TRAUMA.pptx7777777777777777777777777777777777

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1. SECONDARY SURVEY IN TRAUMA MODULE: SURGERY LECTURER: DR MOHAMED SALIEU SOH PRESENTER: FATIMA ZAINAB KAMARA

2. 0UTLINE Introduction History Blunt trauma Penetrating trauma Physical Examination Neurological System

3. INTRODUCTION The secondary s urvey does not begin until primary survey is completed, resuscitation and improvement of the patients vitals functions have been seen. The secondary survey is head to toe examination of trauma patient i.e complete history and physical examination including reassessment of all vital signs. Each region of body is completely examined . SIMPLE GUIDE: DCAP BTLS

4. HISTORY Every complete medical assessment includes a history of mechanism of injury. Includes :- allergies, medication currently used, past illness or pregnancy last meal , events/environment related to the injury

5. C0NC…. Knowledge of the mechanism of in jury can enhance understanding of the patients physiological state and provide clue of anticipated injuries .

6. BLUNT TRAUMA Blunt trauma often results from automobile collisions falls and other injuries related to transportation and occupation Important information to obtain about automobile collisions includes Seat belt use Steering wheel deformation Present and activation of airway device

7. PENETRATING TRAUMA Factors that determine type and extent of injury and subsequent management includes the body organ that was injured organs in the path of the penetrating object, and velocity of the missile. Therefore in gunshot victims the velocity ,caliber, presumed path of the bullet and distance from weapon to the wound can provide important clues regarding the extent of injury .

8. PHYSICAL EXAMINATION During the secondary survey physical examination follows sequence of head, maxilla facial structures, cervical spine and neck, chest ,abdomen ,pelvis, peritoneum/rectum/vagina ,musculoskeletal and then neurological system HEAD The secondary survey begins with evaluating the head to identify all related neurological injury and any other significant injury MAXILLOFACIAL STRUCTURES Examination of face should include palpation of all bony structure, assessment of occlusion ,intra oral examination and assessment of soft tissue. Maxillofacial trauma that is not associated with airway obstruction and major bleeding should be treated only after the patient is stabilized and life threatening injuries has been managed .

9. CONC… CERVICAL SPINE AND NECK Patient with maxillofacial or head trauma should be presumed to have a cervical spine injury and cervical spine motion must be restricted CHEST Visual evaluation of chest both anterior and posterior can identify conditions such as open pneumothorax and large flair segments. Significant chest injuries can manifest with pain, dyspnoea and hypoxia.

10. ABDOMEN AND PELVIS Abdominal injury must be identified and treated aggressively Pelvis fracture can be suspected by identification of ecchymosis over iliac wings,pubis,labia or scrotum PERINEUM,RECTUM AND VAGINA Perineum should examine for contusion, hematoma, laceration and urethral bleeding MUSCULOSKELETAL The extremities should be inspected for contusion and deformity Palpation of bones and examination for tenderness and abnormal movement adds in the identification of occult fractures.

11. NEUROLOGICAL SYSTEM A comprehensive neurological examination includes motor, sensory evaluation of extremities as well as revaluation of the patients level of consciousness and pupil size and response The GCS score facilitates detection of early changes and trends in patient neurological status