Advanced Trauma Life Support ATLS Student Course Manual 2018

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TRANSFER PROTOCOLS 249 stabilize the patient’s condition before transport, ensure transfer personnel are properly trained, and make provisions for managing unexpected crises during transport. To ensure safe transfers, trauma surgeons must be involved in training, continuing education, and quality improvement programs designed for transfer personnel and procedures. Surgeons also should be actively involved in developing and maintaining systems of trauma care. See “Appropriate use of Helicopter Emergency Medical Services for transport of trauma patients: Guidelines from the Emergency Medical System Subcommittee, Committee on <strong>Trauma</strong>, American College of Surgeons.” in transfer. The most acceptable IT (information technology) enhanced communication medium may be used to avoid delay in transfer. Treatment during Transport Trained personnel should transfer the patient, based on the patient’s condition and potential problems. Treatment during transport typically includes: •• Monitoring vital signs and pulse oximetry •• Continuing support of cardiorespiratory system Transfer Protocols Pitfall prevention When protocols for patient transfer do not exist, the following guidelines regarding information from the referring doctor, information to transferring personnel, documentation, and treatment during transport are suggested. Information from Referring Doctor The doctor who determines that patient transfer is necessary should speak directly to the physician accepting the patient at the receiving hospital. The ABC-SBAR (refer to n TABLE 13-2) can serve as a checklist for the telephone report between physicians and the verbal report to transporting personnel. Information to Transferring Personnel Information regarding the patient’s condition and needs during transfer should be communicated to the transporting personnel (refer to the ABC-SBAR template in n TABLE 13-2). Documentation A written record of the problem, treatment given, and patient status at the time of transfer, as well as certain physical items (e.g., disks that contain radiologic images), must accompany the patient (n FIGURE 13-4). Digital media may be transmitted to the referring facility to expedite the transfer of information and make imaging available for review at a distance; when electronic transmission is not possible, facsimile transmission of reports may be used to avoid delay Dislodged or malpositioned endotracheal tubes and intravenous lines during transport Failure to anticipate deterioration in the patient’s neurologic condition or hemodynamic status during transport • Ensure that necessary equipment for reintubation and line placement accompanies the patient. • Verify that transfer personnel are capable of performing the procedure and managing any potential complications that occur. • Ensure tubes and lines are adequately secured. • For elderly patients, intoxicated patients, and patients with head injuries, there is often no way to predict if neurological status will change; thus, airway protection during transport is sometimes indicated for individuals with GCS scores >8. • The transporting physician should consider the possibility of potential neurological change and airway compromise when deciding to intubate before transport. • The receiving surgeon should offer advice if the decision to intubate is not clear based on consideration of the injury pattern and transport time. n BACK TO TABLE OF CONTENTS
250 CHAPTER 13 n Transfer to Definitive Care n FIGURE 13-4 Sample Transfer Form. This form includes all the information that should be sent with the patient to the receiving doctor and facility. 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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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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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%
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Page 310 and 311: Appendix A OCULAR TRAUMA OBJECTIVES
Page 312 and 313: 259 APPENDIX A n Ocular Trauma In c
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Page 318 and 319: Appendix B HYPOTHERMIA AND HEAT INJ
Page 320 and 321: 267 APPENDIX B n Hypothermia and He
Page 328 and 329: Appendix C TRAUMA CARE IN MASS-CASU
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Page 342 and 343: Appendix D DISASTER PREPAREDNESS AN
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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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