Trauma Assessment - Multiple Injuries (Part 2)

Рет қаралды 141,265

12 жыл бұрын

This video - produced by students at Oxford University Medical School in conjunction with the faculty - demonstrates how to perform the initial assessment of a patient with suspected traumatic injury. This video is part 2 of a muti-system injury scenario (airway compromise, tension pneumothorax, bleeding and head injury).
All videos on this channel are linked to Oxford Medical Education (www.oxfordmedicaleducation.com)
This video was produced in collaboration with Oxford Medical Illustration - a department of Oxford University Hospitals NHS Trust. For more information, please visit www.oxfordmi.nhs.uk

Пікірлер: 22

@luisgonzalez9043 7 ай бұрын

She is having so much fun isn’t she?

@OxfordMedicalVideos 11 жыл бұрын

Thanks for your comment - a fair point. This video is really just to demonstrate the systematic approach to trauma management but yes, as the patient is unlikely to be able to protect his airway with a GCS < 8, intubation would be indicated.

@leannejackson9026 9 жыл бұрын

This is a brilliant video and although i am a Student Nurse doing an OSCE soon, it is still very useful. It is a shame that there isn't any of these specifically for Student Nurse OSCE's. Thank you

@OxfordMedicalVideos 11 жыл бұрын

As you say, this is a training video so just runs through the basic steps. You're absolutely right though, permissive hypotension is now widely practised and ATLS 8e reflects this. There is reasonable evidence to suggest that - in trauma - fluid resuscitation to maintain a palpable radial pulse (systolic 80-90mm Hg) is optimal as it decreases ongoing haemorrhage by allowing clot stabilisation. Giving blood followed by definitive surgical management is ideal. Good point though, thank you.

@fastmango 11 жыл бұрын

Good video for medical student OSCEs. One thing though, surely with a palpable radial pulse and BP 110/70, you practice permissive hypotension and don't give fluids. If he does need fluids it should then be blood

@warrenmaya7934 8 жыл бұрын

Great video, thanks for posting. Just an observation: I didn't see him actually palpating/compressing/assessing the pelvis. If the patient has an unstable pelvic fracture, he/she would need a pelvic binder. By the time the pelvic x-rays is reviewed, the patient may have lost a great volume of blood. I'm not sure if I missed that part.

@OxfordMedicalVideos 8 жыл бұрын

+Warren Maya Good point, thanks. There should always be a very low threshold for binding the pelvis and getting imaging if any suspicion of fracture (e.g. pain or mechanism of injury). Palpating, compressing or 'springing' the pelvis should not be done as it is a poor sign may worsen haemorrhage... www.trauma.org/archive/ortho/clinicalexam.html

@carlosriquelme841 3 жыл бұрын

Very Nicke training, thanks!

@Dr.AishaSattar 3 жыл бұрын

Very nice precentation

@andrii0905 10 жыл бұрын

A very good way of teaching! Although I was wondering why there was no examination or assessment of the spine/vertebrae, though you did stabilize the c-spine. Why no radiological assessment?

@OxfordMedicalVideos 9 жыл бұрын

Thanks for your comment. In this case we are running through a trauma scenario primary survey only. The c-spine is therefore stabilised empirically to ensure efficient speed through this section. Full clinical c-spine assessment would come later in the secondary survey, with radiological assessment based on that.

@louisdebernard9332 4 жыл бұрын

Patient should really have a full body CT scan as they are stable haemodynamically and have clinical signs of head and cardiothoracic injury, preferably after an RSI to protect the airway and to provide secondary neuroprotection. Plain C-spine X-ray is not sensitive enough to rule out C-spine injury in patients whom are unable to response adequately for clinical assessment of their cervical spine. This patient has a high risk of C-spine injury due to their comorbid head injury so a CT scan is warranted. pubmed.ncbi.nlm.nih.gov/15920400/ www.ncbi.nlm.nih.gov/pmc/articles/PMC3177586/

@juicystories7006 Жыл бұрын

Good job,

@bokasahamad8151 5 жыл бұрын

Very nice What about the urine catheter?

@N305UK3 11 жыл бұрын

Interesting video, thanks for posting it. I have a question though. It seems like his Glasgow score was < 8 on D avaliation, wouldn't that be an indication for immediate intubation?

@lucijakarija8928 3 жыл бұрын

He was intubated in the first part

@azizmarouani7691 Жыл бұрын

Better to intubate the pt with univent bronchial blocker if GCS below 8 to preserve the airway especially pt has tension pneumothorax

@endliberalism382 7 жыл бұрын

is this training for paramedics or nurses?

@kyleocallaghan9185 4 жыл бұрын

It's a medical student, ie training to a be a Dr, but from a paramedic perspective prehospitally we still perform the same assessment and carry out a similar level of patient management depending on skill level.

@FrankEdavidson 10 ай бұрын

OCSE for Emergency Medicine blokc of MBChB / MBBS. Perhaps might be repeated for postgrads as it never hurts to go through basic algorithms. I might be wrong but or pre-hospital care even if trauma / ED surgeon, anaesthetist is on scene definitive airway i.e. Intubation might not be possible due to lack of monitoring, surgical backup, sterile field? Pt would probably arrive immobilised by ambulance personnel.

@bobjohns2118 10 жыл бұрын

FAST in ED job not surgeons.

@FrankEdavidson 10 ай бұрын

FAST is also available in prehospital care in some areas depending on how equipped the ambulance service and field medical / voluntary network organisations e.g. BASICS (UK), United Hatzalah (IL) are and local policies. I've seen FAST demonstrated by Professor James Ferguson, EM consultant for use in prehospital care by Scottish Ambulance Service and/or BASICS.