Must-Know Essentials: Resuscitative Endovascular Balloon Occlusion of the Aorta in Abdominal Trauma (Blunt/Penetrating) Background ■ For resuscitative endovascular balloon occlusion of the aorta (REBOA), an endovascular balloon is placed in the aorta to control hemorrhage, as well as to maintain myocardial and cerebral perfusion in traumatic arrest and hemorrhagic shock by augmenting afterload. Zones of Aorta for Reboa Placement ■ Average diameter of the aorta ■…

Must-Know Essentials: Viscoelastic Hemostatic Assay You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Algorithm: Management of hemorrhagic shock Open full size image Must-Know Essentials: Principles of Management of Hemorrhagic Shock Control of Airway and Ventilation ■ Supplemental oxygen ■ Definitive airway ■ Endotracheal intubation/surgical airway ■ Ventilatory support Access for Fluid Resuscitation ■ Peripheral line ■ Antecubital peripheral line ■ Two large-caliber (14–16 gauge) catheters ■ Short, large-caliber peripheral IV lines are preferred for rapid infusion of large volumes…

Algorithm: Assessment of shock in trauma patients Open full size image Must-Know Essentials: Shock in Trauma Patients Classification of Shock in Trauma Patients ■ Hemorrhagic shock: most common in trauma patients ■ Bleeding from lacerations ■ Bleeding in the soft tissue of the extremity injuries ■ Fractures: due to bleeding at fracture sites ■ Pelvic fractures: 2000–3000 mL ■ Femur shaft fracture: 1000–1500 mL ■ Tibia…

Algorithm: Compromised breathing and ventilation Open full size image Must-Know Essentials: Causes of Compromised Breathing and Ventilation Emergent Concern of Breathing and Ventilation ■ Complex maxillofacial trauma ■ Midface fractures ■ Bilateral mandibular body fracture ■ Severe brain injury (GCS score <8), leading to decreased central respiratory drive ■ Comatose patients ■ Hemorrhagic shock ■ High cervical spine injury ■ High cervical cord injury at C3/4…

Algorithm: Assessment and Management of Airway Open full size image Must-Know Essentials: Assessment of Compromised Airway Manifestations of Compromised Airway ■ Patient unable to verbalize ■ Noisy breathing ■ Stridor ■ Patient using or retracting accessary muscles of breathing ■ Agitation ■ Central nervous depression ■ Tachypnea ■ Cyanosis ■ Low oxygen saturation Must-Know Essentials: Definitive Airway Definition of Definitive Airway ■ A tube in the…

The vicious cycle of trauma and the lethal triad Open full size image Must-Know Essentials: The Vicious Cycle of Trauma and the Lethal Triad Definition ■ Vicious cycle of trauma ■ Hemorrhage after trauma initiates a cycle of acidosis, hypothermia, and coagulopathy that leads to continued bleeding with eventual death. ■ Lethal triad ■ A combination of hypothermia, acidosis, and coagulopathy ■ Associated with very high…

Algorithm: Evaluation of trauma patients (ATLS guidelines) Open full size image Must-Know Essentials: Process of Evaluation of Trauma Patients Primary Survey (A, B, C, D, E) and Resuscitation ■ A: Airway and cervical spine protection ■ B: Breathing and ventilation ■ C: Circulation and control of hemorrhage ■ D: Disability: Neurological status ■ E: Exposure and environmental protection Secondary Survey ■ After primary survey and management…

Trimodal distribution of deaths in trauma patients Open full size image Must-Know Essentials: Death in Trauma Patients You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here