创伤Advanced Trauma Life Support

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1、AdvancedTraumaLifeSupportPatrickCheah,MDLi-ShinHospitalEmergencyDepartment1/0011.Preparation2.Triage3.PrimarySurvey(ABCDEs)4.Resuscitation5.Adjunctstoprimarysurvey&resuscitation6.SecondarySurvey(headtotoeevaluation&history)7.Adjunctstosecondarysurvey8.Continuedpost-resuscitationmonito

2、ring&re-evaluation9.Definitecare.1/0021.PREPARATIONAPre-hospitalphaseReceivinghospitalisnotifiedfirst.Sendtotheclosest,appropriatefacility.BInHospitalPhaseAdvancedplanningforthetraumaptarrival.MethodtosummonextramedicalassistanceTransferagreementwithverifiedtraumacenterestablished.Pro

3、tectfromcommunicabledisease.1/0032.TRIAGEAMultipleCasualtiesnoofseverity&ptdonotexceedtheabilityofthefacility.BMassCasualtiesno&severityofptEXCEEDthecapabilityofthefacility&staff.1/0043.PRIMARYSURVEYA:Airwaywithcervicalspineprotect.B:BreathingC:Circulation--controlexternalbleeding.D:D

4、isabilityorneurologicalstatusE:Exposure(undress)&Environment(tempcontrol)1/005PRIMARYSURVEYPrioritiesforthecareofAdult,Pediatrics&Pregnancywomenareallthesame.DuringtheprimarysurveylifethreateningconditionsareidentifiedandmanagementisinstitutedSIMULTANEOUSLY.1/006A.AirwayMaintenancewit

5、hCervicalSpineProtection.*GCSscoreof8orlessrequiretheplacementofdefiniteairway.*Protectionofthespine&spinalcordistheimportantmanagementprinciple.*Neurologicalexamalonedoesnotexcludeacervicalspineinjury.*Alwaysassumeacervicalspineinjuryinanyptwithmulti-systemtrauma,especiallywithanalte

6、redlevelofconsciousnessorbluntinjuryabovetheclavicle.1/007B.Breathing&Ventilation*Airwaypatencydoesnotassureadequateventilation.C.CirculationwithHemorrhageControl.1.BloodVolume&CardiacOutputa.levelofconsciousness.b.skincolorc.Pulse.2.Bleeding*externalbleedingisidentified&controlledint

7、heprimarysurvey.*Tourniquetsshouldnotbeuse.1/008D.Disability(NeurologicalEvaluation)SimpleMnemonictodescribelevelofconsciousnessA:AlertV:RespondstoVocalstimuliP:RespondstoPainfulstimuliU:UnresponsivetoallstimuliNotforgettousealsoGlascowComaScale.1/009E.Exposure/EnvironmentalControl*It

8、isthe