ASSESSMENT AND INITIAL

MANAGEMENT OF TRAUMA
PATIENT
Tim Diklat IRD RSSA
OVERVIEW
- SIX STAGES OF AN AMBULANCE CALL.
- TRAUMA ASSESSMENT.
- PRELIMINARY ACTIONS AT THE SCENE
- PATIENT ASSESMENT AND MANAGEMENT
- CRITICAL INJURIES/CONDITION.
- SECONDARY SURVEY
- REASSESMENT SURVEY.
SIX STAGE OF AN AMBULANCE CALL.
1. PREDISPATCH.
2. DISPATCH.
3. TRAVEL TO SCENE
4. ACTIONS AT THE SCENE
5. TRAVEL TO THE HOSPITAL
6. ACTIONS AT THE HOSPITAL
Predispatch

Fase Persiapan
Inspeksi Harian
Pemeriksaan sistem
kendaraan
Pemeriksaan peralatan
medis
Dispatch
Komunikasi Medik
Ambulance Responce
Ambulance Mapping
Travel to the Scene

Sesuai kebutuhan
Route efisien & alternatif
Traffic Law
Jarak minimum iring-iringan 500 ft
Sirine & Lampu
Radio Medik
At the Scene
Scene size-up
Primary Survey
Load and Go

Travel to the Hospital
Secondary Survey
Radio Medik
Reassessment
Recording
At the Hospital
Laporan recording
Serah terima pasien
SCENE SURVEY
1. ASSESS FOR HAZADS
2. EXTRICATION REQUIRED.
3. NOTE MECHANIMS OF INJURY.
4. NOTE NUMBER OF VICTIMS.
5. REQURIES ANY ADDITIONAL HELP NOW!
HAZARDS
LOOK BEFORE YOU LEAP
. PARK VEHICLE IN NEAREST SAFE PLACE.
- IS IT SAFE TO APPROCH VICTIM ?
- IS SPESIAL EQUYIPMENT NEEDED ?
- IS IMMEDIATE MOVEMENT OF VICTIM INDICATED
?
SAFETY FIRST
YOUR FIRST
RESPONBILITY IS TO
TAKE CARE OF YOURSELF
ESSENTIAL EQUIPMENT
1. PERSONAL PROTECTION EQUIPMENT.
2. LONG BACK BOARD
3. CERVICAL COLLAR.
4. AIRWAY EQUUIPMENT - OXYGEN
- SUCTION.
5. TRAUMA BOX.
ASSESSMENT AND INITIAL
MANAGEMENT
1. PRIMARY SURVEY - ABCs.
2. TRANSPORT DECISION AND CRITICAL
INTERVENTIONS
3. SECONDARY SURVEY
4. REASSESSMENT SURVEY.
PRIMARY SURVEY
- RAPID NECK-TO-KNEE EXAM.
- FOCUS ON IMMEDIATE LIVE THEATENING
CONDITION.
- SHOULD TAKE NO LONGER THAN 2 MINUTE.
- STOP SURVEY ONLY FOR AIRWAY OBSTRUCTION
OR CARDIAC ARREST.
- CONTROL MAJOR BLEEDING DURING THIS TIME.
PRIMARY SURVEY
-TOTAL OVERVIEW OF PATIENT SITUATION
WHILE YOU APPROACH.
- AIRWAY, C-SPINE CONTROL., AND LOG.
- BREATHING.
- CIRCULATION
- CONTROLE HEMORRHAGE.
WHEN PRIMARY SURVEY
COMPLETED...
. TRANSFER PATIENT TO BACKBOARD
- CHECK BACK.
- MAKE TRANSPORT AND CRITICAL DECISIONS.
TRANSPORT DECISION
AND
CRITICAL INTERVENTIONS.
LOAD AND GO SITUATIONS
- TRANSPORT THESE PATIENTS IMMEDIATELY !
- ABNORMAAL RESPIRATION
- ABNORMAL CIRCULATION
- SHOCK.
- UNCONTROLLABLE BLEEDING
- DECREASED LOC
- TENDER ABDOMEN
- PELVIC INSTABILITY
- BILATERAL FEMUR FRACTURES
IN LOAD AND GO SITUATIONS..
- ON-SCENE INTERVENTIONS ARE LIMITED TO
CORRECTING IMMEDATE THREATS TO LIFE :
- AIRWAY
- DECOMPRESS TENSION PNEUMOTHORAX.
-CONTROLE MAJOR BLEEDING.
- ALL OTHER INTERVENTIONS SHOULD TAKE
PLACE ENROUTE TO HOSPITAL
SECONDARY SURVEY
- DETAILED EXAM
- PROVIDES BASELINE FOR FUTURE DECISIONS
- SPLINT FRACTURES
- DRESS WOUNDS
- RECORD YOUR FINDINGS.
SECONDARY SURVEY
- VITAL SIGN
- HISTORY
- HEAD-TO-TOE EXAM
- FURTHER BANDAGING AND SPLINTING
- CONTINUALLY MONITOR
HISTORY OF INJURY
- S YMPTOMS
- A LLERGIES.
- M EDICATIONS
- P AST MEDICAL HISTORY
- L MAST MEAL
- E VENT PRECEDING THE INJURY
- SOURCES OF INFORMATION
- PERSONAL OBSERVATION.
- PATIENT & BYSTANDRES
NEUROLOGICAL EXAM
LEVEL OF CONSIOUSNESS
A - ALLERT
V - RESPONSE TO VERBAL
P - RESPONSE TO PAIN
U - UNRESPONSIVE
MOTOR
SENSATION
PULSE
REASSESSMENT SURVEY
- PURPOSE:
- TO MONITOR FOR CHANGES IN PATIENTS
CONDITION.
- PERFORM :
- EVERY 5 MINUTES DURING TRANSPORT
- ANYTIME PATIENTS CONDITION WORSENS
REASSESSMENT SURVEY
- LOC
- AIRWAY
- BREATHING
- RATE & QUALITY
- CHECK FOR JVD & TRACHEA POSITION
- LISTEN FOR BEATH SOUNDS
- CIRCULATION
- PULSE RATE AND QUALITY
- BLOOD PREASSURE
- SKIN CONDITION

REASSESSMENT SURVEY
. CHECK ABDOMEN
- ASSESS ANY PERTINENT FINDING
NOTE IN PRIMARY OR SECONDARY SURVEY
- CHECK INTERVENTIONS
- INTUBATIONS
- DRESSINGS
- SPLINTS
COMMUNICATIONS WITH MEDICAL
DIRECTION
- EARLY CONTACT
- CONCISE AND TO THE POINT
- DESTINATION AND ETA