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    Trauma Evaluation and Assessment

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    Ehrli Cuaresma
    1. Trauma is a leading cause of death for people ages 1 to 45 in the US. Effective trauma care systems have reduced preventable trauma deaths by 13-7% in recent decades. 2. Anesthesia plays a key role in trauma care from the emergency department through the operating room and intensive care unit by managing the airway, breathing, and circulation of trauma patients. 3. Initial trauma evaluation prioritizes airway evaluation and intervention, management of breathing abnormalities, and management of shock through addressing hemorrhage. Airway management depends on the type and severity of injury as well as the patient's hemodynamic and oxygenation status.

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    Trauma Evaluation and Assessment

    Uploaded by

    Ehrli Cuaresma
    32 views16 pages
    1. Trauma is a leading cause of death for people ages 1 to 45 in the US. Effective trauma care systems have reduced preventable trauma deaths by 13-7% in recent decades. 2. Anesthesia plays a key role in trauma care from the emergency department through the operating room and intensive care unit by managing the airway, breathing, and circulation of trauma patients. 3. Initial trauma evaluation prioritizes airway evaluation and intervention, management of breathing abnormalities, and management of shock through addressing hemorrhage. Airway management depends on the type and severity of injury as well as the patient's hemodynamic and oxygenation status.

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    1. Trauma is a leading cause of death for people ages 1 to 45 in the US. Effective trauma care systems have reduced preventable trauma deaths by 13-7% in recent decades. 2. Anesthesia plays a key role in trauma care from the emergency department through the operating room and intensive care unit by managing the airway, breathing, and circulation of trauma patients. 3. Initial trauma evaluation prioritizes airway evaluation and intervention, management of breathing abnormalities, and management of shock through addressing hemorrhage. Airway management depends on the type and severity of injury as well as the patient's hemodynamic and oxygenation status.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    32 views16 pages

    Trauma Evaluation and Assessment

    Uploaded by

    Ehrli Cuaresma
    1. Trauma is a leading cause of death for people ages 1 to 45 in the US. Effective trauma care systems have reduced preventable trauma deaths by 13-7% in recent decades. 2. Anesthesia plays a key role in trauma care from the emergency department through the operating room and intensive care unit by managing the airway, breathing, and circulation of trauma patients. 3. Initial trauma evaluation prioritizes airway evaluation and intervention, management of breathing abnormalities, and management of shock through addressing hemorrhage. Airway management depends on the type and severity of injury as well as the patient's hemodynamic and oxygenation status.

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    TRAUMA ANESTHESIA

    Dr. Edgard M. Simon


    Associate Professor
    UP College of Medicine
    ANESTHESIA FOR TRAUMA
    Leading cause of death between the ages of 1 to 45
    In the US, preventable deaths decreased 13% to 7%
    over the past decades because of more efficient
    systems of trauma care.
    Anesthesia care
    Airway and Resuscitation in Emergency Department
    Operating Room Care
    Management in Intensive Care Unit
    Evaluation
    PRIORITIZING TRAUMA CARE
    INITIAL EVALUATION AND
    RESUSCITATION
    Airway Evaluation and Intervention
    Management of breathing abnormalities
    Management of shock
    AIRWAY OBSTRUCTION

    Direct injury
    Hemorrhage
    Diminished Consciousness
    Aspiration
    Misapplication of Airway/Endotracheal Tube
    INADEQUATE VENTILATION
    Diminished Respiratory Drive
    Direct Injury
    Aspiration
    Bronchospasm
    INDICATIONS FOR ENDOTRACHEAL
    INTUBATION
    Cardiac or Respiratory Arrest

    Respiratory Insufficiency/Airway Protection

    Deep Sedation or Analgesia/General Anesthesia

    Transient Hyperventilation

    Space Occupying Intracranial Lesion/Increased ICP

    Delivery of 100% O2/Carbon Monoxide Poisoning

    Facilitation of Diagnostic Workup

    Uncooperative or Intoxicated Patient


    PROPHYLAXIS AGAINST
    ASPIRATION

    Always considered to have full stomach

    Administer non-particulate antacid

    Cricoid pressure/Sellick Maneuver

    Avoidance of ventilation between administration of medication


    and intubation
    CANADIAN C-SPINE RULE
    DIAGNOSIS OF CERVICAL INJURY AND IDENTIFY PATIENTS WHO
    REQUIRE CT
    PROTECTION OF THE CERVICAL
    SPINE
    blunt trauma victims assumed to have an unstable
    cervical spine
    Direct laryngoscopy causes cervical motion and the
    potential to exacerbate spinal cord injury
    An “uncleared” cervical spine mandates Manual In-line
    Stabilization (MILS). Not Traction.
    Front of the cervical collar may be removed for greater
    mouth opening and jaw displacement
    AIRWAY/BREATHING
    Verification of adequate airway and acceptable
    respiratory mechanics is of primary importance

    Hypoxia is the most immediate threat to life

    Inability to oxygenate a patient will lead to


    permanent brain injury and death within 5 to 10
    Minutes
    CIRCULATION

    Hemorrhage is the next most pressing concern

    Ongoing blood loss will be fatal in minutes to hours

    Shock is presumed to be a consequence of hemorrhage


    until proven otherwise
    AIRWAY EVALUATION AND
    INTERVENTION

    Airway management
    1. type of injury
    2. nature and degree of airway compromise
    3. hemodynamic and oxygenation status
    ASA difficult airway algorithm in Trauma
    - cancellation of airway management when difficulty
    arises is not an option
    - awake may be preferred
    ASA DIFFICULT AIRWAY
    ALGORITHM
    Modification of the ASA DA Algorithm for Trauma
    Management Choices Standard ASA DA Trauma ASA ADA

    Unsuccessful intubation Awakening is always an


    after gen. anesthesia option Awakening/stopping seldom an option

    Performed for failed


    Surgical airway decision intubation/failed May be first and best choice
    ventilation

    Management of recognized Awake intubation only if uncooperative,


    difficult airway Awake intubation stable, spontaneously ventilating

    Uncooperative/combative patient
    Failed awake intubation Cancel is an option requires gen. anesthesia with or without
    spontaneous ventilation

    Regional Anesthesia option Occasionally an option

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