![]() Decreased lung sounds can be a sign of pneumothorax or hemothorax. Then, auscultation of both lungs should be conducted to identify decreased or asymmetric lung sounds. ![]() The practitioner should look for tracheal deviation, an open pneumothorax or significant chest wounds, flail chest, paradoxical chest movement, or asymmetric chest wall excursion. This assessment is performed first by inspection. Patients with airway obstruction demand immediate intervention. Once the patient is stabilized in this scenario, their neck should be secured with a cervical collar.Īirway protection is necessary for many trauma patients. In this procedure, a two-person spinal stabilization technique is recommended. This means one provider maintains the in-line immobilization, and the other manages the airway. The cervical spine should be stabilized by manually maintaining the neck in a neutral position, in alignment with the body. During these evaluations and possible interventions, caution is necessary to ensure that the cervical spine is immobilized and maintained in line. If there are other causes of obstruction, a definitive airway should be established, whether through intubation or the creation of a surgical airway such as cricothyroidotomy. If there is a foreign body, it should be removed. Jaw thrust by placing the long fingers behind the angle of the mandible and pushing anteriorly and superiorly.įoreign bodies, secretions, facial fractures, or airway lacerations are also sought out. Perform either a chin lift or jaw thrust if airway obstruction is identified, although a jaw thrust is preferred if cervical spine injury is suspected.Ĭhin lift by placing the thumb underneath the chin and lifting forward. If the patient can speak coherently, the patient is responsive, and the airway is open. This assessment is of the patency of the patient’s airway. īelow is each sequential area of focus for evaluation and intervention.Ī: Airway with cervical spine precautions /or protection. One caveat is that if a patient appears to be exsanguinating from a massive wound that can be addressed before starting the ABCDE algorithm, fortunately, the widespread adoption of the use of tourniquets in the field has limited the need to staunch massive bleeding in the trauma bay. If a patient is noncooperative or combative and it interferes with conducting a proper primary trauma survey, then the patient should be sedated and intubated so that the exam may proceed. These steps are followed in the same order in every trauma resuscitation procedure to ensure that no critical or life-threatening injuries are overlooked. If any abnormality is identified in one of the areas of focus, it should be resolved before a practitioner progresses further through the algorithm. The common acronym for performing the primary trauma survey is ABCDE, each letter representing an area of focus.
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