Advanced Trauma Life Support ATLS Student Course Manual 2018

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AIRWAY 191 table 10-3 pediatric equipment a AIRWAY AND BREATHING AGE AND WEIGHT O 2 MASK ORAL AIRWAY BAG- VALVE LARYNGO- SCOPE ET TUBE STYLET SUCTION Premie 3 kg Premie, newborn Infant Infant 0 straight 2.5–3.0 no cuff 6 Fr 6–8 Fr 0–6 mos 3.5 kg Newborn Infant, small Infant 1 straight 3.0–3.5 no cuff 6 Fr 8 Fr 6–12 mos 7 kg Pediatric Small Pediatric 1 straight 3.5–4.0 cuffed or uncuffed 6 Fr 8-10 Fr 1–3 yrs 10–12 kg Pediatric Small Pediatric 1 straight 4.0–4.5 cuffed or uncuffed 6 Fr 10 Fr 4–7 yrs 16–18 kg Pediatric Medium Pediatric 2 straight or curved 5.0–5.5 no cuff 14 Fr 14 Fr 8–10 yrs 24–30 kg Adult Medium, large Pediatric, adult 2-3 straight or curved 5.5–6.5 cuffed 14 Fr 14 Fr AGE AND WEIGHT BP CUFF CIRCULATION IV CATHETER b OG/NG TUBE SUPPLEMENTAL EQUIPMENT CHEST TUBE URINARY CATHETER CERVICAL COLLAR Premie 3 kg Premie, newborn 22–24 ga 8 Fr 10-14 Fr 5 Fr feeding — 0–6 mos 3.5 kg Newborn, infant 22 ga 10 Fr 12-18 Fr 6 Fr or 5–8 Fr feeding — 6–12 mos 7 kg Infant, child 22 ga 12 Fr 14-20 Fr 8 Fr Small 1–3 yrs 10–12 kg Child 20-22 ga 12 Fr 14-24 Fr 10 Fr Small 4–7 yrs 16–18 kg Child 20 ga 12 Fr 20-28 Fr 10-12 Fr Small 8–10 yrs 24–30 kg Child, adult 18-20 ga 14 Fr 28-32 Fr 12 Fr Medium a Use of a length-based resuscitation tape, such as a Broselow TM Pediatric Emergency Tape, is preferred. b Use of the largest IV catheter that can readily be inserted with reasonable certainty of success is preferred. n BACK TO TABLE OF CONTENTS
192 CHAPTER 10 n Pediatric <strong>Trauma</strong> A B n FIGURE 10-1 Resuscitation Tape. A. A length-based resuscitation tape, such as the Broselow® Pediatric Emergency Tape, is an ideal adjunct to rapidly determine weight based on length for appropriate fluid volumes, drug doses, and equipment size. B. Detail, showing recommended drug doses and equipment needs for pediatric patients based on length. cause of cardiac arrest in children. Therefore, the child’s airway is the first priority. (Also see Chapter 2: Airway and Ventilatory Management, and Appendix G: Airway Skills.) Plane of face is not parallel to spine board Anatomy The smaller the child, the greater is the disproportion between the size of the cranium and the midface. The large occiput results in passive flexion of the cervical spine, leading to a propensity for the posterior pharynx to buckle anteriorly. To avoid passive flexion of the cervical spine, ensure that the plane of the midface is maintained parallel to the spine board in a neutral position, rather than in the “sniffing position” (n FIGURE 10-2A). Placement of a 1-inch layer of padding beneath the infant or toddler’s entire torso will preserve neutral alignment of the spinal column (n FIGURE 10-2B). Several anatomical features of children affect airway assessment and management. The soft tissues of an infant’s oropharynx (i.e., the tongue and tonsils) are relatively large compared with the tissues in the oral cavity, which may compromise visualization of the larynx. A child’s larynx is funnel shaped, allowing secretions to accumulate in the retropharyngeal area. The larynx and vocal cords are more cephalad and anterior in the neck. The vocal cords are frequently more difficult to visualize when the child’s head is in the normal, supine, anatomical position during intubation than when it is in the neutral position required for optimal cervical spine protection. An infant’s trachea is approximately 5 cm long and grows to 7 cm by about 18 months. Failure to appreciate this short length can result in intubation of the right A B Plane of face is parallel to spine board n FIGURE 10-2 Positioning for Airway Maintenance. A. Improper positioning of a child to maintain a patent airway. The disproportion between the size of the child’s cranium and midface leads to a propensity for the posterior pharynx to buckle anteriorly. The large occiput causes passive flexion of the cervical spine. B. Proper positioning of a child to maintain a patent airway. Avoid passive flexion of the cervical spine by keeping the plane of the midface parallel to the spine board in a neutral position, rather than in the “sniffing position.” Placement of a 1-inch layer of padding beneath the infant’s or toddler’s entire torso will preserve neutral alignment of the spinal column. mainstem bronchus, inadequate ventilation, accidental tube dislodgment, and/or mechanical barotrauma. The optimal endotracheal tube (ETT) depth (in centimeters) can be calculated as three times the appropriate n BACK TO TABLE OF CONTENTS
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TENTH EDITION ATLS ® Advanced Trau
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Chair of Committee on Trauma: Ronal
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FOREWORD My first exposure to Advan
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viii PREFACE MyATLS Mobile Applicat
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x PREFACE Gary A. Vercruysse, MD, F
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xii PREFACE Jacqueline Bustraan, MS
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ACKNOWLEDGMENTS It is clear that ma
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xvii ACKNOWLEDGMENTS Bertil Bouillo
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xix ACKNOWLEDGMENTS Oscar Guillamon
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xxi ACKNOWLEDGMENTS Mahesh Misra, M
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xxiii ACKNOWLEDGMENTS James Vosswin
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xxv ACKNOWLEDGMENTS James A. Geilin
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xxvii ACKNOWLEDGMENTS Tone Slåke R
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xxx COURSE OVERVIEW m. Protection o
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xxxii COURSE OVERVIEW Atls and Trau
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xxxiv COURSE OVERVIEW a systematize
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xxxvi COURSE OVERVIEW 69. Switzerla
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xxxviii COURSE OVERVIEW United Stat
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xl COURSE OVERVIEW 67. Hendrickson
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xlii COURSE OVERVIEW 122. Palusci V
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BRIEF CONTENTS Foreword Preface Ack
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xlviii DETAILED CONTENTS Teamwork 5
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l DETAILED CONTENTS Introduction 21
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1 INITIAL ASSESSMENT AND MANAGEMENT
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4 CHAPTER 1 n Initial Assessment an
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10 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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Page 196 and 197: GENERAL MANAGEMENT 143 them to the
Page 198 and 199: BIBLIOGRAPHY 145 Bibliography 1. Bi
Page 201 and 202: 8 MUSCULOSKELETAL TRAUMA Injuries t
Page 203 and 204: 150 CHAPTER 8 n Musculoskeletal Tra
Page 221 and 222: 9 THERMAL INJURIES The most signifi
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Page 227 and 228: 174 CHAPTER 9 n Thermal Injuries Pi
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Page 237 and 238: 184 CHAPTER 9 n Thermal Injuries 4.
Page 239 and 240: 10 PEDIATRIC TRAUMA Injury remains
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Page 257 and 258: 204 CHAPTER 10 n Pediatric Trauma G
Page 259 and 260: 206 CHAPTER 10 n Pediatric Trauma C
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Page 268 and 269: CHAPTER 11 Outline Objectives iNtro
Page 270 and 271: PRIMARY SURVEY WITH RESUSCITATION 2
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Page 274 and 275: SPECIFIC INJURIES 221 table 11-6 ph
Page 276 and 277: BIBLIOGRAPHY 223 comprise only 12%
Page 279 and 280: 12 TRAUMA IN PREGNANCY AND INTIMATE
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242 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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Advanced Trauma Life Support ATLS Student Course Manual 2018

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