Advanced Trauma Life Support ATLS Student Course Manual 2018

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xvii ACKNOWLEDGMENTS Bertil Bouillon, MD Professor and Chairman Department of Trauma and Orthopaedic Surgery University of Witten/Herdecke, Cologne Merheim Medical Center Cologne Germany Guy Brisseau, MD, MEd, FACS Director, Pediatric Trauma; Director, Surgical Education Sidra Medical and Research Center Doha Qatar Troy Browne, MBChB, FCA(SA), FANZCA, FCICM Medical Leader—Anaesthesia, Radiology and Surgical Services; Director of Intensive Care/High Dependency Unit Bay of Plenty District Health Board Tauranga New Zealand Shane Brun, MD, M.Trauma, M.Ed, FFSEM(UK), FACRRM, FRACGP Associate Professor James Cook University Queensland Australia Stephen Bush, MA(Oxon), FRCS, FRCEM Consultant in Emergency Medicine Leeds Teaching Hospitals Trust Leeds, West Yorkshire United Kingdom Jacqueline Bustraan, MSc Educational Advisor, Trainer, and Researcher Leiden University Medical Center/BOAT (Bustraan Organisation, Advice and Training) Leiden The Netherlands Vilma Cabading Trauma Courses Office, Deanship of Postgraduate Education King Saud Bin Abdulaziz University for Health Sciences Riyadh Kingdom of Saudi Arabia Sally Campbell, RN, BA ATLS Course Director Kaiser Medical Center/David Grant Medical Center Vacaville/Travis Air Force Base, California United States Juan Carlos Puyana, MD, FACS Professor of Surgery, Critical Care Medicine and Clinical Translational Medicine University of Pittsburgh Pittsburgh, Pennsylvania United States Narain Chotirosniramit, MD, FACS, FICS, FRCST Chief, Trauma and Critical Care Unit; Department of Surgery, Faculty of Medicine Chiangmai University Chiangmai Thailand Ian Civil, MBChB, FRACS, FACS Director of Trauma Services Auckland City Hospital Auckland New Zealand Keith Clancy, MD, MBA, FACS Trauma Medical Director Geisinger Wyoming Valley Medical Center Wilkes-Barre, Pennsylvania United States Peter Clements Frederic J. Cole, Jr., MD, FACS Legacy Emanuel Medical Center Portland, Oregon United States Jaime Cortes-Ojeda, MD, FACS Chief Department of Surgery Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera" San José Costa Rica Renn J. Crichlow, MD MBA Orthopaedic Trauma Surgeon St. Vincent Indianapolis Trauma Center OrthoIndy Hospital Indianapolis, Indiana United States Scott D’Amours, MD, FRCS(C), FRACS, FRCS(Glasg) Trauma Surgeon, Director of Trauma Liverpool Hospital Sydney, New South Wales Australia
xviii ACKNOWLEDGMENTS Marc DeMoya, MD, FACS Associate Professor of Surgery Massachusetts General Hospital/Harvard Medical School Boston, Massachusetts United States Newton Djin Mori, MD, PhD, FACS General and Trauma Surgeon Hospital das Clinicas–University of São Paulo São Paulo, São Paulo Brazil Cristiane de Alencar Domingues, RN, MSN, PhD Professor Faculdade das Américas (FAM) São Paulo, São Paulo Brazil Jay Doucet, MD, FRCSC, FACS Professor of Surgery University of California, San Diego San Diego, California United States Julia A. Dunn, MD, MS, FACS Medical Director, Trauma Research and Education UC Health Northern Colorado Loveland, Colorado United States Lesley Dunstall, RN National Coordinator; EMST/ATLS Australasia Royal Australasian College of Surgeons North Adelaide, South Australia Australia David Efron, MD, FACS Professor of Surgery; Chief, Division of Acute Care Surgery; Director of Adult Trauma The Johns Hopkins University School of Medicine Baltimore, Maryland United States Froilan Fernandez, MD, FACS Chair, ACS-COT Chile; Associate Senior Surgical Staff Hospital Del Trabajador Santiago Chile John Fildes, MD, FACS Foundation Professor; Chair, Surgery; Chief, Division of Acute Care Surgery; Program Director, Acute Care Surgery Fellowship University of Nevada, Reno School of Medicine Las Vegas, Nevada United States Esteban Foianini, MD, FACS Medical Director Clinica Foianini Santa Cruz de la Sierra Bolivia Adam Fox, DPM, DO, FACS Assistant Professor of Surgery and Section Chief, Trauma Division of Trauma Surgery and Critical Care, Rutgers NJMS; Associate Trauma Medical Director, NJ Trauma Center Newark, New Jersey United States Robert Michael Galler, DO, FACS, FACOS Associate Professor, Neurosurgery and Orthopedics; Co-Director, Comprehensive Spine Center, Institute for Advanced Neurosciences Stony Brook University Medical Center Long Island, New York United States Raj Gandi, MD Trauma Medical Director JPS Health Network Fort Worth, Texas United States Naisan Garraway, CD, FRCSC, FACS Medical Director, Trauma Program Vancouver General Hospital Vancouver, British Columbia Canada Subash Gautam, MB, FRCS(Eng, Edn, and Glasg), FACS Head of Department Fujairah Hospital Fujairah United Arab Emirates Julie Gebhart, PA-C Lead Orthopedic Trauma Physician; Assistant Manager, Orthopedic Advanced Practice Providers OrthoIndy Hospital Indianapolis, Indiana United States Agienszka Gizzi Regional and International Programmes Coordinator The Royal College of Surgeons of England London United Kingdom
Page 1 and 2: TENTH EDITION ATLS ® Advanced Trau
Page 3 and 4: Chair of Committee on Trauma: Ronal
Page 6: FOREWORD My first exposure to Advan
Page 9 and 10: viii PREFACE MyATLS Mobile Applicat
Page 11 and 12: x PREFACE Gary A. Vercruysse, MD, F
Page 13 and 14: xii PREFACE Jacqueline Bustraan, MS
Page 16 and 17: ACKNOWLEDGMENTS It is clear that ma
Page 20 and 21: xix ACKNOWLEDGMENTS Oscar Guillamon
Page 22 and 23: xxi ACKNOWLEDGMENTS Mahesh Misra, M
Page 24 and 25: xxiii ACKNOWLEDGMENTS James Vosswin
Page 26 and 27: xxv ACKNOWLEDGMENTS James A. Geilin
Page 28: xxvii ACKNOWLEDGMENTS Tone Slåke R
Page 31 and 32: xxx COURSE OVERVIEW m. Protection o
Page 33 and 34: xxxii COURSE OVERVIEW Atls and Trau
Page 35 and 36: xxxiv COURSE OVERVIEW a systematize
Page 37 and 38: xxxvi COURSE OVERVIEW 69. Switzerla
Page 39 and 40: xxxviii COURSE OVERVIEW United Stat
Page 41 and 42: xl COURSE OVERVIEW 67. Hendrickson
Page 43 and 44: xlii COURSE OVERVIEW 122. Palusci V
Page 46: BRIEF CONTENTS Foreword Preface Ack
Page 49 and 50: xlviii DETAILED CONTENTS Teamwork 5
Page 51: l DETAILED CONTENTS Introduction 21
Page 55 and 56: 1 INITIAL ASSESSMENT AND MANAGEMENT
Page 57 and 58: 4 CHAPTER 1 n Initial Assessment an
Page 63 and 64: 10 CHAPTER 1 n Initial Assessment a
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16 CHAPTER 1 n Initial Assessment a
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2 AIRWAY AND VENTILATORY MANAGEMENT
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24 CHAPTER 2 n Airway and Ventilato
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3 SHOCK The first step in the initi
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44 CHAPTER 3 n Shock The first step
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46 CHAPTER 3 n Shock Recognition of
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48 CHAPTER 3 n Shock However, the a
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50 CHAPTER 3 n Shock Class II Hemor
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52 CHAPTER 3 n Shock hypothermia, a
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54 CHAPTER 3 n Shock replacement du
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56 CHAPTER 3 n Shock aggregation an
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58 CHAPTER 3 n Shock Presence of Pa
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60 CHAPTER 3 n Shock rate can be ac
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4 THORACIC TRAUMA Thoracic injury i
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64 CHAPTER 4 n Thoracic Trauma Thor
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66 CHAPTER 4 n Thoracic Trauma shoc
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68 CHAPTER 4 n Thoracic Trauma comp
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70 CHAPTER 4 n Thoracic Trauma Norm
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72 CHAPTER 4 n Thoracic Trauma Seco
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74 CHAPTER 4 n Thoracic Trauma A B
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76 CHAPTER 4 n Thoracic Trauma Spec
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78 CHAPTER 4 n Thoracic Trauma temp
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80 CHAPTER 4 n Thoracic Trauma 18.
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ABDOMINAL AND 5 PELVIC TRAUMA When
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84 CHAPTER 5 n Abdominal and Pelvic
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100 CHAPTER 5 n Abdominal and Pelvi
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6 HEAD TRAUMA The primary goal of t
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104 CHAPTER 6 n Head Trauma Head in
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106 CHAPTER 6 n Head Trauma fibrous
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108 CHAPTER 6 n Head Trauma n FIGUR
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110 CHAPTER 6 n Head Trauma table 6
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112 CHAPTER 6 n Head Trauma covery.
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120 CHAPTER 6 n Head Trauma necessa
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122 CHAPTER 6 n Head Trauma Use 0.2
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124 CHAPTER 6 n Head Trauma not rea
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126 CHAPTER 6 n Head Trauma 18. Mar
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CHAPTER 7 Outline Objectives iNtrod
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ANATOMY AND PHYSIOLOGY 131 B A n FI
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RIGHT INTERNATIONAL STANDARDS FOR N
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DOCUMENTATION OF SPINAL CORD INJURI
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SPECIFIC TYPES OF SPINAL INJURIES 1
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RADIOGRAPHIC EVALUATION 139 Penetra
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GENERAL MANAGEMENT 141 When the low
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GENERAL MANAGEMENT 143 them to the
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BIBLIOGRAPHY 145 Bibliography 1. Bi
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8 MUSCULOSKELETAL TRAUMA Injuries t
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150 CHAPTER 8 n Musculoskeletal Tra
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9 THERMAL INJURIES The most signifi
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170 CHAPTER 9 n Thermal Injuries Th
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172 CHAPTER 9 n Thermal Injuries Ch
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174 CHAPTER 9 n Thermal Injuries Pi
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176 CHAPTER 9 n Thermal Injuries th
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178 CHAPTER 9 n Thermal Injuries ju
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180 CHAPTER 9 n Thermal Injuries Im
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182 CHAPTER 9 n Thermal Injuries lo
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184 CHAPTER 9 n Thermal Injuries 4.
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10 PEDIATRIC TRAUMA Injury remains
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188 CHAPTER 10 n Pediatric Trauma I
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190 CHAPTER 10 n Pediatric Trauma c
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192 CHAPTER 10 n Pediatric Trauma A
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194 CHAPTER 10 n Pediatric Trauma b
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196 CHAPTER 10 n Pediatric Trauma b
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198 CHAPTER 10 n Pediatric Trauma t
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200 CHAPTER 10 n Pediatric Trauma f
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202 CHAPTER 10 n Pediatric Trauma t
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204 CHAPTER 10 n Pediatric Trauma G
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206 CHAPTER 10 n Pediatric Trauma C
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208 CHAPTER 10 n Pediatric Trauma
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210 CHAPTER 10 n Pediatric Trauma 1
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212 CHAPTER 10 n Pediatric Trauma 6
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CHAPTER 11 Outline Objectives iNtro
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PRIMARY SURVEY WITH RESUSCITATION 2
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PRIMARY SURVEY WITH RESUSCITATION 2
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SPECIFIC INJURIES 221 table 11-6 ph
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BIBLIOGRAPHY 223 comprise only 12%
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12 TRAUMA IN PREGNANCY AND INTIMATE
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228 CHAPTER 12 n Trauma in Pregnanc
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240 CHAPTER 13 n Transfer to Defini
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Appendix A OCULAR TRAUMA OBJECTIVES
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259 APPENDIX A n Ocular Trauma In c
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261 APPENDIX A n Ocular Trauma to t
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Appendix B HYPOTHERMIA AND HEAT INJ
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267 APPENDIX B n Hypothermia and He
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Appendix C TRAUMA CARE IN MASS-CASU
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277 APPENDIX C n Trauma Care in Mas
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Appendix D DISASTER PREPAREDNESS AN
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291 APPENDIX D n Disaster Preparedn
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Pitfall Inadequate security Failed
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Appendix E ATLS AND TRAUMA TEAM RES
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305 APPENDIX E n ATLS and Trauma Te
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Appendix F TRIAGE SCENARIOS OBJECTI
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319 APPENDIX F n Triage Scenarios T
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333 APPENDIX F n Triage Scenarios 4
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Skill Station A AIRWAY Part 1: Basi
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339 APPENDIX G n Skills One-Person
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341 APPENDIX G n Skills STEP 5. Con
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343 APPENDIX G n Skills STEP 13. Co
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346 APPENDIX G n Skills STEP 1. D
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Skill Station C CIRCULATION LEARNIN
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351 APPENDIX G n Skills manual trac
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353 APPENDIX G n Skills STEP 3. Aft
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355 APPENDIX G n Skills STEP 2. If
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358 APPENDIX G n Skills A. Note fac
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360 APPENDIX G n Skills •• Flex
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362 APPENDIX G n Skills Utilization
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366 APPENDIX G n Skills n FIGURE G-
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368 APPENDIX G n Skills less than 1
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372 APPENDIX G n Skills G. Inspect
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374 APPENDIX G n Skills in the inju
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378 INDEX LTA for, 31-32, 32f Malla
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380 INDEX atlanto-occipital disloca
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382 INDEX Frostbite, 181-183, 182f
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384 INDEX Kussmaul’s sign, 69 Lac
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386 INDEX PEA. See Pulseless electr
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388 INDEX for musculoskeletal traum
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390 INDEX Tibial fractures, 163 Tou
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TRAUMA SCORES Correct triage is ess
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394 TRAUMA SCORES on Field Triage,
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396 INJURY PREVENTION Safety Admini
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398 INJURY PREVENTION providers to
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BIOMECHANICS OF INJURY Injuries occ
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402 BIOMECHANICS OF INJURY Ejection
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404 BIOMECHANICS OF INJURY •• A
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406 BIOMECHANICS OF INJURY in a 30-
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408 TETANUS IMMUNIZATION •• Wou
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410 TETANUS IMMUNIZATION Summary Gu
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SAMPLE TRAUMA FLOW SHEET Page 1 of
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414 SAMPLE TRAUMA FLOW SHEET Page 3
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420 SAMPLE TRAUMA FLOW SHEET Some h
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