Management of Emergencies And Trauma in Adults

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Note: Initial Emergency Management: For all emergencies and trauma, the following format should be applied in management {ABCDE}:

• A - Airway
  • Assess for patency.
  • Suctioning, Positioning, Jaw thrust, Guedel (oropharyngeal) airway, immobilize CSpine in trauma patients.
• B - Breathing
  • Respiratory rate, O₂ Saturations, O₂ Therapy, Inspection, Palpation, and Auscultation of chest Assist respirations if needed.     
• C - Circulation
  • In trauma patient compress active bleeding.
  • BP and HR, Capillary refill time, Check warmth of hands.
  • IV access {use green or grey cannula in adults}, obtain appropriate blood samples.
  • Palpate abdomen for tenderness and pelvis for instability in trauma patients.
• D - Disability
  • AVPU or GCS {see table below}
  • Don't forget to check Glucose
  • Check for neurological deficits
• E - Exposure
  • Check Temperature
  • Expose the rest of the body looking for rashes, bruising, petechiae or other signs of trauma

Key points:

• Apply pelvic binder for unstable pelvic fractures
• For suspected fractures aim to immobilize and give analgesics before referral
• Open fractures require sterile dressing and IV antibiotics
• TTV for all wounds and open fractures

	AVPU TABLE
Awake	Patient is Awake
Verbal	Patient responds to Verbal Stimulus
Pain	Patient responds to Pain Stimulus
Unresponsive	Patient is Unresponsive to any stimuli

 

GCS TABLE	1	2	3	4	5	6
Motor	Unresponsive	Extension to pain	Flexion to pain	Withdraws from pain	Localizes pain	Obeys commands
Verbal	No sounds	lncompre- hensible sounds	Words but no conversation	Confused conversation	Comprehensive speech
Eye	No eye opening	Opens to Pain	Opens to voice	Opens sponta- neously