tailieunhanh - Trauma Resuscitation - part 5

Tóm tắt để bụng và khung chậu có thể khác nhau vô cùng về độ lớn. Sự hiện diện của chấn thương đáng kể có thể không phải luôn luôn được rõ ràng về trình bày. Các dấu hiệu lâm sàng có thể thêm vào sự nhầm lẫn. | 124 TRAUMA RESUSCITATION Summary Injuries to the abdomen and the pelvis can vary immensely in magnitude. The presence of significant injury may not always be obvious on presentation. The clinical signs may add to the confusion. The trauma team leader must be suspicious of the existence of abdominal trauma in all patients of multiple injuries and must have a clear understanding of the mechanism of injury. It is best to assume that abdominal trauma exists unless proven otherwise. The investigations available to establish a diagnosis all have their roles and must be used liberally according to the index of suspicion. Transfer of patients for such investigations must only be done with stable haemodynamically normal patients. Such heightened awareness and a policy of aggressive investigation will help reduce unexpected findings in the abdomen and the avoidable deaths that still occur due to abdominal trauma. Further reading College of Surgeons Committee on Trauma 1997 Advanced Trauma Life Support for Physicians. Chicago American College of Surgeons. 6 Head trauma D Bryden C Gwinnutt Objectives In order to care for a patient with a head injury members of the trauma team must be familiar with normal anatomy and physiology the anatomical and physiological changes that may occur following a head injury the terms commonly used when describing the type of head injury sustained how to assess the patient with a head injury how safely to manage a patient with a head injury when and how to communicate with a neurosurgeon when to perform investigations or carry out specific treatments. Introduction Of all patients attending a UK ED 11 will have sustained some form of head injury. Only 1 of patients with a head injury will be referred to a specialist neurosurgical unit and so staff working within the ED must become familiar with managing all forms of head-injured patients since they represent a large proportion of their workload. As the majority of head injuries