Random quetion 4-Trauma - stranger016

[ArchivalUser]

so the summary is

in case of trauma it is ABCD
while in unresponsive patients it is CAB

Am i right????

[ArchivalUser]

trauma pt ABC , but the patient is conscious and airway is not a problem u did your abc already , that is secured airway already. If unconscious trauma pt airway first too. your pt is o2 sat 78% with face mask, facial trauma too so even if awake -intubate because airway is a problem.
CAB is for u see a pt unresponsive , not trauma pt so possible chocking or heart problem.

[ArchivalUser]

Well unresponsive in this case may be due to severe Head Injury GCS 8 or less, and moreover the facial bones fractures like multiple mandible and maxilla as in this case is associated with massive oropharyngeal and nasopharyngeal bleeding makes intubation impossible, and a surgical airway such as Cricothyroidotomy or Tracheostomy, the former being faster is warranted.
Unresponsive patient due to hypovolumic shock has to be in Class 4 shock which involves massive exsanguination of more than 3-4 litres of blood volume, and that has to involve abdominal organ ruptures like spleen and liver along with a few long bone fractures, unlike the single femur fracture possibly mentioned as in this case.
So, the unresponsiveness in this case may be contributed by head injury and asphyxia due to nasal and pro pharyngeal airways obstruction, rather than circulatory insufficiency which may be minimally contributory as well.
So, on application of ABCD as per ATLS algorithms I would go for option C crioithyroidotomy as an answer in this case.

[ArchivalUser]

Unconscious pt in trauma always intubate.