The different levels ie Level 15 refer to the kinds of resources available in a trauma centre and the number of patients admitted yearly ID: 913822
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Slide1
KGMU Trauma 2
Slide2Levels of trauma centre*
The different levels (i.e. Level 1-5) refer to the kinds of resources available in a trauma centre and the number of patients admitted yearly.
*(American college of surgeons and COT)
Slide3Level 5
A Level 5 Trauma Centre provides initial evaluation, stabilization and diagnostic capabilities and prepares patients for transfer to higher levels of care.
Elements of Level 5 Trauma Centres Include:
Basic emergency department facilities to implement ATLS protocols
Available trauma nurse(s) and physicians available upon patient arrival.
Has developed transfer agreements for patients requiring more comprehensive care at a Level I to III Trauma Centres.
Slide4Level 4
A Level 4 Trauma Centre has demonstrated an ability to provide advanced trauma life support (ATLS) prior to transfer of patients to a higher level trauma centre.
It provides evaluation, stabilization, and diagnostic capabilities for injured patients.
Slide5Elements of Level 4 Trauma Centres Include:
Basic emergency department facilities to implement ATLS protocols and 24-hour laboratory coverage.
Available trauma nurse(s) and physicians available upon patient arrival.
May provide minor surgery and critical-care services if available.
Has developed transfer agreements for patients requiring more comprehensive care at a Level I or Level II Trauma Centre.
Incorporates a comprehensive quality assessment program
Involved with prevention efforts and must have an active outreach program for its referring communities.
Slide6Level 3
A Level 3 Trauma Centre has demonstrated an ability to provide prompt assessment, resuscitation, Gen surgery, intensive care and stabilization of injured patients.
Slide7Elements of Level 3 Trauma Centres Include:
24-hour immediate coverage by emergency medicine physicians and the prompt availability of general surgeons and anaesthesiologists.
Incorporates a comprehensive quality assessment program
Has developed transfer agreements for patients requiring more comprehensive care at a Level I or Level II Trauma
Center
.
Provides back-up care for rural and community hospitals.
Involved with prevention efforts and must have an active outreach program for its referring communities.
Slide8Level 2
A Level 2 Trauma Centre is able to initiate definitive care for all injured patients.
Elements of Level 2 Trauma Centres Include:
24-hour immediate coverage by general surgeons, as well as coverage by the specialties of orthopaedic surgery, neurosurgery, anaesthesiology, radiology and critical care.
Tertiary care needs such as cardiac surgery, haemodialysis and micro vascular surgery may be referred to a Level I Trauma Centre.
Provides trauma prevention and to continuing education programs for staff.
Incorporates a comprehensive quality assessment program
.
Slide9Level 1
Level 1 Trauma Centre is a comprehensive regional resource that is a tertiary care facility central to the trauma system.
A Level 1 Trauma Centre is capable of providing total care for every aspect of injury – from prevention through rehabilitation.
.
Slide10Elements of Level 1 Trauma Centres Include:
24-hour in-house coverage by general surgeons, and prompt availability of care in specialties such as orthopaedic surgery, neurosurgery, anaesthesiology, radiology, plastic surgery, oral and maxillofacial, paediatric and critical care.
Referral resource.
Leadership in prevention, public education to surrounding communities.
Slide11Continuing education of the trauma team members.
Comprehensive quality assessment program.
Teaching and research effort to help direct new innovations in trauma care.
Program for substance abuse screening and patient intervention.
Meets minimum requirement for annual volume of severely injured patients
Slide12Primary survey
ABCDEs of trauma care
A Airway and c-spine protection
B Breathing and ventilation
C Circulation with hemorrhage control
D Disability/Neurologic status
E Exposure/Environmental control
Slide13Airway Assessment and Intervention
Airway should be assessed for patency
Assume c-spine injury in patients with multisystem trauma
Supplemental oxygen
Suction
Chin lift/jaw thrust
Oral/nasal airways
Definitive airways
RSI for agitated patients with c-spine immobilization
ETI for comatose patients (GCS<8)
Slide14Breathing Assessment and Intervention
Inspect, palpate, and
auscultate
Deviated trachea,
crepitus
, flail chest, sucking chest wound, absence of breath sounds
CXR to evaluate lung fields
Ventilate with 100% oxygen
Needle decompression if tension
pneumothorax
suspected
Chest tubes for
pneumothorax
/
hemothorax
Occlusive dressing to sucking chest wound
If
intubated
, evaluate ETT position
Slide15Circulation Assessment and Intervention
Rapid assessment of hemodynamic status
Level of consciousness, Skin color, Pulses in four extremities and Blood pressure and pulse pressure. Cardiac monitor
Apply pressure to sites of external hemorrhage
Establish IV access
Cardiac
tamponade
- decompression if indicated
Volume and Blood resuscitation
Slide16Disability
Abbreviated neurological exam
Level of consciousness
Pupil size and reactivity
Motor function
GCS (Glasgow Coma Score)
Slide17Exposure
Complete disrobing of patient
Logroll to inspect back
Rectal temperature
Warm blankets/external warming device to prevent hypothermia
Slide18Trauma 1 and Trauma 2
Trauma 1
New emergency
And
Trauma centre
Trauma 2
Trauma centre
Slide19Phase wise facilities at Trauma 2
Phase 1
(From 1
st
Jan 2016 to 31st may 2016)
Level 3-4 facility
40 beds
3 ventilators
Phase 2
(From 1
st
June to 30
th
Sep2016)
Level 3 facility
100 beds
6 ventilators
Slide20Treatment of all kind of trauma patients, including general surgery , orthopaedic surgery, oral surgery, plastic surgery, critical care.
All patients of head injury will be entertained but patients having GCS <10 or requiring active neurosurgical management (operation) will be transferred to KGMU Trauma 1
.
All pathological investigations and ultrasound will be available round the clock.
CT Scan & X-ray machines to be
installed soon.
Slide21Phase 3
(From 1
st
Oct 2016 to 31
st
march 2017)
Level 2 facility
218 beds
28 ventilators
Phase 4
(From 1
st
April 2017 onwards)
Level 1 facility, With teaching and research and to start Super speciality courses
Slide22The activist is not the man who says the river is dirty. The activist is the man who cleans up the river.
(Ross Perot)
Slide23Sapne
unhi
ke
sach
hote
hain
,
jinke
sapno
mai
jaan
hoti
hai
hai
.
Sirf
pankh
hone se
kuchh
nahi
hota
,
hausalon
se
udaan
hoti
hai
.
Slide24Thankyou