Tri-modal distribution of mortality
immediate cause of death
early deaths within 1-3 hours
Prevention
golden hour
trauma systems are organized approach to acutely injured people providing personnel, facilities, and equipment for optimal care on an emergency basis, within a defined geographical area
The ABCDEs
The primary survey provides a rapid assessment of critical functions and resucscitate simultaneously.
Fix problems immediately as they are identified
Check airway protection
Obtain and maintain the airway
predict and protect
oxygenate and ventilate
MVCs often follow trips to restaurants.
Facial smash.
Airway patency
Airway and c-spine
Breathing and Ventilation
threats:
pulse
blood pressure
respiratory rate
capillary refill
urine output
fluid replacement
Completely expose the patient
logroll the patient
rectal examination (rectal tone, high-riding prostate, gross blood)
urethral meatus for blood
Trauma series: CXR, lateral C-spine, pelvis
DPL, US, CT
FAST: focused abdominal sonography for trauma
bedside screening test to identify free fluid