BASIC
SUMMARY OF
INDEX
POLY-TRAUMATIZED PATIENT
SHOCK
COMPLICATIONS OF BLOOD TRANSF.
SURGICAL & HAND INFECTIONS
SALIVARY GLANDS
SWELLINGS
LYMPH NODE
SURGICAL NUTRITION
ELECTROLYTE IMBALANCE
ENDOCRINOLOGY if you found it useful
MISCELLANEOUS kindly share!
, Management of poly-trauma pt.
“Q. should be written in any major trauma”
(Air way & breathing only)
1RY SURVEY 2RY SURVEY 3RY SURVEY
Identify & Treat any life threatening condition
AFTER GENERAL EXAM. Definitive TTT of each
PRE-HOSPITALIZATION (ABCDE) AT HOSPITAL
(ABCDE) (head to toe) injury individually!
Airway: 1) Clear airway from vomit, blood or FB. Cricothyroidotomy or
2) Head tilt & chin lift ® # if you suspect Cx. spine Tracheostomy.
CX. SPINE If failed or there's head · X Ray: Spine (lat. · H & N & Face.
SUPPORT injury (Cx. Tenderness – MF trauma ) ® Jaw view), Chest, Pelvis.
injury or M-F trauma ® · Lumbar spine,
thrust + Cx. Collar + Never move ! pt. ETT (not routine) HISTORY (AMPLE) Transport as 1 unit
3) Oropharyngeal tube. · A =Allergy. "log rolling"
Breathing 1) TENSION PNEUMOTH.: ®Needle decomp. ICT TUBE · M =Medications. · Chest - Limbs.
· Engorged neck veins. · Shifted mediastinum. · P =Past medical hx. · GCS + CT brain
· Dyspnea. · Air blow. +VE CRITERIA IN DPL:
· L =Last meal.
> 100,ooo RBCs / mm3
2) OPEN PNEUMOTH. ® Occlusive dressing IC TUBE · E =Events of injury.
RESONANT ON PERCUSSION + ¯ AIR ENTRY. ABDOMEN > 500 WBCs / mm2
>175 IU Amylase
3) CARDIAC TAMPONADE AT 150 ML PERICARDIOTOMY IN
Beck's triad (Engorged NVs, hypotension, ¯HS) MOST OF PTS.
ER Exploration Invest.
® Needle pericardiocentesis
4) FLAIL CHEST ® Paradoxical mov. ® strapping ETT. (PEEP)
· Penetrating trauma. CBC / US / DPL
TENDERNESS OVER A CERTAIN SEGMENT.
(CT better postponed
· Gun shot. till the pt. is stable)
5) MASSIVE HEMOTH. ® IC tube ± THORACOTOMY
DULL ON PERCUSSION + ¯ AIR ENTRY · Shocked.
Circ. Explain Classes & management of hypovol. Shock. · hemo-peritoneum.
Solid organ & Major injury or Any
A = Alert V = responds to Vocal stimuli. (T-R-R-G) minor injury hollow organ injury
Disability:
AVPU P = Painful stimuli. U = Unresponsiveness.
Exposure & Remove all cloths + Warmth. Insert 3 ® اﻧﺎﺑﯾب Conserative Exploration
1
Environment IV line, foley’s, Ryle.
, “Def.: Inadequate tissue perfusion ® ETIOLOGY:
Anaerobic metabolism + M. Acidosis” 1) LOSS OF BLOOD ® Hge. (internal or external)
2) PLASMA ® burns, pancreatitis & peritonitis.
3) NA CONTAINING FLUIDS ® sever NVD, IO,
high output intestinal fistula!
BODY
PATHOG.
RESPONSE
1) HOMEOSTASIS: 1) m CIRCULATION 2) CELLULAR DERANGEMENT:
dt failure of Na/K pump ®
· VC of arterioles. inability of cells to get rid of
· Platelet plug. Na ® water retention.
· Blood clotting. Revesrsible phases Irreversible phases 3) M. ACIDOSIS.
4) ORGAN ® MOF:
2) NEURAL: Å of Arterial baro-rs & Atrial
strech rs ® ¯ the Vagal inhibitory impulses · Heart ® HF.
on VMC + Å of sympath. system. A) COMPENSATORY PHASE: VC of C) DECOMPENSATION PHASE: · Lungs ® ARD$.
3) HORMONAL: CS, RAS, ADH, GH & CA. pre-cap. sphincter ® ¯ cap. pressure ® Anoxia & Acidosis · Liver ® Cholestasis.
® cap. refills from the interstitial space.
® relaxation of the pre-cap. · Kidneys ® ATN ® ARF.
4) TRANS-CAPILLARY RE-FILLING: VC of B) CELLULAR DISTRESS PAHSE: sphincter only ® accum. of RBCs · GIT ® Bact. Translocation.
arterioles ® ¯ cap. pr. ® cap. refills Opening of the A-V shunts ® Stasis ® m thrombi.
from the interstitial space. ® deprive tissues from O2
® Anaerboic metabolism D) FAILURE: FINALLY the post cap.
® metabolites & histamine sphicter will relax ® passage of the
® contraction of post cap. sphincter sludge & m thrombi to the circ. 2
SUMMARY OF
INDEX
POLY-TRAUMATIZED PATIENT
SHOCK
COMPLICATIONS OF BLOOD TRANSF.
SURGICAL & HAND INFECTIONS
SALIVARY GLANDS
SWELLINGS
LYMPH NODE
SURGICAL NUTRITION
ELECTROLYTE IMBALANCE
ENDOCRINOLOGY if you found it useful
MISCELLANEOUS kindly share!
, Management of poly-trauma pt.
“Q. should be written in any major trauma”
(Air way & breathing only)
1RY SURVEY 2RY SURVEY 3RY SURVEY
Identify & Treat any life threatening condition
AFTER GENERAL EXAM. Definitive TTT of each
PRE-HOSPITALIZATION (ABCDE) AT HOSPITAL
(ABCDE) (head to toe) injury individually!
Airway: 1) Clear airway from vomit, blood or FB. Cricothyroidotomy or
2) Head tilt & chin lift ® # if you suspect Cx. spine Tracheostomy.
CX. SPINE If failed or there's head · X Ray: Spine (lat. · H & N & Face.
SUPPORT injury (Cx. Tenderness – MF trauma ) ® Jaw view), Chest, Pelvis.
injury or M-F trauma ® · Lumbar spine,
thrust + Cx. Collar + Never move ! pt. ETT (not routine) HISTORY (AMPLE) Transport as 1 unit
3) Oropharyngeal tube. · A =Allergy. "log rolling"
Breathing 1) TENSION PNEUMOTH.: ®Needle decomp. ICT TUBE · M =Medications. · Chest - Limbs.
· Engorged neck veins. · Shifted mediastinum. · P =Past medical hx. · GCS + CT brain
· Dyspnea. · Air blow. +VE CRITERIA IN DPL:
· L =Last meal.
> 100,ooo RBCs / mm3
2) OPEN PNEUMOTH. ® Occlusive dressing IC TUBE · E =Events of injury.
RESONANT ON PERCUSSION + ¯ AIR ENTRY. ABDOMEN > 500 WBCs / mm2
>175 IU Amylase
3) CARDIAC TAMPONADE AT 150 ML PERICARDIOTOMY IN
Beck's triad (Engorged NVs, hypotension, ¯HS) MOST OF PTS.
ER Exploration Invest.
® Needle pericardiocentesis
4) FLAIL CHEST ® Paradoxical mov. ® strapping ETT. (PEEP)
· Penetrating trauma. CBC / US / DPL
TENDERNESS OVER A CERTAIN SEGMENT.
(CT better postponed
· Gun shot. till the pt. is stable)
5) MASSIVE HEMOTH. ® IC tube ± THORACOTOMY
DULL ON PERCUSSION + ¯ AIR ENTRY · Shocked.
Circ. Explain Classes & management of hypovol. Shock. · hemo-peritoneum.
Solid organ & Major injury or Any
A = Alert V = responds to Vocal stimuli. (T-R-R-G) minor injury hollow organ injury
Disability:
AVPU P = Painful stimuli. U = Unresponsiveness.
Exposure & Remove all cloths + Warmth. Insert 3 ® اﻧﺎﺑﯾب Conserative Exploration
1
Environment IV line, foley’s, Ryle.
, “Def.: Inadequate tissue perfusion ® ETIOLOGY:
Anaerobic metabolism + M. Acidosis” 1) LOSS OF BLOOD ® Hge. (internal or external)
2) PLASMA ® burns, pancreatitis & peritonitis.
3) NA CONTAINING FLUIDS ® sever NVD, IO,
high output intestinal fistula!
BODY
PATHOG.
RESPONSE
1) HOMEOSTASIS: 1) m CIRCULATION 2) CELLULAR DERANGEMENT:
dt failure of Na/K pump ®
· VC of arterioles. inability of cells to get rid of
· Platelet plug. Na ® water retention.
· Blood clotting. Revesrsible phases Irreversible phases 3) M. ACIDOSIS.
4) ORGAN ® MOF:
2) NEURAL: Å of Arterial baro-rs & Atrial
strech rs ® ¯ the Vagal inhibitory impulses · Heart ® HF.
on VMC + Å of sympath. system. A) COMPENSATORY PHASE: VC of C) DECOMPENSATION PHASE: · Lungs ® ARD$.
3) HORMONAL: CS, RAS, ADH, GH & CA. pre-cap. sphincter ® ¯ cap. pressure ® Anoxia & Acidosis · Liver ® Cholestasis.
® cap. refills from the interstitial space.
® relaxation of the pre-cap. · Kidneys ® ATN ® ARF.
4) TRANS-CAPILLARY RE-FILLING: VC of B) CELLULAR DISTRESS PAHSE: sphincter only ® accum. of RBCs · GIT ® Bact. Translocation.
arterioles ® ¯ cap. pr. ® cap. refills Opening of the A-V shunts ® Stasis ® m thrombi.
from the interstitial space. ® deprive tissues from O2
® Anaerboic metabolism D) FAILURE: FINALLY the post cap.
® metabolites & histamine sphicter will relax ® passage of the
® contraction of post cap. sphincter sludge & m thrombi to the circ. 2
