TCLS.pptx Trauma care life support or Advanced trauma life support

trauma care should be as much necessary to preserve and safeguard victims life

1. Trends and Advancements in Trauma Care –A look to ATLS Presented By, Prof. Ramaprasad S M.Sc (N), SCEM,FCEM Dept. Medical Surgical Nursing ( Neurosciences Nursing) Trainer in Skills Lab/FRT/GFATM/ENLS/BCLS/TCLS /Guide/Co Guide for KSOU/Reviewer /AHA certified BLS & ACLS Provider

2. Introduction Total near 4.5 lakhs of RTA are recorded in India in 2022 WHO reported that around 15% increase in the death rate in India because of RTA from 2010 to 2021( Source:road safety report 2023) there were 44,500 cases of RTA in india and among these 23,652 deaths. ( Source:Hindustan times 29.02.2024) In Bengaluru 4974 cases were reported for RTA and and increased from 3823 cases in 2022 (open city source: 18.01.2024)

3. How do you respond immediately in case of trauma ?

4. How Trauma Patients are attended? PRE HOSPITAL PHASE HOSPITAL PHASE

5. Pre Hospital Phase Provided by activating the EMS Critical component of the pre hospital care airway maintenance /control of external bleeding and shock/ Immobilization/ Transport to Trauma care center

6. How to carry shorter pre hospital time? Notification Time Scene Time Transport Time Response Time

7. Hospital Phase hand over between pre hospital provider and receiving hospital should be smooth The critical aspects of preparation include the following, Properly Functioning Airway equipment Crystalloids solution A Protocol for additional medical assistance Transfer Agreement

8. Code Trauma Code Trauma can be activated via PAS (Public Activated System)

9. Code Massive Transfusion Protocol (MTP) Institutional Policies such as CODE MTP can be activated which facilitate the blood bank to relese emergent requirement of O Negetive PRBC blood products

10. Triage System Level 1 Resuscitation Those Who are having immediate threatt to life or limb Level 2 Urgent Those who are Potential Threat to life /limb /or Function Should Receive care within 30 mins Level 3 Less Urgent Conditions with Mild to moderate discomfort

11. Categories of Caeses for Triage Cardiac Arrest/Stroke/ Seizures/GCS >8/Status Asthmatics Localized Injuries without immediate systemic implications who require minimum care Severe abdominal pain/head ache with focal signs/dehydration/ penetrating foreign bodies in eyes/ mild chest pain.

12. APPROACHES TO TRAUMA CARE

13. The Universal Protocol for Trauma Care is H : Control of catastrophic haemorrhage A: Maintaining Patent airway B: Breathing C: Circulation D: Check for Disability E: Exposure

14. Haemorrhage Control Use the appropriate method to stop bleeding and it is the first priority Direct Pressure Pressure dressing Torniquet

15. Airway Three things to be observed for airway maintenance Is cervical spine is stable : perform Three point immobalization Is patient is conscious : AVPU Is airway is obstructed : check for gurgling and snoring use air way manoeuvres and adjuncts

16. Breathing Check for the three things in breathing assessment Is patient having bradypnea or tachypnea Is patient is hypoxic Are chest movements and auscultation is normal

17. Interventions such as needle thoracostomy and ICD 3 way gauze dressing Are done to relieve tracheal deviation and pneumothorax

18. Circulation Check for pulse rate Peripheral or Vital organ perfusion (MSE/UO/CRT/Cyanosis) Check for Blood Pressure radial pulse + SBP 90mmhg : IO Femoral +SBP 70mmhg : Fluid resucitation only carotid pulse + SBP 70 mmhg : Fluid Resucitation MAP ,65 Shock : Blood Transfusion

19. Disability Assess for the neurological disability Consciousness by AVPU : (pupillary Exam/Gross motor/gross sensory) Reassess the target BP (SBP is 110mmhg)

20. Exposure Examination of the anterior and posterior body Check for the rectal tone and tender or loose prostate in case of spinal injury

21. Any Question?

22. Thank You