Disability in trauma patient: meaning – and management.pptx
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This document provides guidance on assessing and managing patients with neurological disabilities or metabolic emergencies. It discusses using the Glasgow Coma Scale and AVPU scores to evaluate neurological status. Pupil examination can indicate conditions like head injuries, opiate toxicity, or brain death. Seizures may be treated with lorazepam, diazepam, or midazolam. Hypoglycemia is managed with oral glucose or IV dextrose. Hyperglycemia and diabetic ketoacidosis require fluid resuscitation and insulin. Organophosphorus poisoning requires airway protection, oxygen, atropine, and decontamination. Warfarin overdose is treated with vitamin K. Ethylene glycol poisoning may require
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Disability in trauma patient: meaning – and management.pptx
- 1. BY DR. AHMED ABDELTAWAB AZAB Emergency Consultant American Heart Association Instructor Emergency lecturer
- 3. Definition. • Disability: any problem could affect pt. life or limb threat or affect prognosis and out come. • Types: – Neurological. – Metabolic.
- 4. Assessment • Assessment of neurological statues of any pt. done during primary survey by • Use GCS score • Use AVPU score. • Pupil size.
- 8. AVPU score • Easy applicable. • Easy remembering. – A – Alert. – V – respond to Verbal stimulation – P – respond to Painful stimulation. – U – Unresponsive • P score equal 8 score in GCS. • U score equal 3 – 7 score in GCS.
- 10. Pupil examination • Normal pupil with coma exclude intracranial hemorrhage but dose not exclude toxicity. • Bilateral constricted: pin point pupil: • Organophosphorus toxicity. • Opiate toxicity – heroin – cocain. • Pontine hge. • Bilateral dilated fixed pupil: brain death. • Bilateral dilated reactive pupil: • Hallucination drugs – amphetamin
- 12. Pupil examination. • Unilateral dilated pupil: • Intracranial hge : subdural hge .
- 13. Quiz
- 14. Convulsions • Febrile convulsions • Children 1 – 5 years • Simple epilepsy • Less than 5 minutes – regain full consciousness • Status epilepticus • More than 5 - 15 minutes • Not regain consciousness fully between attack
- 15. Convulsions • At home management: – Protect air way – left lateral position – Need for neck collar ?? – Protect from head trauma – Close light – Quit environment. – Post epilepsy state – recovery position. – Safe transfer.
- 16. Convulsions • Medication: – Oral – buccal Lorazepam ½ wt – Rectal diazepam ½ wt. – IV midazolam 1/10 wt – Maximal attempts is twice 20 min. apart. • Antipyretic and fomentation may help in febrile convulsion
- 17. Convulsions • At hospital: – The same like home 1st 2 doses. – If recurrence: start phenytoin – epanutin infusion • 20 mg / kg IV over 30 – 60 minutes – If recurrence: intubation and general anesthesia. – Extra investigations.
- 19. Hypoglycemia: • Management: –Protect airway –If conscious – oral glucose. –If drowsy or unconscious with IV access: –IV dextrose: 50% - 25% - 10% - 5% –If drowsy or unconscious without IV access: –IM glucagon
- 21. Hyperglycemia and DKA • Management: –Fluid –Fluid –Fluid –Insulin –Admission.
- 22. Intoxicated patient. • Do not forget. – Safety for you. – Safety for the patient. – Airway protection. – Decontamination – Rapid transportation. – Antidote.
- 24. Organophosphorus • Management: – Airway – open and suction – Breathing – high flow O2 – intubation. – Circulation – IV access. – Disability – constricted pupils. – Exposure – decontamination – Antidote – atropine IV ??
- 33. Ethylene glycol السيارات راديتير مبرد Ethanol Hemodialysis