominal trauma is commonly encountered in the emergency department and can be challenging to diagnose due to subtle or delayed presentations of serious intra-abdominal injuries.
2) A thorough primary and secondary survey including vital signs monitoring, focused assessment with ultrasound, and diagnostic tests like CT scan are used to identify injuries.
3) Uncontrolled hemorrhage and sepsis are major causes of mortality, so prompt diagnosis and management of injuries is important to prevent complications.
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The document discusses Advance Trauma Life Support (ATLS). It describes ATLS as a general guideline for managing trauma patients that focuses on urgent problems during the critical "Golden Hour" period. The key components of ATLS include triage, primary survey and resuscitation (addressing ABCDE - Airway, Breathing, Circulation, Disability, Exposure), secondary survey to identify all injuries, and definitive care involving specialist treatment of injuries identified. The goal of ATLS is to prioritize assessment and rapid intervention for life-threatening injuries during the initial stages after trauma occurs.
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Thoracic trauma can result in serious injuries and accounts for over 25% of trauma deaths, with blunt trauma making up 70% of chest injuries mostly from motor vehicle accidents. Common thoracic injuries include rib fractures, pneumothorax, hemothorax, and injuries to the heart and great vessels which require stabilization of the airway, breathing, and circulation followed by diagnostic imaging and treatment of life-threatening injuries. Management involves establishing ABCs, treating tension pneumothorax and sucking chest wounds, and having a high index of suspicion to identify specific injuries like aortic injuries that require further evaluation.
Abdominal trauma
This document discusses approaches to managing abdominal trauma in the emergency department. It begins by outlining learning objectives which include identifying abdominal trauma, learning assessment approaches, and trauma management. It then discusses the primary and secondary surveys as well as indications of shock. Specific injuries like solid organ injuries, hollow visceral injuries, retroperitoneal injuries, and diaphragmatic injuries are examined. Mechanisms of injury, physical exam findings, ultrasound, and management are also reviewed to provide emergency physicians with guidance on evaluating and treating abdominal trauma.
ppt Abd trauma Present.pptx
Abdominal trauma is a leading cause of death and disability. It commonly affects adults aged 20-39 years old, with road accidents being the most common cause. Diagnosis can be challenging as injuries may not be apparent initially. Evaluation involves history, physical exam, diagnostic tests like ultrasound, CT scan, and more invasive tests if needed. Management depends on whether the trauma is blunt or penetrating. Unstable patients or those with signs of intra-abdominal bleeding or injury typically require laparotomy for exploration and treatment of injuries.
Approach to trauma- ATLS update by Dr.Damodhar.M.V
This document provides an overview of the Approach to Trauma- Advanced Trauma Life Support (ATLS) program. It discusses the history and concepts of ATLS, which was created in 1976 to standardize trauma care. The document outlines the ABCDE approach to the primary and secondary trauma surveys, which are designed to rapidly identify and treat life-threatening injuries. It covers steps for airway management, breathing and ventilation support, circulation stabilization, disability assessment, and full patient exposure and monitoring. Adjunct procedures like IV access, imaging, and fluid resuscitation are also reviewed.
Management of polytrauma.pptx
This document discusses the management of polytrauma patients. Polytrauma is defined as multiple injuries exceeding a certain severity threshold or involving multiple body regions. Over 1 million people die each year from traffic injuries worldwide. The management of polytrauma patients requires a multidisciplinary team approach led by a general surgeon. The team evaluates patients using scoring systems like the Injury Severity Score to predict outcomes. The evaluation involves a primary survey to address life threats and a secondary full-body examination to identify and treat all injuries.
Dr radhey shyam(polytrauma management)
This document discusses the management of polytrauma patients. It defines polytrauma as injuries involving two or more major body systems. The goals of management are to save the patient's life, salvage limbs, and restore function if possible. A team approach is needed involving surgeons, physicians, and other specialists. The initial focus is a thorough primary survey and resuscitation to address life-threatening injuries like airway obstruction, hemorrhage, and spinal cord injury.
Atls 5th Sem
ATLS (Advanced Trauma Life Support) provides guidelines for the initial care and resuscitation of trauma patients. It was introduced in the 1970s and focuses on assessing and treating life-threatening injuries during the "Golden Hour" after trauma occurs. The goals of ATLS are to identify injuries killing the patient, treat those injuries, find all other injuries, and develop a treatment plan. The primary and secondary surveys guide trauma evaluations and focus on the airway, breathing, circulation, disability, and exposure of patients. ATLS aims to optimize trauma care during the critical first hour after injury occurs.
Polytrauma
Polytrauma, or multisystem trauma, refers to injuries that affect multiple body systems and require a team-based approach to management. It is a leading cause of death among younger individuals. The document outlines the definition of polytrauma and discusses the priorities and processes for managing polytrauma patients, including establishing airway and breathing, controlling circulation through fluid resuscitation, conducting thorough primary and secondary surveys, obtaining diagnostic imaging, and managing specific life-threatening injuries like those involving the head, spine, pelvis or long bones. A team-based approach is emphasized to efficiently evaluate and treat multiple injuries.
Assessment and management of trauma
This document discusses the initial assessment and management of trauma patients based on ATLS guidelines. It covers the primary and secondary surveys, with a focus on airway management, breathing, circulation, disability, and exposure. Specific injuries such as tension pneumothorax, cardiac tamponade, and hemorrhagic shock are reviewed. Resuscitative endovascular balloon occlusion of the aorta and resuscitative thoracotomy are described as emergency procedures for trauma patients in shock. The document emphasizes treating the greatest threats to life first in trauma resuscitation.
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Vascular injuries
- 1. Vascular Injuries Mohammad Shihata 02/01/2014
- 2. Objectives ✤ Principles of trauma management ✤ Vascular zones of the body ✤ Mechanisms of vascular trauma ✤ Recognition of vascular injuries ✤ Management of Vascular injuries
- 4. My ATLS App for smart phones and tablets
- 5. A, B, C, D, E Primary survey –A Airway maintenance with cervical spine protection –B Breathing and ventilation –C Circulation with hemorrhage control –D Disability : Neurological status –E Exposure/Environmental control : completely undress the patient,but prevent hypothermia
- 6. Resuscitation ✤ Control Bleeding ✤ Protect and maintain airway ✤ Two large bore IVs for rapid infusion
- 7. Secondary survey Secondary survey does not begin until the primary survey (ABCDEs) is completed, resuscitative efforts are well established, and the patient is demonstrating normalization of vital functions.
- 8. Secondary Survey – Total patient evaluation • history : AMPLE • physical examination – Complete neurologic examination – Head and skull – Maxillofacial – Neck – Chest – Abdomen – Perineum/rectum/vagina – Musculoskeletal – Tubes and fingers in every orifice
- 9. “He Who wants to be a surgeon, should go to war” Hippocrates (460 - 377 BC)
- 10. Mechanisms of Vascular Injuries ✤ Penetrating Trauma ✤ Blunt Trauma ✤ Blast injuries ✤ Iatrogenic Injuries
- 11. Ask yourself IIss tthhiiss bblluunntt oorr ppeenneettrraattiinngg iinnjjuurryy ?? IIss tthhiiss AArrtteerriiaall oorr VVeennoouuss iinnjjuurryy ?? SShhoouulldd II ttaakkee tthhee ppaattiieenntt ttoo tthhee ooppeerraattiinngg rroooomm oorr ddoo ffuurrtthheerr iinnvveessttiiggaattiioonnss??
- 13. Venous Injuries ✤ Low pressure ✤ Dark blood ✤ Non-expanding hematoma
- 14. Upper Extremity
- 15. Lower Extremity
- 18. Neck Vessels
- 20. Thoracic Aorta
- 21. Aortic Arch Tear
- 23. Aortic Arch Transection ✤ Common in deceleration ( blunt ) type injuries ✤ Most common site is the ligamentum attachment ( isthmus) ✤ Free rupture is incompatible with life ✤ Contained rupture is associated with increased risk of free rupture ✤ Usually associated with other life threatening injuries
- 24. Principles of Vascular Repairs ✤ Know your anatomy ( Course, Feeding vessel, Run-off) ✤ Adequate Exposure ✤ Proximal and distal control ✤ Tension free repair ✤ Adjuncts (intra op tPA, Imaging, .....) ✤ Assess the need for fasciotomy
- 25. Options for peripheral vascular repair No Transection ✤ Primary Repair ✤ Patch Angioplasty ✤ Endovascular treatment Complete Transection ✤ Primary end to end anastomosis ✤ Interposition graft ✤ Bypass
- 27. End to End anastomosis
- 29. Complications of Vascular Injuries ✤ Life threatening bleeding ✤ End organ ischemia ✤ Associated injuries ✤ Sensory / Motor Loss ✤ AV fistula ✤ Pseudoaneurysm
- 30. Thank You