《宠物急诊抢救》急诊优先步骤.ppt
TriagePriorities
in
Trauma
IntroductionTelephone/ReceptiontoExamRoomBePreparedEquipmentChecklistsSystemsPrioritiesinTraumaPrimarySurveySecondarySurvey
TelephoneTriageFirstContactStaffmustbetrainedtoassessWaitingRoomReceptionneedstohavequeuesWhatconstitutesanemergencyfromsomethingthatcanwait?InformationKeepclientinformedastopetsstatusStaffneedstobecomfortingintimesofstress
BePreparedEquipmentandCrashCartItemsDailyChecksStaffTrainingandSimulationMinutesCount
SystemsPrioritiesinTraumaA,B,C,D’sArterialBleedingRespiratorySystemsCardiovascularSystemHemorrhageandTransfusionNeurologicalSystemMusculoskeletalSystemAbdominalInjuries
ArterialBleedingSpurtingBrightBloodOftenPatientWillBleedtoDeathBeforeContactStopQuicklyandMoveonPressureClamp
RespiratorySystemAIRWAY,AIRWAY,AIRWAYDifficult?MandibularFractureTrachea/LaryngealInjurySQEmphysema
RespiratorySystemBreathingRespiratoryDistressMucousMembraneColorDoesBodyPositionorMovementEffectPenetratingWoundFlailChestBreathSounds
RespiratorySystemPneumothoraxOpenClosedTensionPulmonaryContusionRibFractureFlailChestHemothoraxHydrothorax
CirculationEvidenceofOn-goingHemorrhageMucousMembraneColorandCRTPulseRateandQualityHeartRateandPulseRateMatchingWarmthofExtremitiesDistentionorCollapseofVesselsFluids!!!!!!!!
HemorrhageandTransfusionIncreaseinBloodPressureMayIncreaseBleedingCrystalloids/ColloidsOxygenCarryingCapacityAnemia/HemodilutionCriticalBloodLossTransfusionWholeBlood,PackedRBC’s,orHBOC
TransfusionFormulaBloodVolumeApproximately90ml/kg2.2ccofwholebloodper1kg/BWwillraiseHCTbyapproximately1%1ml/1#BW/1%(ruleofones)HBOC(Oxyglobin?)10-30ml/kg/day
NeurologicSystemHeadTraumaSpinalInjuryPeripheralNerveInjury
NeurologicExaminationPupilsandPLR’sResponsivenessPosture
MusculoskeletalInjuryExtremityFractureOpenClosedSwellingNeurologicInjuryPelvicFractureBladderBowe
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