Advanced Trauma Life Support ATLS Student Course Manual 2018

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MANAGEMENT OF OXYGENATION 37 A B C D n FIGURE 2-16 Surgical Cricothyroidotomy. A. Palpate the thyroid notch, cricothyroid interval, and sternal notch for orientation. B. Make a skin incision over the cricothyroid membrane and carefully incise the membrane transversely. C. Insert a hemostat or scalpel handle into the incision and rotate it 90 degrees to open the airway. D. Insert a properly sized, cuffed endotracheal tube or tracheostomy tube into the cricothyroid membrane incision, directing the tube distally into the trachea. n BACK TO TABLE OF CONTENTS
38 CHAPTER 2 n Airway and Ventilatory Management Because changes in oxygenation occur rapidly and are impossible to detect clinically, pulse oximetry must be used at all times. It is invaluable when difficulties are anticipated in intubation or ventilation, including during transport of critically injured patients. Pulse oximetry is a noninvasive method of continuously measuring the oxygen saturation (O 2 sat) of arterial blood. It does not measure the partial pressure of oxygen (PaO 2 ) and, depending on the position of the oxyhemoglobin dissociation curve, the PaO 2 can vary widely (n TABLE 2-2). However, a measured saturation of 95% or greater by pulse oximetry is strong corroborating evidence of adequate peripheral arterial oxygenation (PaO 2 >70 mm Hg, or 9.3 kPa). Pulse oximetry requires intact peripheral perfusion and cannot distinguish oxyhemoglobin from carboxyhemoglobin or methemoglobin, which limits its usefulness in patients with severe vasoconstriction and those with carbon monoxide poisoning. Profound anemia (hemoglobin
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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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Page 41 and 42: xl COURSE OVERVIEW 67. Hendrickson
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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
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Page 75 and 76: 2 AIRWAY AND VENTILATORY MANAGEMENT
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Page 95 and 96: 3 SHOCK The first step in the initi
Page 97 and 98: 44 CHAPTER 3 n Shock The first step
Page 99 and 100: 46 CHAPTER 3 n Shock Recognition of
Page 101 and 102: 48 CHAPTER 3 n Shock However, the a
Page 103 and 104: 50 CHAPTER 3 n Shock Class II Hemor
Page 105 and 106: 52 CHAPTER 3 n Shock hypothermia, a
Page 107 and 108: 54 CHAPTER 3 n Shock replacement du
Page 109 and 110: 56 CHAPTER 3 n Shock aggregation an
Page 111 and 112: 58 CHAPTER 3 n Shock Presence of Pa
Page 113 and 114: 60 CHAPTER 3 n Shock rate can be ac
Page 115 and 116: 4 THORACIC TRAUMA Thoracic injury i
Page 117 and 118: 64 CHAPTER 4 n Thoracic Trauma Thor
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Page 121 and 122: 68 CHAPTER 4 n Thoracic Trauma comp
Page 123 and 124: 70 CHAPTER 4 n Thoracic Trauma Norm
Page 125 and 126: 72 CHAPTER 4 n Thoracic Trauma Seco
Page 127 and 128: 74 CHAPTER 4 n Thoracic Trauma A B
Page 129 and 130: 76 CHAPTER 4 n Thoracic Trauma Spec
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Page 133 and 134: 80 CHAPTER 4 n Thoracic Trauma 18.
Page 135 and 136: ABDOMINAL AND 5 PELVIC TRAUMA When
Page 137 and 138: 84 CHAPTER 5 n Abdominal and Pelvic
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88 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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