急诊创伤个案讨论.pptVIP

ATLS: 初級評估與處置 ATLS: 5 Steps Preparation Triage Primary survey (ABCDE) + Resuscitation Adjuncts to primary survey Secondary survey Adjuncts to secondary survey Continued monitoring and reevaluation Definite care / Transfer Primary Survey Airway + C-spine protection Breathing + R/O tension pneumothorax Circulation + stop bleeding Disability (GCS) + pupils + MP x 4 Exposure + Environmental control Adjuncts to Primary Survey NG/OG, Foley X-rays: Chest, pelvis, c-spine DPL or FAST Monitoring: ECG, BP, SpO2, ABG, ETCO2 Secondary Survey Does not begin until Primary survey (ABCDE) is completed Normalization of vital signs after resuscitation Secondary Survey Complete History AMPLE Complete PE Head to toes Finger to holes Secondary Survey History: Allergies Medication Past illness / pregnancy Last meal Events / environment Adjuncts to Secondary Survey Specialized diagnostic tests CT scans Contrast x-rays Extremity x-rays Endoscopy and ultrasonography Reevaluation Reevaluation constantly (start with ABCDE) To discover new findings To discover deterioration Continuous monitoring Vital signs, EKG U/O ABG, SpO2 ETCO2 Definite Care and Transfer Decision during the primary survey and resuscitation D2D communication Transfer after life-saving resuscitation 謝謝聆聽 * * 急診創傷個案討論 新光醫院 急診科 張志華 醫師 2005 / 09 / 22 考題！ *