ATLS (Advanced Trauma Life Support) - Key Concepts and Management Strategies, Exams of Nursing

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Advanced Trauma Life Support

ATLS - ANSWER>>System for initial management of trauma patients Trimodal distribution - ANSWER>>Trauma mortality occurs in three phases: immediate, early, and late ATLS algorithm - ANSWER>>ABCDE: Airway, Breathing, Circulation, Disability, Exposure Cervical spine injury - ANSWER>>Assume present until excluded in trauma patients Obstructed airway - ANSWER>>Can be caused by trauma, burns, blood, vomit, or foreign body Signs of airway obstruction - ANSWER>>Snoring, stridor, hoarseness, or silent C-spine immobilization - ANSWER>>Manual in-line stabilization and collar +/- blocks Airway adjuncts - ANSWER>>Devices used to manage airway obstruction High flow oxygen - ANSWER>>Initial treatment for respiratory distress, supplemented with bag valve mask if necessary

Tension pneumothorax - ANSWER>>Internal air leak into pleural cavity causing increased pressure on mediastinum Clinical features of tension pneumothorax - ANSWER>>Respiratory distress, hypoxia, tracheal deviation, engorged neck veins Management of tension pneumothorax - ANSWER>>Ventilatory support, needle decompression, definitive chest drain Open pneumothorax - ANSWER>>Open chest wound acting as a 'one- way' valve, causing lung collapse Clinical features of open pneumothorax - ANSWER>>Respiratory distress, hypoxia, can easily develop into tension pneumothorax Management of open pneumothorax - ANSWER>>Ventilatory support, 3- sided dressing, definitive chest drain Massive haemothorax - ANSWER>>Large volume intrathoracic hemorrhage causing respiratory distress and hypoxia Clinical features of massive haemothorax - ANSWER>>Dull percussion, no air entry on auscultation, signs of hemodynamic instability Management of massive haemothorax - ANSWER>>Ventilatory support, circulatory support, surgical chest drain

Flail chest - ANSWER>>Independent movement of a section of the ribcage due to multiple rib fractures Clinical features of flail chest - ANSWER>>Paradoxical movement of the thoracic cage, respiratory distress, hypoxia, pain Management of flail chest - ANSWER>>Ventilatory support, analgesia, likely CCU admission Identifying circulatory compromise - ANSWER>>Inspect areas for blood loss and signs of poor peripheral perfusion Management of circulatory compromise - ANSWER>>Control obvious sources of bleeding, replace losses with fluids and blood products Cardiac tamponade - ANSWER>>Excess blood in the pericardium causing constriction of the heart Clinical features of cardiac tamponade - ANSWER>>Hypotension, jugular venous distension, muffled heart sounds Management of cardiac tamponade - ANSWER>>Pericardiocentesis under ultrasound guidance Shock - ANSWER>>Circulatory failure resulting in inadequate oxygen delivery to tissues

Types of shock - ANSWER>>Haemorrhagic, non-haemorrhagic, cardiogenic, neurogenic, septic, anaphylactic Compensatory mechanisms in shock - ANSWER>>Increased respiratory rate, increased heart rate, cold peripheries Disability - ANSWER>>Refers to the level of consciousness and neurological function Glasgow Coma Scale - ANSWER>>Assessment tool for level of consciousness in head injury AVPU scale - ANSWER>>Assessment tool for level of consciousness Examination of the patient - ANSWER>>Perform a full examination and keep the patient warm Common sites to miss injuries - ANSWER>>Back of head, back, buttocks, perineum, axillae, skin folds Next steps after primary survey - ANSWER>>Senior decision making, further imaging, critical care review, urgent surgery Secondary survey - ANSWER>>Systematic top-to-toe examination of the patient

Life-threatening conditions - ANSWER>>ATOM FC: Airway obstruction, tension pneumothorax, open pneumothorax, massive haemothorax, flail chest, cardiac tamponade