《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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