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Management and treatment of cardiac arrest in trauma patients follows the principles detailed in earlier chapters. The primary arrhythmia in adult traumatic cardiac arrest is pulseless electrical activity PEA, and specific causes should be sought and treated.
Paediatric traumatic arrests are usually due to hypoxia or neurological injury, in either case, adequate ventilation is particularly important in the management of these patients.
Receiving the patient Management of the trauma patient in hospital should begin It is important that a well organised trauma team receives the patient with a clear and concise handover from the ambulance crew, who should give a summary of the incident, the mechanism of injury, the clinical condition of the patient on scene, suspected injuries, and any treatment given in the pre-hospital setting.
During this handover, it is imperative that the receiving team remain silent and listen to these important details. Trauma team It is important that a well organised trauma team should receive the patient.
The aim of airway management is to allow both adequate oxygenation to prevent tissue hypoxia and adequate ventilation to prevent hypercapnia.
Loss of consciousness diminishes the protective upper airway reflexes cough and gag, endangering the airway further through aspiration and its sequelae.
If the patient is able to talk it means that the airway is patent and breathing and the circulation is adequate to perfuse the brain with oxygenated blood.
However, respiratory deterioration in these patients will necessitate intubation. Basic airway manoeuvres Manoeuvres to open the airway differ from those used in the management of primary cardiac arrest.
The standard head tilt and chin lift results in significant extension of the cervical spine and is inappropriate when cervical spine injury is suspected.
Airway adjuncts If basic airway manoeuvres fail to clear the airway, consider the use of adjuncts, such as an oropharyngeal Guedel or nasopharyngeal airway.
The oropharyngeal airway is inserted into the mouth inverted and then rotated 180 before being inserted fully over the tongue.
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