Training Surgeons for Disasters
|
|
- Arron Daniel
- 5 years ago
- Views:
Transcription
1 SURGICAL RESPONSE TO DISASTERS Training Surgeons for Disasters M. Margaret Knudson MD, FACS Chief of Surgery, San Francisco General Hospital and Trauma Center A MASS CASUALTY EVENT IS NOT JUST ANOTHER BUSY NIGHT IN AN URBAN TRAUMA CENTER! ACS/COT Mass Casualty Management: A Weekly Event Propper et al: Annals of Surgery 2009 Elster et al: Implications of Combat Casualty Care for Mass Casualty Care, JAMA
2 4 Operating Rooms: 2 pts each Surgical Response in Boston Amputations Vascular Injuries Senior Visiting Surgeon Program Response in Haiti: ACS Operation Giving Back Massive Destruction US Naval Response 2
3 Asiana Flight 214 Departed from Incheon So. Korea for SFO Boeing 777 aircraft 307 passengers on board 70 Chinese high school students en route to summer camp in So. CAL 11:28 Crashed on final approach Plane Crash 3
4 Fate of the Passengers 181 injured passengers 12 critical: 10 SFGH/2 Stanford 2 deaths at the scene Several victims ejected out back Found on the runway still in seats 9 hospitals admitted 182 pts. Fate of the Plane Boeing 777 Held up Well Saturday 11:30 SFGH Trauma surgeon on-call for 24 hours Just finished making rounds Enjoying a Breakfast of Champions Powerbar and a Latte Courtesy call from ED: small plane crash 4
5 JULY 6 TH 2013; 12:30 pm First wave of injured patients arrive Six critical condition Burns and Inhalation injuries? Severe blunt trauma Two very unstable: taken to the OR within minutes PATIENT CRITICAL INJURIES: FIRST WAVE INJURIES #1 TBI, Facial Burns, Inhalation*, Spine #2 Major intestinal, spine with paralysis; road burns #3 Chest, intestinal, spine with paralysis, mandible, > 30% TBSA road burns #4 Extremity injury with compartment Sx #5 Severe TBI, spine, sternum, ribs #6 TBI, spine, sternum, extremity fractures 3 Waves of Patients Total seen at SFGH: Adults 31 Children 36: Admitted Keeping track of patients/injuries Singular focus: Doing the right thing 5
6 OPERATING ROOM: FIRST 48 HOURS Other Unique Challenges Crash Related Damage control laparotomy; burns Reduction of fracture; fasciotomy Damage control laparotomy; burns Laminectomy; spinal fusion Spinal decompression Craniotomy Spinal fusion Take-back laparotomy Take-back laparotomy Other emergencies Hand fracture Appendectomy Stab wound to the abdomen Wrist fracture Craniotomy Wound debridement Wound debridement Infection Fracture Fracture Blood bank supply: >100 U Judicious monitored use Chance Plus One Chance Fractures: A Rare Occurrence Combination of intestinal injuries and spine fractures Most commonly seen with lap-belt use Severe flexion over a fixed object Most common injuries:spine;chest 6
7 Potential Toxic Exposure Strange metabolic picture: acidosis, hypocalcemia; hypotension Persisted for days among survivors Toxic exposure: jet fuels, foam, cargo? Hydrogen Fluoride Inhalation Injury: Fire Suppression System Fire suppression System: HFC-227/US military Converts on heating to HF HF: devastating inhalation injury Fluoride binds Ca++: liquifaction/cardiac arrthymias 3/5 soldiers died: survivors treated with nebulized Ca++ Other Major Challenges Damage control surgery/multiple take-backs Road Burns : wound care/skin grafts Cardiac arrhythmias, low Ca++, low platelets Renal failure: CVVH Intestinal Fistulas Intra-abdominal infections Emotional Stress: Families 2 deaths at the scene Different Customs and Cultures and Languages 7
8 Other Unique Problems Children without parents Families separated by acuity No one had been through customs! Homeland security: set up in cafeteria Media Accurate and regularly scheduled updates They will be there for days camped out One death in our hospital: Black Friday The Tail Goes on for Days/Weeks and Months Long after the press goes home.. And the public almost forgets.. There are still critically injured patients Require multiple surgeries, rehabilitation Decompression for the Team: July!! 8
9 China s Zhejang Province 9
Director, Burn Center MetroHealth Medical Center Professor of Surgery Case Western Reserve University
Director, Burn Center MetroHealth Medical Center Professor of Surgery Case Western Reserve University BLAST INJURY Which of following statements concerning blast lung injury are FALSE? 1)Blast lung injury
More informationCivilian Hospital Response to Mass Casualty Events The Israeli Experience
Civilian Hospital Response to Mass Casualty Events The Israeli Experience William Schecter, MD Professor of Clinical Surgery University of California, San Francisco Chief of Surgery San Francisco General
More informationRestore adequate respiratory and circulatory conditions. Reduce pain
Pre-hospital management of the trauma patient is best performed by an integrated team focused on minimizing the time from injury to definitive care at an appropriate trauma center. Dispatchers, first responders,
More informationFractures of the Thoracic and Lumbar Spine
A spinal fracture is a serious injury. Nader M. Hebela, MD Fellow of the American Academy of Orthopaedic Surgeons http://orthodoc.aaos.org/hebela Cleveland Clinic Abu Dhabi Cleveland Clinic Abu Dhabi Neurological
More informationCLINICAL MANUAL. Trauma System Activation Trauma Code Criteria
CLINICAL MANUAL Policy Number: CM T-28 Approved by: Nursing Congress, Management Forum Issue Date: 09/1999 Applies to: Downtown Value(s): Respect, Integrity, Innovation Page(s): 1 of 4 Trauma System Activation
More informationShenandoah Co. Fire & Rescue. Injuries to. and Spine. December EMS Training Bill Streett Training Section Chief
Shenandoah Co. Fire & Rescue Injuries to the Head and Spine December EMS Training Bill Streett Training Section Chief C.E. Card Information BLS Providers 2 Cards / Provider Category 1 Course # Blank Topic#
More informationWhere Have we Come From, and Where are we Going
Where Have we Come From, and Where are we Going James Augustine, MD, FACEP Emergency Physician and Fire/EMS Medical Director Naples, Atlanta, and Dayton Clinical Professor, Wright State Univ. Dept of Emergency
More informationCivilian versus Military Trauma Management
Western University From the SelectedWorks of Vivian C. McAlister November, 2010 Civilian versus Military Trauma Management Vivian C. McAlister Available at: https://works.bepress.com/vivianmcalister/151/
More informationPediatric Aspects of Advanced Trauma Life Support: Transition from EMS to the Trauma Room PEDIATRIC TRAUMA DIRECTOR, HASBRO CHILDREN S HOSPITAL
Pediatric Aspects of Advanced Trauma Life Support: Transition from EMS to the Trauma Room HALE WILLS, MD PEDIATRIC TRAUMA DIRECTOR, HASBRO CHILDREN S HOSPITAL Objectives 1. Identify the critical components
More informationDATA COLLECTION AND MANAGEMENT
DATA COLLECTION AND MANAGEMENT PURPOSE To specify the components of the data collection and management processes. RELATED POLICIES Patient Care Record, # 8115; Quality Improvement and System Evaluation,
More informationEMS System for Metropolitan Oklahoma City and Tulsa 2019 Medical Control Board Treatment Protocols
EMERGENCY MEDICAL RESPONDER EMT EMT-INTERMEDIATE 85 ADVANCED EMT PARAMEDIC 14G PATIENT PRIORITIZATION While each patient will receive the best possible EMS care in a humane and ethical manner, proper patient
More informationFocused History and Physical Examination of the
Henry: EMT Prehospital Care, Revised 3 rd Edition Lecture Notes Chapter 10: Focused History and Physical Examination of Trauma Patients Chapter 10 Focused History and Physical Examination of the Trauma
More informationKinetic Energy Energy in Motion KE = Mass (weight) X Velocity (speed)² 2 Double Weight = Energy Double Speed = Energy IS THE GREATEST DETERMINANT
1 Chapter 17 Blunt Trauma 2 Introduction to Blunt Trauma Most common cause of trauma death and disability exchange between an object and the human body, without intrusion through the skin 3 Blunt trauma
More informationPRE-HOSPITAL PATIENT CARE PROTOCOLS BASIC LIFE SUPPORT/ADVANCED LIFE SUPPORT
PRE-HOSPITAL PATIENT CARE PROTOCOLS BASIC LIFE SUPPORT/ADVANCED LIFE SUPPORT Board Approved June 2007 Revised December 2009 Revised July 2011 Revised June 2015 435 Hunter Street Fredericksburg, VA 22401
More informationESCAMBIA COUNTY TRAUMA TRANSPORT
TRAUMA ALERT CRITERIA are established state mandated criteria. ADULT TRAUMA ALERT CRITERIA (Physical and anatomical characteristics of a person 16 years of age or older) Any 1 of the following: 1. Airway:
More informationTrauma Overview. Chapter 22
Trauma Overview Chapter 22 Kinematics of Trauma Injuries are the leading cause of death among children and young adults. Kinematics introduces the basic physical concepts that dictate how injuries occur
More informationLittle Kids in Big Crashes The Bio-mechanics of Kids in Car Crashes. Lisa Schwing, RN Trauma Program Manager Dayton Children s
Little Kids in Big Crashes The Bio-mechanics of Kids in Car Crashes Lisa Schwing, RN Trauma Program Manager Dayton Children s Very Little Research There has been very little research on the forces a crash
More informationSIERRA-SACRAMENTO VALLEY EMS AGENCY PROGRAM POLICY
SIERRA-SACRAMENTO VALLEY EMS AGENCY PROGRAM POLICY PURPOSE: To identify those patients who are at greatest risk for severe injury and determine the most appropriate facility to transport persons with different
More informationPEDIATRIC TRAUMA I: ABDOMINAL TRAUMA BURNS. December 19, 2012
PEDIATRIC TRAUMA I: ABDOMINAL TRAUMA BURNS Niel F. Miele,, M.D. December 19, 2012 EPIDEMIOLOGY Major Trauma responsible for
More informationPost-Traumatic Thromboembolism. Pathogenesis, Diagnosis and Prevention M. Margaret Knudson, MD
Post-Traumatic Thromboembolism Pathogenesis, Diagnosis and Prevention M. Margaret Knudson, MD Historical Perspectives A study of protocols of 9,882 postmortem exams including death from injury in the traumatic
More informationEMS System for Metropolitan Oklahoma City and Tulsa 2018 Medical Control Board Treatment Protocols
EMERGENCY MEDICAL RESPONDER EMT EMT-INTERMEDIATE 85 ADVANCED EMT PARAMEDIC 14G PATIENT PRIORITIZATION While each patient will receive the best possible EMS care in a humane and ethical manner, proper patient
More informationPre-hospital Trauma Life Support. Rattiya Banjungam Emergency Physician, Khon Kaen Hospital
Pre-hospital Trauma Life Support Rattiya Banjungam Emergency Physician, Khon Kaen Hospital Golden principles of Prehospital Trauma Care Golden Hour There is a golden hour if you are critically injured,
More informationThe Dynamics of Trauma. Jamie Syrett, MD Director of Prehospital Care Rochester General Health System
The Dynamics of Trauma Jamie Syrett, MD Director of Prehospital Care Rochester General Health System Me Boarded EM physician Fellowship trained in EMS Volunteer EMT-B,D,P,L5...etc etc etc Today - Commitment
More informationPrinciples of combat surgical care in a staged evacuation system
Western University From the SelectedWorks of Vivian C. McAlister November, 2011 Principles of combat surgical care in a staged evacuation system Vivian C. McAlister Rob Stiegelmar Brian Church Ray Kao
More informationReview. 1. Kinetic energy is a calculation of:
Chapter 22 Review Review 1. Kinetic energy is a calculation of: A. weight and size. B. weight and speed. Caring for victims of traumatic injuries requires the EMT to have a solid understanding of the trauma
More informationChapter 8 Trauma Patient Assessment The Patient Assessment Process The Primary Assessment ABCDE s Airway, Breathing, Circulation while securing
1 2 3 4 5 6 Chapter 8 Trauma Patient Assessment The Patient Assessment Process The Primary Assessment ABCDE s Airway, Breathing, Circulation while securing D-Disability Chief complaint and/or Mechanism
More informationShock and Resuscitation: Part II. Patrick M Reilly MD FACS Professor of Surgery
Shock and Resuscitation: Part II Patrick M Reilly MD FACS Professor of Surgery Trauma Patient 1823 / 18 Police Dropoff Torso GSW Lower Midline / Right Buttock Shock This Monday Trauma Patient 1823 / 18
More informationDamage Control in Abdominal and Pelvic Injuries
Damage Control in Abdominal and Pelvic Injuries Raul Coimbra, MD, PhD, FACS The Monroe E. Trout Professor of Surgery Surgeon-in Chief UCSD Medical Center Hillcrest Campus Executive Vice-Chairman Department
More informationD. Pre-Hospital Trauma Triage and Bypass Algorithm
D. Pre-Hospital Trauma Triage and Bypass Algorithm Hospital bypass is defined as transporting the patient to the nearest hospital that has the appropriate level of care for the patient s suspected severity
More informationITLS Pediatric Provider Course Advanced Pre-Test
ITLS Pediatric Provider Course Advanced Pre-Test 1. You arrive at the scene of a motor vehicle crash and are directed to evaluate a child who was in one of the vehicles. The patient appears to be a child
More informationThe ABC s of Chest Trauma
The ABC s of Chest Trauma J Bradley Pickhardt MD, FACS Providence St Patrick Hospital What s the Problem? 2/3 of trauma patients have chest trauma Responsible for 25% of all trauma deaths Most injuries
More informationThree Cases of Spine Fractures after an Airplane Crash
CASE REPORT Korean J Neurotrauma 2015;11(2):195-200 pissn 2234-8999 / eissn 2288-2243 http://dx.doi.org/10.13004/kjnt.2015.11.2.195 Three Cases of Spine Fractures after an Airplane Crash Han Joo Lee, MD,
More informationPEDIATRIC TRAUMA EMERGENCIES
PEDIATRIC TRAUMA EMERGENCIES Last Revised: January 2015 1 PEDIATRIC COMA SCALE Indicator Eye Opening Spontaneous 4 To verbal stimuli 3 To pain only 2 No response 1 Verbal Response Oriented, appropriate
More informationMcHenry Western Lake County EMS System Paramedic, EMT-B and PHRN Optional Continuing Education 2019 #2 Blunt Trauma
McHenry Western Lake County EMS System Paramedic, EMT-B and PHRN Optional Continuing Education 2019 #2 Blunt Trauma Blunt trauma is the most common cause of traumatic death and disability. The definition
More informationEMERGENCY MEDICAL SERVICES ONLINE COURSE CATALOG. TargetSolutions. Technology with a Purpose
EMERGENCY MEDICAL SERVICES ONLINE COURSE CATALOG 1 Technology with a Purpose TargetSolutions delivers employee training that helps organizations achieve compliance, mitigate We risk, believe reduce a well-trained
More informationPediatric Trauma. Sept 2nd, Patrick Murphy Neil Merritt
Pediatric Trauma Sept 2nd, 2015 Patrick Murphy Neil Merritt Objectives Objectives Medical Expert 1. Describe the types of pediatric injuries sustained with a given mode of trauma, and identify the most
More informationPediatric Trauma Karim Rafaat, MD
Pediatric Trauma Karim Rafaat, MD Goals Time is short I m going to presume you know your basic ATLS (that s that whole ABCD thing, by the way) Discuss each general trauma susceptible region Focus on: Epidemiology
More informationPatient Assessment. Chapter 8
Patient Assessment Chapter 8 Patient Assessment Scene size-up Initial assessment Focused history and physical exam Vital signs History Detailed physical exam Ongoing assessment Patient Assessment Process
More informationIsolated Sternal Fracture S-M Yuan ABSTRACT. Isolated sternal fracture is rare and benign. A 36-year-old female presented had severe chest
S-M Yuan ABSTRACT Isolated sternal fracture is rare and benign. A 36-year-old female presented had severe chest pain and mild dyspnea after her anterior chest wall was bluntly injured by the front seat
More informationTrauma Workshop! Skills Centre, St George Hospital! Saturday 15 March 2014!
Trauma Workshop Skills Centre, St George Hospital Saturday 15 March 2014 VMO facilitators: Dr Ricardo Hamilton (Campbelltown Hospital) Dr Mary Langcake (St George Hospital) Dr Anthony Chambers (St George
More informationTrauma surgeons insight: Speed, Cars, Crashes, The Recovery
Trauma surgeons insight: Speed, Cars, Crashes, The Recovery Moderator Jerome Carslake NRSPP Manager ARRB Group P: +61 3 9881 1670 E: jerome.carslake@arrb.com.au Housekeeping Webinar is = 45 mins Question
More informationCounty of Santa Clara Emergency Medical Services System
County of Santa Clara Emergency Medical Services System EMS System Policy Change Coversheet EMS SYSTEM POLICY CHANGE COVERSHEET Policy Number and Name: 605: Prehospital Trauma Triage Date: May 27, 2014
More informationPARA107 Summary. Page 1-3: Page 4-6: Page 7-10: Page 11-13: Page 14-17: Page 18-21: Page 22-25: Page 26-28: Page 29-33: Page 34-36: Page 37-38:
PARA107 Summary Page 1-3: Page 4-6: Page 7-10: Page 11-13: Page 14-17: Page 18-21: Page 22-25: Page 26-28: Page 29-33: Page 34-36: Page 37-38: Injury, Mechanisms of Injury, Time Critical Guidelines Musculoskeletal
More informationPEDIATRIC TRAUMA: Implications for Respiratory Care
PEDIATRIC TRAUMA: Implications for Respiratory Care 17 th Annual Rainbow Respiratory Conference - September 4, 2015 Mike Dingeldein, MD Pediatric Surgeon Pediatric Trauma Medical Director Disclosures none
More informationCORE STANDARDS STANDARDS USED IN TARN REPORTS
CORE STANDARDS Time to CT Scan BEST PRACTICE TARIFF SECTION 4.10 MAJOR TRAUMA 7 If the patient is admitted directly to the MTC or transferred as an emergency, the patient must be received by a trauma team
More informationUsing Local Data to Drive Injury Prevention Strategies Disclosures Objectives
Using Local Data to Drive Injury Prevention Strategies Lee Ann Wurster MS, RN, CPNP Trauma Coordinator Disclosures No financials interest or other relationships with commercial entities Objectives Analyze
More informationCombined CFRN and CTRN Detailed Content Outline
Clinical items (primarily category, Assessment (15-20%), 1. General principles of transport nursing practice 19 31 A. Transport physiology 1. Physiologic stressors of transport 2. Effects of altitude on
More informationPan Scan Instead of Clinical Exam? David A. Spain, MD
Pan Scan Instead of Clinical Exam? David A. Spain, MD Granted, some patients don t t need CT scan Platinum Package Stanford Special CT Scan Head Neck Chest Abdomen Pelvis Takes about 20 minutes to do
More informationSituation Manual. 230 Minutes. Time Allotted. Situation Manual Tabletop Exercise 1 Disaster Resistant Communities Group
Situation Manual 230 Minutes Situation Manual Tabletop Exercise 1 Disaster Resistant Communities Group www.drc-group.com ACE St George Start Exercise During the exercise it will be important to remember
More informationof Trauma Assembly 27 th Page 1
Eastern Association for the Surgery of Trauma 27 th Annual Scientific Assembly Sunrise Session 08 To Scan or Not To Scan Thatt is the Question January 16, 2014 Waldorf Astoria Naples Naples, Floridaa Page
More informationPediatric Abdomen Trauma
Pediatric Abdomen Trauma Susan D. John, MD, FACR Pediatric Trauma Trauma is leading cause of death and disability in children and adolescents Causes and effects vary between age groups Blunt trauma predominates
More informationAcutely Ischaemic Arm Spoke Sites (RWHT + WMH)
Ward In patients/medical ward Acutely Ischaemic Arm Spoke Sites (RWHT + WMH) Sudden onset of painful, pale and cold arm. Worrying features: -loss of sensation In patients/medical ward On call surgical
More informationDeveloping a Disaster Mindset: Myths & Stereotypes of Disasters. John H. Armstrong, MD, FACS University of Florida, Gainesville
National Emergency Management Summit The Medical Disaster Planning & Response Process Developing a Disaster Mindset: Myths & Committed to excellence in trauma care Stereotypes of Disasters John H. Armstrong,
More informationDifficulty breathing Altered level of consciousness Amputated arm
Difficulty breathing 22-year-old male, severe difficulty breathing, chest sinks in on inspiration, respirations over 30/min, radial pulse present, responds to instructions. Altered level of consciousness
More informationSupporting Information Table SI. Individual rfixfc Pharmacokinetic Parameters Determined Using Compartmental Analysis (Major Surgeries)
Supporting Information Table SI. Individual rfixfc Pharmacokinetic Parameters Determined Using Compartmental Analysis (Major Surgeries) Subject ID Study arm * Actual dose (iu/kg) Terminal half-life (h)
More informationTime Equals Neurons - Spinal Cord Injury Management in the first 4 Hours
Time Equals Neurons - Spinal Cord Injury Management in the first 4 Hours William D. Whetstone M.D. Clinical Professor UCSF Department of Emergency Medicine SFGH ED Center for Neuro-Critical Emergencies
More informationDental aspects in Disaster Management
Dental aspects in Disaster Management Dr Bernadette Pushpaangaeli BDS (Fiji); MSc(DPH) UK; DDPH (RCS-Eng); FICD Senior Lecture in Dental Public Health Department of Oral health Fiji School of Medicine
More informationBody Changes With Aging
Body Changes With Aging University of Michigan Program for Injury Research and Education Automotive Safety Vehicles are safer than they have ever been. Laboratory testing using idealized occupants and
More informationSpinal injury. Structure of the spine
Spinal injury Structure of the spine Some understanding of the structure of the spine (spinal column) and the spinal cord is important as it helps your Neurosurgeon explain about the part of the spine
More informationDivision of Acute Care Surgery Clinical Practice Policies, Guidelines, and Algorithms: Enteral Nutrition Algorithm Clinical Practice Guideline
Division of Acute Care Surgery Clinical Practice Policies, Guidelines, and Algorithms: Enteral Nutrition Algorithm Clinical Practice Guideline Original Date: 08/2011 Purpose: To promote the early use of
More informationMichael Avant, M.D. The Children s Hospital of GHS
Michael Avant, M.D. The Children s Hospital of GHS OVERVIEW ER to ICU Transition Early Management Priorities the First 48 hours Organ System Support Complications THE FIRST 48 HOURS Communication Damage
More informationEvaluation of Children with Blunt Abdominal Trauma. James F. Holmes, MD, MPH UC Davis School of Medicine
Evaluation of Children with Blunt Abdominal Trauma James F. Holmes, MD, MPH UC Davis School of Medicine Objectives Epidemiology of intra-abdominal injury (IAI) Physical examination findings with IAI Laboratory
More informationADULT TRAUMA EMERGENCIES
ADULT TRAUMA EMERGENCIES Last Revised: May 2017 1 GLASGOW COMA SCALE Indicator Response Score Eye Opening Spontaneous 4 To voice 3 To pain 2 None 1 Verbal Response Oriented 5 Confused 4 Inappropriate words
More informationTrauma. Neck trauma zones. Neck Injuries 1/3/2018. Basic principles A ; Airway B ; Breathing C ; Circulation D ; Disability E ; Exposure
Trauma 45 minutes highest points Ahmed Mahmoud, MD Basic principles A ; Airway B ; Breathing C ; Circulation D ; Disability E ; Exposure Neck trauma zones Airway ;Rapid sequence intubation Breathing ;Needle
More informationEmergency Medical Technician Common Course Outline
Emergency Medical Technician Common Course Outline Course Information Organization South Central College Revision History 2008-2009 Course Number HEMS1200 Department EMS Total Credits 6 Description This
More informationTrauma Life Support Pre-Hospital (TLS-P) Preparatory Materials
Trauma Life Support Pre-Hospital (TLS-P) Preparatory Materials 1 1. A high-risk bodily fluid for spreading infection is blood. 2. Items that can reduce the spread of infection include masks, gloves, and
More informationPolicy/ Purpose: Definitions: (Definitions of acronyms or specialized terminology) Instructions:
Title: Surgical Procedure Scheduling After 2200 Hours by Central Processing Document #: 5962 Version: 1 Facility: St. Charles Bend Page 1 of 5 Owner: Roberts, Andrew,Manager Central Processing Effective
More informationITLS Pediatric Provider Course Basic Pre-Test
ITLS Pediatric Provider Course Basic Pre-Test 1. You arrive at the scene of a motor vehicle collision and are directed to evaluate a child who was in one of the vehicles. The patient appears to be a child
More informationCommon Sports Injuries in the Weekend Warrior
Common Sports Injuries in the Weekend Warrior Michael E. Zychowicz, DNP, FAAN, FAANP Professor and Director, MSN Program Orthopedic NP Specialty Lead Faculty Duke University School of Nursing As a result
More informationMIAMI-DADE COLLEGE. Common Course Number: HSC Course Title: Basic Emergency Care. Course Catalog Description:
Common Course Number: HSC 2400 MIAMI-DADE COLLEGE Course Title: Basic Emergency Care Course Catalog Description: Designed to provide opportunities to develop, practice, and display skills concerning emergency
More informationHospital-Based Injury & Violence Prevention Intervention
Hospital-Based Injury & Violence Prevention Intervention Presented by: Nichole Kent Spivey, MBA Injury Prevention Coordinator Palmetto Health Richland Level I Trauma Center # 1 Killer for Ages 1-44 Source:
More informationManagement of the Trauma Patient. Elizabeth R Benjamin MD PhD Trauma and Surgical Critical Care Critical Care Symposium April 20, 2015
Management of the Trauma Patient Elizabeth R Benjamin MD PhD Trauma and Surgical Critical Care Critical Care Symposium April 20, 2015 Saturday Night 25 yo M s/p high speed MVC Hypotensive in the ED, altered
More informationActivity Three: Where s the Bleeding?
Activity Three: Where s the Bleeding? There are five main sites of potentially fatal bleeding in trauma, remembered by the phrase on the floor and four more. On the floor refers to losing blood externally
More informationImaging in the Trauma Patient
Imaging in the Trauma Patient David A. Spain, MD Department of Surgery Stanford University Pan Scan Instead of Clinical Exam? 1 Granted, some patients don t need CT scan Platinum Package Stanford Special
More informationLoma Linda University Children s Hospital Loma Linda, CA ORTHOPAEDIC SURGERY PRIVILEGE FORM
Name: Page 1 of 6 REQUEST CATEGORY MEMBERSHIP CATEGORY Provisional (Bylaws 4.3) Administrative (Bylaws 4.7) Affiliate (Bylaws(4.9) Active (Bylaws 4.2) Courtesy (Bylaws 4.4) Consulting (Bylaws 4.5) All
More informationGeneral Surgery Curriculum Royal Australasian College of Surgeons, General Surgeons Australia & New Zealand Association of General Surgeons
General Surgery Curriculum Royal Australasian College of Surgeons, General Surgeons Australia & New Zealand Association of General Surgeons MODULE TITLE: TRAUMA 7-Nov-2016 DEVELOPED BY: Zsolt Balogh, Peter
More information1. In a rear-impact motor vehicle crash, which area of the spine is most susceptible to injury? A. Cervical B. Thoracic C. Lumbar D.
1. In a rear-impact motor vehicle crash, which area of the spine is most susceptible to injury? A. Cervical B. Thoracic C. Lumbar D. Sacral-coccygeal 2. A 36-year-old male sustains blunt force thoracic
More informationAviation Rescue Swimmer Course
Aviation Rescue Swimmer Course Primary Survey LT 5.4 December 2003 1 Objectives List the procedures used in a primary survey. Demonstrate primary survey procedures used in a mock trauma (moulage) scenario
More informationSAN LUIS OBISPO COUNTY EMERGENCY MEDICAL SERVICES AGENCY PREHOSPITAL POLICY
SAN LUIS OBISPO COUNTY EMERGENCY MEDICAL SERVICES AGENCY PREHOSPITAL POLICY Policy Reference No: 153 [01/08/2013] Formerly Policy No: 201.3 Effective Date: 11/01/2012 Review Date: 03/01/2014 TRAUMA PATIENT
More informationGunshot Wounds of the Abdomen: Association of Surface Wounds with Internal Injuries
Gunshot Wounds of the Abdomen: Association of Surface Wounds with Internal Injuries Abstract Ashfaq A. Razzaq ( Department of Surgery, Jinnah Post-graduate Medical Center, Karachi. ) Objective: To evaluate
More informationPatient Assessment From Brady s First Responder (8th Edition) 83 Questions
Patient Assessment From Brady s First Responder (8th Edition) 83 Questions 1. Which question is important if your patient may be a candidate for surgery? p. 183 *A.) When did you last eat? B.) What is
More informationOverview. Overview. Chapter 30. Injuries to the Head and Spine 9/11/2012. Review of the Nervous and Skeletal Systems. Devices for Immobilization
Chapter 30 Injuries to the Head and Spine Slide 1 Overview Review of the Nervous and Skeletal Systems The Nervous System The Skeletal System Devices for Immobilization Cervical Spine Short Backboards Long
More informationAdult Trauma Advances in Pediatrics. (sometimes they are little adults) FAST examination. Who is bleeding? How much and what kind of TXA volume?
Adult Trauma Advances in Pediatrics (sometimes they are little adults) Alisa McQueen MD, FAAP, FACEP Associate Professor of Pediatrics The University of Chicago Alisa McQueen MD, FAAP, FACEP Associate
More informationMajor Trauma Scenarios. Ballarat Health Services Emergency Medicine Training Hub
Major Trauma Scenarios Ballarat Health Services Emergency Medicine Training Hub Trauma Scenario 1 You receive a phone call from the ambulance service. They have a 27 yr old male involved in a MCA, he is
More informationOral and Maxillofacial Surgeons and the seriously injured patient. Barts and The London NHS Trust
Oral and Maxillofacial Surgeons and the seriously injured patient Barts and The London NHS Trust How do you assess this? Primary Survey A B C D E Airway & Cervical Spine Breathing & Ventilation Circulation
More informationAbdomen and Genitalia Injuries. Chapter 28
Abdomen and Genitalia Injuries Chapter 28 Hollow Organs in the Abdominal Cavity Signs of Peritonitis Abdominal pain Tenderness Muscle spasm Diminished bowel sounds Nausea/vomiting Distention Solid Organs
More informationInterQual Level of Care 2018 Index
InterQual Level of Care 2018 Index Rehabilitation Criteria Index Words by Subset The Index is an alphabetical listing of conditions and/or diagnoses designed to guide the user to the criteria subset where
More informationDeceleration during 'real life' motor vehicle collisions: A sensitive predictor for the risk of sustaining a cervical spine injury?
Deceleration during 'real life' motor vehicle collisions: A sensitive predictor for the risk of sustaining a cervical spine injury? 1 Patient Safety in Surgery March 8, 2009 Martin Elbel, Michael Kramer,
More informationAbdominal V.A.C. Therapy in Trauma
Abdominal V.A.C. Therapy in Trauma Stefaan Nijs, M.D., Ph.D. Mathieu D Hondt, M.D. Dept Abdominal Surgery UZ Leuven 1 2 Damage control = naval technique Damage Control in Trauma 3 USS Nevada 4 In extremis
More informationPancreatico-Duodenal Trauma: Drain, Debride, Divert, Despair BACKGROUND EPIDEMIOLOGY 9/11/2018
Pancreatico-Duodenal Trauma: Drain, Debride, Divert, Despair Rochelle A. Dicker, M.D. Professor of Surgery and Anesthesia UCLA BACKGROUND Lancet 1827: Travers, B Rupture of the Pancreas British Journal
More informationRESUSCITATION IN TRAUMA. Important things I have learnt
RESUSCITATION IN TRAUMA Important things I have learnt Trauma resuscitation through the decades What was hot and now is not 1970s 1980s 1990s 2000s Now 1977 Fluids Summary Dogs subjected to arterial hemorrhage
More informationINJURIES CHEST, ABDOMEN, LIMBS. FN Brno November 2011
INJURIES CHEST, ABDOMEN, LIMBS FN Brno November 2011 Injury Chest Abdomen Limbs Injury to the rib cage Fractured one or more ribs Sharp pain at the site of fracture Pain on taking a deep breath Shallow
More informationEmergency Department Thoracotomy
Emergency Department Thoracotomy November 3, 2017 North Oaks Shock Trauma Symposium Jeremy R. Timmer, M.D., FACS Objectives Background of RT Indications for RT Contraindications for RT Survival Benefits
More informationHYPOTHERMIA IN TRAUMA. Kevin Palmer EMT-P, DiMM
HYPOTHERMIA IN TRAUMA Kevin Palmer EMT-P, DiMM DISCLOSURE No Financial conflicts of interest Member of the Wilderness Medical Society Diploma in Mountain Medicine Fellowship in the Academy of Wilderness
More informationIntroduction. Abstract
263 K. Knobloch, S. Wagner, C. Haasper, C. Probst, C. Krettek, M. Richter Trauma Department, Medical School Hannover, Germany D. Otte Accident Research Unit, Medical School Hannover, Germany Sternal Fractures
More informationInitial Pelvic Fracture Management. Patrick M Reilly MD FACS February 27, 2010
Initial Pelvic Fracture Management Patrick M Reilly MD FACS February 27, 2010 John Pryor MD Field Triage* * Step One : Physiology * Step Two : Anatomy * Step Three : Mechanism * Step Four : Co-Morbid Conditions
More informationSelective Spinal Immobilization
Selective Spinal Immobilization Objectives Understand the background of spinal immobilization. Understand the rationale for developing a current selective spinal immobilization protocol. Review the data
More information55-year-old male with 2nd and 3rd degree burns to face, chest, and arms on 25% of the body Respirations: 34 Pulse: 120 Mental Status: moans to painful stimulus Mucous membranes charred Stridor 10 cm scalp
More informationYou Are the Emergency Medical Responder
Lesson 32: Injuries to the Chest, Abdomen and Genitalia You Are the Emergency Medical Responder Your police unit responds to a call in a part of town plagued by violence. When you arrive, you find the
More informationBLOOD IN THE AIR: THE STARS EXPERIENCE Dr. Ryan Deedo MD DipAeroRT FRCPC Transport Physician STARS Medical Communications Lead (Calgary)
BLOOD IN THE AIR: THE STARS EXPERIENCE Dr. Ryan Deedo MD DipAeroRT FRCPC Transport Physician STARS Medical Communications Lead (Calgary) What s new at STARS? STARS bases and response areas Operations
More information