Principles and Techniques of Trauma Care

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INTRAOSSEOUS ACCESS •Intraosseous puncture provides quick access to circulation in shocked child if venous cannulation impossible •Fluids, blood, medicines may be given •Fluids may need to be given under pressure •If intraosseous needles unavailable, use spinal or bone marrow biopsy needle Intraosseous needle normally sited in upper tibia at junction of upper and middle third, avoiding growth plate 76 | Emergency and Essential Surgical Care (EESC) programme www.who.int/surgery
TRAUMA IN CHILDREN • Most sensitive indicator of fluid status in a child is urine output • Infants are unable to concentrate urine as well as adults, thus more susceptible to electrolyte abnormalities • Dosage calculation (based on weight), for fluids, transfusions, drugs is crucial to correct management Normal Urine output: (ml/kg/hour) Infants 1-2 ml/kg/h Children 1 ml/kg/h Adults 0.5 ml/kg/h How much urine would you expect a 20 kg child to produce in 24 hours 77 | Emergency and Essential Surgical Care (EESC) programme www.who.int/surgery
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EMERGENCY & TRAUMA CARE TRAINING CO
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Additional links to WHO Resources:
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MODULE 1 Principles and Techniques
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SIX PHASES OF TRAUMA CARE MANAGEMEN
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TRAUMA CARE MANAGEMENT Phase I Phas
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MAJOR TRAUMA Trauma mechanism: •
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PHASE I: TRIAGE Triage: sorting and
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AIRWAY Always assess the airway •
Page 17 and 18:
TECHNIQUES FOR OPENING THE AIRWAY M
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AIRWAY Before attempting intubation
Page 21 and 22:
INDICATIONS FOR CHEST DECOMPRESSION
Page 23 and 24:
TENSION PNEUMOTHORAX • Air from l
Page 25 and 26: INSERTION OF CHEST DRAIN NAV A B C
Page 27 and 28: CIRCULATION: HAEMORRAGHIC SHOCK Ass
Page 29 and 30: CIRCULATION Obtain two large bore I
Page 31 and 32: DISABILITY or DAMAGE Checking for n
Page 33 and 34: GLASGOW COMA SCORE Eyes +Verbal + M
Page 35 and 36: EXPOSURE • Remove all patient's c
Page 37 and 38: PHASE III: SECONDARY SURVEY Head Ex
Page 39 and 40: REASSESSMENT • Always perform an
Page 41 and 42: Patient Referral and Transport 41 |
Page 43 and 44: DECISION MAKING Can we do procedure
Page 45 and 46: TRANSFER OF TRAUMA PATIENT Planning
Page 47 and 48: PATIENT SAFETY: Consent With invasi
Page 49 and 50: RECORD KEEPING Admission note/preop
Page 51 and 52: RECORD KEEPING Progress note - Need
Page 53 and 54: OXYGEN SUPPLEMENTATION • Reliable
Page 55 and 56: OXYGEN SUPPLEMENTATION • Start ox
Page 57 and 58: INTRAVENOUS ACCESS: Central veins F
Page 59 and 60: FLUIDS AND MEDICINES • Avoid flui
Page 61 and 62: SURGICAL CRICOTHYROIDOTOMY 4 • Ro
Page 63 and 64: Trauma in Children 63 | Emergency a
Page 65 and 66: TRAUMA IN CHILDREN Airway Breathing
Page 67 and 68: MANAGING THE AIRWAY IN A CHILD WITH
Page 69 and 70: LOGROLL IN SUSPECTED NECK TRAUMA
Page 71 and 72: OROPHARYNGEAL AIRWAYS • Can impro
Page 73 and 74: HOW TO GIVE OXYGEN 73 | Emergency a
Page 75: INTRAVENOUS ACCESS IN CHILDREN •S
Page 79 and 80: TRAUMA IN CHILDREN • Malnutrition
Page 81: TRAUMA IN THE ELDERLY • Injury ri
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Principles and Techniques of Trauma Care

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