• Impact
• Fall
• Violent
• Penetrating
• Blunt
• Sporting
• Horses
• Rugby
• Burns

Drowning

• Worry about:
• Hypothermia
• Neck trauma
• Cardiorespiratory arrest
• Why they fell in
• Seizure
• Alcohol
• CPVT (Catecholaminergic Polymorphic Ventricular Tachycardia)

Burns

• Airway obstruction is caused by:
• Bronchospasm initially
• Upper airway oedema later (2-4 hrs) => Intubate early if signs of burning (hoarse voice, soot, singed hair)

Primary survey (what's going to kill them)

• A
• Flail chest (>1 break in >1 ribs)
• => Pain relief, CPAP, Intubation
• B
• Tension pneumothorax
• "I'm going to die"
• Haemothorax
• C
• Hypovolaemic shock
• #Femur
• Retroperitoneal bleed
  
• Aortic dissection
• Can plug with a haematoma, which displaces much later
• D
• GCS
• Pupils
• Limb movement
• GLUCOSE
• E
• FULL exposure
• Environment
  
• Temp => Clotting => DIC

Intubation

• Indications
• GCS <8
• Predicted clinical course
• RSI
  
• Suxamethonium (40" on, 5' off, except in slow metabolisers)
• Induction agent (propofol, thiopentone, ketamine)
• Sellick manoeuvre
• BEWARE sudden cardiac arrest, hypotension, anaphylaxis
  

Notes

• Think LATERALLY and SCEPTICALLY
• Old people can # C-spine from standing => All get a CT
• Ventilation refers to CO2 movement
• FAST is NOT a definitive assessment in trauma
• NOT a rule-out test
• Can easily miss a bleed
• Trismus
• "A firm closing of the jaw due to tonic spasm of the muscles of mastication from disease of the motor branch of the trigeminal nerve, usually associated with general tetanus."
• May generally refer to all causes of limited mouth opening
• Even with a pulse, start CPR if HR <60 (in a child)