Multiple Trauma: Initial In-hospital management: Part II
Summary
In hospital, the primary survey is a structured clinical and ultra-sonographic examination aiming at identifying acute life-threatening injuries that require immediate resuscitation, and constructing a therapeutic and diagnostic sequence. This phase has to follow a protocol known by all team members. It must be simple but systematic to avoid missing injuries, from head to toe, targeting A/B, C, D, E assessments (see below). Whenever an A/B, C, D, E pathology is identified, a corresponding intervention is carried out without delay. It is crucial for the success of resuscitation, that the team performs primary survey and immediate interventions simultaneously without losing structure and focus, and with no delay to assess and address other vital problems. An intrahospital trauma team is able to manage several problems simultaneously.
General Information
Enrolled trainees 555
Open 25.04.2023
Available for ESICM members
Student effort 3
Last Updated April 25, 2023
Intended Learning Outcomes
After studying this module on Multiple Trauma Part II: Initial In-hospital management you should be able to:
- To identify the principles of primary assessment of the patient with major trauma.
- To list the indications for common primary interventions needed in the patient with major trauma.
- To list the most important imaging techniques used in major trauma.
- To describe the concept of damage control in the unstable trauma patient.
Relevant competencies in CoBaTrICE
- 1.2 Manages cardiopulmonary resuscitation
- 1.5 Assesses and provides initial management of the trauma patient
- 2.2 Undertakes timely and appropriate investigations
- 2.3a Performs and interprets transthoracic cardiac ultrasound for the recognition and assessment of left ventricular and right systolic failure, contraction pattern and dilation and pericardial tamponade
- 2.3b Performs and interprets ultrasonographic assessment of the lungs and pleura for the recognition and assessment of consolidation, pleural effusion and pneumothorax.
- 2.3c Performs and interprets ultrasonographic assessment of the abdomen to assess intraperitoneal free fluid, hydronephrosis and bladder volume.
- 2.3d Performs and interprets venous ultrasound examination to assess for deep venous thrombosis and to aid vascular access (arterial and venous)
- 2.6 Obtains and interprets the results from blood gas samples
- 2.7 Interprets chest x-rays
- 2.8 Liaises with radiologists to organise and interpret clinical imaging
- 2.9 Monitors and responds to trends in physiological variables
- 2.10 Integrates clinical findings with laboratory investigations to form a differential diagnosis
- 3.3 Recognises and manages the patient with circulatory failure
- 3.4 Recognises and manages the patient with, or at risk of, acute renal failure
- 4.3 Administers blood and blood products safely
- 4.4 Uses fluids and vasoactive / inotropic drugs to support the circulation
- 5.1 Administers oxygen using a variety of administration devices
- 5.2 Performs fibreoptic laryngoscopy
- 5.3 Performs emergency airway management
- 5.4 Performs difficult and failed airway management according to evidence-based protocols
Enrollment Options
You are currently NOT enrolled in this course.
This course is available only for registered ESICM members.
If you are an ESICM member you can enrol yourself by clicking the Enrol Me button.
If there is no Enrol button on the top left of this card please check that you have login and that you are an ESICM Member.
Verify that you are logged in the Academy using your valid ESICM account to enrol yourself in the course.
Disclaimer
All authors of ACE courses sign a document declaring absence or any actual or potential conflicts of interest. In addition, they sign a copyright document confirming the work is their own and that they have obtained the necessary permission for any copyrighted material. The latter document also transfers the intellectual copyright to the ESICM. Both the conflict of interest and copyright forms are filed and stored in compliance with GDPR and are available for inspection upon request.