Severely injured patient with spinal fractrue and unconsciousness first thing to be done is
D i.e. Airway maintenance Management of Polytrauma Patients / Life threatening conditions* The assessment of severely injured patient consists of four overlapping phases:1) Rapid primary evaluation2) Restoration of vital functions3) Detailed secondary evaluation and4) Definitive care* The ABC,s of trauma care identifies & treat life threatening conditions - and can be rememebered as Airway maintenanceQ, with cervical spine control. The cervical spine should be carefully protected at all time and not be hyperextended, hyper flexed or rotated to obtain a patent airway. A chin lift or jaw thurst maneuver should be used to establish an air way.BreathingQ with special emphasis on tension pneumothorax, open pneumothorx, flail chest with pulmonarycontusion & massive hemothorax.CirculationQDisability (neurological status) by Glasgow coma scaleExposure and environmental control (undress the patient but prevent hypothermia)= Fracture splintageQ . Recognition & splintage of major fracture, adequate immobilization of cervical spineQ, and proper handling of injured patient are essential to prevent fuher damage to theneurovsculr elements. As a general rule following measures should be taken:- The joints above & below the fracture should be immobilized. Splints can be improvised with pillows, blanket or clothing.- Immobilization does not need to be absolutely rigid.- Over bleeding should be temponaded with dressing & firm pressure- Tourniquet should be avoided, unless it is obvious that the patient's life is in danger.
GCS scoring
Spinal stabilization by cervical collar
Mannitol drip to decrease ICT
Airway maintenance