TCLS.pptx trauma care life support to be learnt by every emergency care worker

TCLS.pptx trauma care life support to be learnt by every emergency care worker

• 1.
  Trends and Advancementsin Trauma Care –A look to ATLS Presented By, Prof. Ramaprasad S M.Sc (N),SCEM,FCEM Dept. Medical Surgical Nursing ( Neurosciences Nursing) Trainer in Skills Lab/FRT/GFATM/ENLS/BCLS/TCLS /Guide/Co Guide for KSOU/Reviewer /AHA certified BLS & ACLS Provider
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  Introduction  Total near4.5 lakhs of RTA are recorded in India in 2022  WHO reported that around 15% increase in the death rate in India because of RTA from 2010 to 2021(Source:road safety report 2023)  there were 44,500 cases of RTA in india and among these 23,652 deaths. ( Source:Hindustan times 29.02.2024)  In Bengaluru 4974 cases were reported for RTA and and increased from 3823 cases in 2022 (open city source: 18.01.2024)
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  How do yourespond immediately in case of trauma ?
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  How Trauma Patientsare attended? PRE HOSPITAL PHASE HOSPITAL PHASE
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  Pre Hospital Phase Provided by activating the EMS Critical component of the pre hospital care  airway maintenance /control of external bleeding and shock/ Immobilization/ Transport to Trauma care center
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  How to carryshorter pre hospital time? Notification Time Scene Time Transport Time Response Time
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  Hospital Phase  handover between pre hospital provider and receiving hospital should be smooth The critical aspects of preparation include the following, Properly Functioning Airway equipment Crystalloids solution A Protocol for additional medical assistance Transfer Agreement
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  Code Trauma Code Traumacan be activated via PAS (Public Activated System)
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  Code Massive TransfusionProtocol (MTP) Institutional Policies such as CODE MTP can be activated which facilitate the blood bank to relese emergent requirement of O Negetive PRBC blood products
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  Triage System Level 1 Resuscitation ThoseWho are having immediate threatt to life or limb Level 2 Urgent Those who are Potential Threat to life /limb /or Function Should Receive care within 30 mins Level 3 Less Urgent Conditions with Mild to moderate discomfort
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  Categories of Casesfor Triage Cardiac Arrest/Stroke/ Seizures/GCS >8/Status Asthmatics Localized Injuries without immediate systemic implications who require minimum care Severe abdominal pain/head ache with focal signs/dehydration/ penetrating foreign bodies in eyes/ mild chest pain.
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  APPROACHES TO TRAUMACARE
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  The Universal Protocolfor Trauma Care is H : Control of catastrophic haemorrhage A: Maintaining Patent airway B: Breathing C: Circulation D: Check for Disability E: Exposure
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  Haemorrhage Control Use theappropriate method to stop bleeding and it is the first priority Direct Pressure Pressure dressing Torniquet
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  Airway Three things tobe observed for airway maintenance 1. Is cervical spine is stable : perform Three point immobalization 2. Is patient is conscious : AVPU 3. Is airway is obstructed : check for gurgling and snoring use air way manoeuvres and adjuncts
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  Breathing Check for thethree things in breathing assessment 1. Is patient having bradypnea or tachypnea 2. Is patient is hypoxic 3. Are chest movements and auscultation is normal
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  Interventions such asneedle thoracostomy and ICD 3 way gauze dressing Are done to relieve tracheal deviation and pneumothorax
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  Circulation Check for pulserate Peripheral or Vital organ perfusion (MSE/UO/CRT/Cyanosis) Check for Blood Pressure radial pulse + SBP 90mmhg : IO Femoral +SBP 70mmhg : Fluid resucitation only carotid pulse + SBP 70 mmhg : Fluid Resucitation MAP ,65 Shock : Blood Transfusion
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  Disability Assess for theneurological disability 1. Consciousness by AVPU : (pupillary Exam/Gross motor/gross sensory) 2. Reassess the target BP (SBP is 110mmhg)
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  Exposure Examination of theanterior and posterior body Check for the rectal tone and tender or loose prostate in case of spinal injury
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  Any Question?
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  Thank You