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Initial Management

Initial Management. Primary Survey (ABCs) Airway maintenance with cervical spine control Breathing and Ventilation Circulation with hemorrhage control Disability or Neurologic status Exposure / Environmental Control Resuscitation. Know your ABCs . Airway Cervical immobilization

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Initial Management

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  1. Initial Management • Primary Survey (ABCs) • Airway maintenance with cervical spine control • Breathing and Ventilation • Circulation with hemorrhage control • Disability or Neurologic status • Exposure / Environmental Control • Resuscitation

  2. Know your ABCs • Airway • Cervical immobilization • Early orotrachealintubation • Breathing • Supplemental Oxygen therapy • Monitor pulse oximetry • Ensure no concomitant injury or pneumothorax

  3. Know your ABCs • Circulation • Stop external bleeding (direct digital pressure) • Approximate cardiovascular status by palpating peripheral pulses • IV access for resuscitation • 2 peripheral catheters • Venous lines: short with a large diameter • Blood type matching

  4. And your D & E. A - Alert V - Responds to Vocal stimuli P - Responds to Painful stimuli U - Unresponsive • Disability • Check neurology (GCS) • pupillary size and reaction • Exposure/ Environmental Control • Check for other wounds • Cover and protect from hypothermia • Warm blankets • Intravenous fluids should be warmed • Maintain warm environment

  5. Glasgow Coma Scale • Quantify consciousness when a patient has altered level of consciousness because of head trauma or another hypoxic event • Max. score of 15  optimal level of consciousness • The lower the score, the more severe the impairment of consciousness • Lowest possible score: 3

  6. Remember! Life threatening conditions are identified and management is begun simultaneously!

  7. Resuscitation • Fluid Replacement • 1L intravenous bolus of normal saline, Lactated Ringer’s Solution or other isotonic crystalloid for every 750ml blood loss • If more than 750ml  whole blood + LRS • If no response, 2L of type O Rh negative blood • * blood type matching

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