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Prehospital Trauma Life Support

Introduction

REFRESHER COURSE

4thEdition

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Developed by the

National Association ofEmergency Medical Technicians

In cooperation with

The Committee on Trauma,American College of Surgeons

This slide presentation is intended for use only

in approved PHTLS courses. R-2

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Purpose of Refresher Course

Review.

Amend.

Revise and update.

Reaffirm.

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PHTLS Refresher Course

Trauma Summary

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Prehospital Trauma Life Support

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Part

1Managing the

Multi-SystemTrauma Patient

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PHTLS Refresher Course

Trauma

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PHTLS Refresher Course

Causes of Trauma Deaths

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Platinum 10 minutes.

Transportation.

Emergency department intervention.

Surgical intervention.

Golden Hour

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Scene

Safety

Situation

Priorities

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Mechanism of injury is the key indication

for the treatment of spinal injury.

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PHTLS Refresher Course

Law of

Conservation of Energy

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Shear

Blunt Trauma

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Vehicular Collisions

Three impacts.

Vehicle.

Occupant.

Internal organs.

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Head-on, frontal.

Rear-end.

Lateral, side.

Rotational, pivot.Roll-over.

Types of Impact

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Primary Survey

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Global assessment.

In-depth systems.

Locate life-threatening injuries.

Manage life-threateningconditions.

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Airway Management

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Manual

Mechanical

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PHTLS Refresher Course

Ventilation

Minute Volume

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PHTLS Refresher Course

Ventilatory Rate

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PHTLS Refresher Course

Oxygen Concentrations

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Goal:

Ensure adequate oxygenation of cells.

Manage airway.

Assure adequate ventilation.

Assure adequate oxygenation.

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Pulse.

Skin.

Capillary refill.

Overt hemorrhage.

Consider shock.

Circulation

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Adequate Circulation

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Pump

Volume of fluid

Container

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Adequately oxygenated RBCs.

Adequate number of RBCs.

Adequate circulation of oxygenated RBCs.

RBCs able to off-load oxygen to cells.

Fick Principle

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Cellular Response to Shock

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Anaerobic metabolism.

Cellular death. Organ death.

Organism death.

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Management of shock inthe first hourdetermines

outcome 2 - 21 dayslater!

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Neurological Assessment

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Check for responsiveness.

Check pupils.

Check for deficit.

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Early recognition.

Meaningful intervention.

Efficiency of care.

Rapid intervention.

Keys to Effective Prehospital Care

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PHTLS Refresher Course

Management: Shock

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Resuscitation phase...

Re-evaluate.

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Correct keyproblems

as found.