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11-18-2009, 07:39 PM
. Review
A) Review of resuscitation
Be sure that there is
No air way obstruction Vital signs near normal.
Good peripheral perfusion Urine output more than 1/2 cc/min.
C.V.P. 5-10 cm water.
B) Review of Evaluation:
[i] Accurate history taking
Time of trauma
Type of trauma Forces involved, speed and circumstances of medico-legal importance.
Allergies, medications, major illness or operations.
[ii] Again careful examination:

1) Head & CNS:
l Scalp haematoma
l Bleeding/orifices Ear, Nose, Mouth & Eyes.
l Neurological system:
Q Mental state and consciousness
Q Cranial nerves & signs of lateralization
Q Motor function
Q Reflexes
2) Neck: l Increasing haematoma in the neck may cause resp. obst. and make intubation difficult.
3) Chest: l Fracture rib, Stove-en chest, Flail chest.
4) Abdomen:
l Tender abdomen, ecchymoses & abrasions may indicate intra-abdominal injuries.
l Bowel sounds may be heard even in the presence of rupture viscus. Conversely silent abdomen may occur as temporary paralysis.
5) Pelvis and perineum:
l Inspect perineum, uretheral meatus and scrotum for haematoma and injury.
6) Extremities:
Vascular system, Examine for distal pulsation, increasing haematomas or bruit.
Bones allover the body.

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