MANAGEMENT OF TRAUMA VICTIMS MAN MOHAN HARJAI Associate Professor Army Hospital (Research and Referral) Delhi Cantt INDIA
MANAGEMENT OF TRAUMA VICTIMS – TASKS AIR WAY CONTROL ADEQUATE VENTILATION WITH MONITORING I.V. ACCESS / BLOOD SAMPLES FLUID/ RESUSUTATION ASSESSMENT
Head tilt, chin lift (not in case of spine trauma) Chin lift, jaw thrust (in case of spine trauma) Manual clearance Suction Positioning of patient with jaw support MANUAL METHODS OF AIRWAY CONTROL
Oropharyngeal air way Nasopharyngeal air way Resuscitube Combitube Laryngeal mask air way (LMA) Endotracheal intubation Needle cricothyrotomy AIR WAY ADJUNCTS
Definitive method of securing air way Ability to deliver high conc. of o 2 Ease of ventilation Prevention of gastric distention and aspiration Tracheal suction and air way clearance Second line route for drug administration ENDOTRACHEAL INTUBATION
Cervical spine trauma Children Short neck Prominent upper incisors Receding mandible Limited jaw opening Limited cervical mobility Facial trauma Laryngeal trauma THE POTENTIALLY DIFFICULT INTUBATION
Means of providing high conc. of O 2 Protection of air way Ease of ventilation ADVANTAGE Ease of insertion without laryngoscope Better protection of air way compared to OP airway, NP airway LARYNGEAL MASK AIR WAY
COMPLICATIONS Accidental displacement Hypoxia Aspiration and vomiting Trauma to soft tissue LARYNGEAL MASK AIR WAY
SPECIAL CONSIDERATIONS Maxillofacial injuries Laryngotracheal injuries Cervical spine injuries Thoracic injuries
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