Advanced Trauma Life Support ATLS Student Course Manual 2018

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373 APPENDIX G n Skills lacerations, tenderness, deformity, and sensation (while restricting spinal motion in patients with possible spinal injury). Apply a Cervical CollAR in a Simulated Trauma Patient STEP 1. Place the patient in the supine position. NEUROLOGICAL STEP 11. Perform a neurological assessment. STEP 1. STEP 2. •• Reevaluate the pupils and level of consciousness. •• Determine the GCS score. •• Evaluate the upper and lower extremities for motor and sensory functions. •• Observe for lateralizing signs. Reduce and Splint a fRActure in a Simulated tRAuma Patient Ensure that the ABCDEs have been assessed and life-threatening problems have been addressed. Completely expose the extremity and remove all clothing. STEP 3. Clean and cover any open wounds. STEP 4. Perform a neurovascular examination of the extremity. STEP 5. Provide analgesia. STEP 6. Select the appropriate size and type of splint. Include the joint above and below the injury. STEP 7. Pad the bony prominences that will be covered by the splint. STEP 8. Manually support the fractured area and apply distal traction below the fracture and counter traction just above the joint. STEP 9. Reevaluate the neurovascular status of the extremity. STEP 10. Place the extremity in the splint and secure. STEP 11. Obtain orthopedic consultation. STEP 2. Place your extended fingers against the patient’s neck. Your little finger should almost be touching the patient’s shoulder. Count how many of your fingers it takes to reach the jawline. Remember, sizing a cervical collar is not an exact science; the available sizes are limited, so make your best estimate. STEP 3. Find the appropriately sized collar or use an adjustable one, if available. STEP 4. Have another provider restrict the patient’s cervical spinal motion by standing at head of bed and holding either side of the head. STEP 5. Slide the posterior portion of the collar behind the patient’s neck, taking care not to move the neck. STEP 6. Place the anterior portion of the collar on while making sure to place the patient’s chin in the chin holder. STEP 7. Secure the collar with the hook and loop fasteners, making it snug enough to prevent flexion but allowing the patient to open his or her mouth. Evaluate for Presence of CompARtment Syndrome STEP 1. Assess the degree of pain — is it greater than expected and out of proportion to the stimulus or injury? STEP 2. Determine if there is pain on passive stretch of the affected muscle. STEP 3. Determine if there is altered sensation or paresthesia distal to the affected compartment. STEP 4. Determine if there is tense swelling of the affected compartment. STEP 5. Palpate the muscular compartments of the extremity and compare the tension n BACK TO TABLE OF CONTENTS
374 APPENDIX G n Skills in the injured extremity with that in the noninjured extremity. Asymmetry may be an important finding. STEP 6. Compartment pressures may be measured, but the diagnosis is clinical. Pressure measurements may be useful in unconscious or neurologically impaired patients. STEP 7. Frequently reevaluate the patient, because compartment syndrome can develop over time. STEP 8:. Obtain surgical or orthopedic consultation early. Links to Future LeARNing Review the secondary survey video on the MyATLS mobile app. Post ATLS—Recognize that the secondary survey is similar to the comprehensive physical examination learned in medical school. It incorporates the AMPLE history and takes into account the mechanism of traumatic injury. It is easy therefore to find opportunities in one’s practice setting to continue to practice the skills learned in the secondary survey skill station. 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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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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321 APPENDIX F n Triage Scenarios T
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Page 390 and 391: Skill Station A AIRWAY Part 1: Basi
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Page 402 and 403: Skill Station C CIRCULATION LEARNIN
Page 404 and 405: 351 APPENDIX G n Skills manual trac
Page 406 and 407: 353 APPENDIX G n Skills STEP 3. Aft
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Page 421: 368 APPENDIX G n Skills less than 1
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Page 431 and 432: 378 INDEX LTA for, 31-32, 32f Malla
Page 433 and 434: 380 INDEX atlanto-occipital disloca
Page 435 and 436: 382 INDEX Frostbite, 181-183, 182f
Page 437 and 438: 384 INDEX Kussmaul’s sign, 69 Lac
Page 439 and 440: 386 INDEX PEA. See Pulseless electr
Page 441 and 442: 388 INDEX for musculoskeletal traum
Page 443 and 444: 390 INDEX Tibial fractures, 163 Tou
Page 445 and 446: TRAUMA SCORES Correct triage is ess
Page 447 and 448: 394 TRAUMA SCORES on Field Triage,
Page 449 and 450: 396 INJURY PREVENTION Safety Admini
Page 451 and 452: 398 INJURY PREVENTION providers to
Page 453 and 454: BIOMECHANICS OF INJURY Injuries occ
Page 455 and 456: 402 BIOMECHANICS OF INJURY Ejection
Page 457 and 458: 404 BIOMECHANICS OF INJURY •• A
Page 459 and 460: 406 BIOMECHANICS OF INJURY in a 30-
Page 461 and 462: 408 TETANUS IMMUNIZATION •• Wou
Page 463 and 464: 410 TETANUS IMMUNIZATION Summary Gu
Page 465 and 466: SAMPLE TRAUMA FLOW SHEET Page 1 of
Page 467 and 468: 414 SAMPLE TRAUMA FLOW SHEET Page 3
Page 473 and 474: 420 SAMPLE TRAUMA FLOW SHEET Some h
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Advanced Trauma Life Support ATLS Student Course Manual 2018

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