Initial Assessment of a Trauma Patient - Multi-System Injury (Part 1).wmv

[zqwerty70]

I'm from the US. ED is basically like an emergency room, right?

[kidcaper007]

@zqwerty70 yes it is ED=emergency department... in the UK they also call it A&E=accident and emergency

[Happyascanbe1]

Perhaps you shouldn't fix the cannula that way as it kinks it. Just leave it perpendicular as it is and keep an eye on it, especially if there is no transfer prior to formal chest drain insertion. Also, in reality you wouldn't be wasting time listening the heart when you have already established that your patient is tensioning, would you? Otherwise you might end up not having much to listen there pretty damn fast, you know. ;-)

[OxfordMedicalSchool]

@Happyascanbe1 This is a teaching scenario, designed to demonstrate the structure of a trauma assessment. In practice it is clearly more flexible, but we feel it is important to teach this format to ensure nothing is missed.

As for the cannula, perpendicular is best as you say. However, the 'patient' may have complained slightly had it actually been inserted.

[cindy1602able]

very polite when making requests!

[upadyaya]

Quite different to what we practice in Australia. But I like that doctor----very calm.

[Soymilllk]

"Could you call the trauma team for me?"

*Nurse walks away and fondles a bag on the table*

[fastroadkill]

those NRB masks used to kill people befor they remove 1 of the 2 one way valves that kept out ambient air. this would happen if the bag was kinked and air flow was blocked,

how did your test dummy like the NRB on his face without o2 flow.

this is a great vid

[fastroadkill]

those NRB masks used to kill people befor they remove 1 of the 2 one way valves that kept out ambient air. this would happen if the bag was kinked and air flow was blocked,

how did your test dummy like the NRB on his face without o2 flow.

this is a great vid

[cromerznurse]

In regards to the warm IV fluids. If the patient is cardiovasculary stable, why run fluids through? Even though there is bleeding, it was stated it was non pulsing. A flush post cannulation would suffice to keep the cannula patent. A temperature of 36 C is not that cold, and the patient will rewarm in resus. It appears that they knew what what coming next, e.g the assistant handing the student the tubes before auscultation, is this scenario reheasrsed or is it improvisation with progression?

[OxfordMedicalSchool]

@cromerznurse All fair points. The students in these videos knew the protocol well (the assistant is also a medical student) but didn't necessarily know exactly what was coming next. The warmed fluids may just be a blanket response to a trauma situation but in this case, as you rightly point out, they may not be absolutely necessary. However, there is no hard and fast rule about this and you would not be failed for erring on the side of caution.

[cromerznurse]

@OxfordMedicalSchool . Sir, I thank you for your very concise videos none the less

[ultimatumjs]

@OxfordMedicalSchool I believe 2l crystalloid is standard for most trauma situations. It is what we are taught at KCL as well.

[deestilo]

@cromerznurse

I can provide a reasoning. Why fluids ? It doesn't matter about the fluid, but theIV line itself is a must. Let's say it;s a VT /VF/ Asystole /name one.... the countdown begins in seconds to minutes. Once the res-lead said "adrenaline /epi 1 mg" the drug must reach the system as fast as it can and there is no "enough" time to search for available veins.

[3cheers4Ger]

Quite interesting...I want to be a Combat Medic in the NJ ARNG.

[deestilo]

@3cheers4Ger

it is interesting. I once wanted to be a combat medic, but put in reality combat medic is effective only in stopping the bleeding (ABC again) and therefore resucitation is the main course. (while avoiding bullets of course XD). But the next logical treatment is hardly done in the field.

[ThatFoolishBoy]

@3cheers4Ger go for it I'm currently training to be a EMT-B and want to continue on to being a paramedic then after a year of experience I may enlist either U.S. marines or Army and continue my training

[nvk1001]

6.11 ROFLLLL

[ThatFoolishBoy]

@nvk1001 QUICK look busy not

[Negativelens]

Very interesting, however I don't think he would've passed with that popped glove

[jetsontherise]

How do you become a patient for when they do these things can u volunteer?

[idigghx]

How the hell can he just lay there with an OPA in? I'd be gagging and flailing like I was drowning.

[OxfordMedicalSchool]

We actually used a half-length Geudel airway for this, just cunningly switched at the last moment!

[idigghx]

@OxfordMedicalSchool ah ha, I see says the blind man, to the deaf dog. Clever.

[deestilo]

@OxfordMedicalSchool

Patient definitely counscious during the training, so it's gotta be half length Geudel. Pls note that inserting a Geudel to the airway starts with one end pointing upward and then when the other end is inserted to the airway, the guedel is rotated 180 so it will also move the tounge away from blocking.

[deestilo]

plus I'd like to see you intubate him...... lol....

wondering if he's start to freak out if you hold the blade next to his cheek ^^

[3cheers4Ger]

@deestilo: I'm a little bit confuzzled by this vid...I'm 16, and I want to join the volunteer ambulance in my town. Will I be taught this stuff?

[deestilo]

@3cheers4Ger

okay, two things first..... BTLS and ATLS.... Basic and Advanced Trauma Life Support. This is why you don't get mixed ideas. BTLS is on scene and transportation. ATLS means the big dogs (or docs xP) handle it at trauma facility /hospital.

The idea however the same (the ABC). Intubation is hardly done on scene, cause it requires stability and clean instruments. So CPR for you is a must, plus, if you do volunteer I can only do thumbs up (4 of em )

[newatvidz]

im taking my EMR course in alberta canada. looks very interesting, just funny how you guys say trachea lol