Management of Emergencies and Trauma in Adults

Clinical Description

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 C-

Spine 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