قسم الـ( Practical Surgery) _الدفعة السادسة
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قناة خاصة بتغطية محاضرات العملي في المستشفيات لكورس الجراحة
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доля реакций к просмотрам- 21 янв. 2025 г.без подписи1,69%
- 31 авг. 2025 г.🧑⚕️ Approach to the Trauma Patient (ATLS) 🧤Preparation & Tools : 1- Gloves 2- Gown 3- ATLS protocol 4- Full trauma team readiness ✨Primary Survey " ABCDE "✨ ☁️A – Airway with Cervical Spine Immobilization · Assess airway patency → if patient can talk, airway is patent. · If secretions present → suction. 🫧Airway adjuncts: -Oropharyngeal airway (OPA) -Nasopharyngeal airway (NPA) -Chin lift / Jaw thrust (without cervical movement if C-spine injury suspected). 🫧Definitive airway (Endotracheal Intubation) – Indications: 1- Airway obstruction 2- Shock 3- Apnea 4- Massive maxillofacial trauma 5- Altered mental status 6- Expanding/pulsatile neck hematoma 7-Subcutaneous emphysema / tracheal injury 🫧Cricothyroidotomy → Contraindicated in children < 11 years. ❄️Before intubation → 6 Ps (Rapid Sequence Intubation "RSI" ) : 1. Preparation: - Equipment (ETT, laryngoscope, suction, O₂ source, LMA, tracheostomy set, torch, drugs, monitor, IV access). 2. Position: -Sniffing position with occiput elevation (~10 cm) unless cervical spine injury. 3. Preoxygenation: - 100% O₂ for 3–5 min (to avoid hypoxia & brain damage). 4. Pretreatment/Paralytics & Sedatives: e.g., Midazolam, Propofol . 5. Placement of tube: - Intubate. 6. Post-intubation confirmation: -Bilateral chest auscultation , chest movement , portable chest X-ray. ☁️B – Breathing : Look, Listen, and Feel for : 1- chest movement 2- breath sounds 3- air entry 🫧Assess for : 1- Cyanosis 2- Respiratory distress 3-Absent breath sounds 🫧Manage life-threatening conditions (e.g., tension pneumothorax → needle decompression + tube thoracostomy). ☁️C – Circulation 🫧Check: Pulse, BP, capillary refill, temperature, active bleeding. 🫧Control external bleeding (direct pressure, tourniquet if severe). 🫧Insert 2 large-bore IV lines → fluid resuscitation. 💡Note : ·If shock persists after fluids → consider FAST (E-FAST ultrasound) for internal bleeding. ·Pelvic binder if unstable pelvic fracture. ·If chest cause suspected → tube thoracostomy. ☁️D – Disability (Neurological) ·Assess GCS (Glasgow Coma Scale) ·Check for hypoglycemia, stroke, intoxication. ☁️E – Exposure & Environment : 🫧Fully expose patient to look for hidden injuries. ·Prevent hypothermia (warm blankets) . ✨Secondary Survey✨ 🪧History: " AMPLE " (Allergies, Medications, Past history, Last meal, Events/Mechanism of injury). 🪧Examination (head-to-toe) : 🫧Head: scalp lacerations, subgaleal hematoma, skull fracture signs. 🫧Face : raccoon eyes, panda eyes, periorbital ecchymosis , nasal deviation, epistaxis. 🫧Neck: JVP, swelling, tracheal deviation, surgical scars. 🫧Chest: symmetry, scars, visible veins, nipple position, breath sounds. 🫧Abdomen: distension, contour, striae, scars , etc... 🫧Pelvis & limbs: deformities, open fractures, distal pulses, motor/sensory function. 🪧Investigations: 🫧Labs: CBC, electrolytes, ABG, coagulation profile. 🫧Imaging: X-ray (C-spine, chest, pelvis), FAST, CT (if stable). ✍🏻/ أنوار المنتصر #الدكتور_اشرف_الفقيه #مستشفى_الشرطة #Group_C #اللجنة_العلمية_للدفعة_السادسة1,05%
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