Nutrition - Poisonings - Trauma(ATLS)

Semester 7th ()

Code MED_741

Hours Teaching 25 hours, Laboratory 0 hours, Tutorial 0 hours , Clinical Training 0 hours (per week)

Teachers

• KAKKOS STAVROS (Professor)
• KEHAGIAS IOANNIS (Professor)
• MAROULIS IOANNIS (Professor)
• FLIGKOU FOTEINI (Associate Professor)
• SKROUBIS GEORGE (Associate Professor)

Description

• Trauma epidemiology
• Laws of energy on trauma
• Airway and respiration
• Shock
• Thoracic trauma
• Head injuries
• Spinal cord and vertebrate injuries
• Hot and cold burn injuries
• Musculoskeletal trauma
• Fractures in childhood
• Post-traumatic distending osteogenesis
• Long bone fractures
• Hip fractures
• Open fractures
• Fractures of the lower radius
• Upper arm brace fractures
• Patient transportation
• Practical application

Scope

EDUCATIONAL GOALS ON TRAUMA- EVALUATION OF MULTIPLE INJURIES

Severe trauma is the leading cause of death among people aged 1-44, while it is the third in line cause of death in all ages after cardiovascular diseases and cancer. It has been estimated that every death due to trauma corresponds to three permanently disabled individuals, whilst a significant percentage of these deaths and disabilities could have been avoided by early intervention. Because trauma adversely affects a young population, it results in the loss of more working years therefore social and economic cost is astounding. Knowledge and application of resuscitation and the handling of a multiple injury diminishes complications and decreases mortality rate and disabilities.

EDUCATIONAL GOALS REGARDING THORACIC TRAUMA

Thoracic trauma accounts directly for 25% of deaths due to injury, but it is also a contribution factor in other causes of death. The majority of these deaths occur after the patient’s arrival in the ER, many of which could have been avoided by immediate diagnosis and treatment. Treatment of a thoracic injury is generally a straight forward procedure if the correct diagnosis has been made. Meanwhile a thoracic trauma that has not been diagnosed or handled in the right way can lead to a quick death. Typically less than 10% of blunt trauma and about 15-30% of penetrating thoracic injuries require surgical treatment (thoracotomy). Most patient with a thoracic trauma are in need of simple interventions (ie tube thoracostomy), that are in the acquired abilities of any medical doctor. In total the mortality rate due to a thoracic trauma is less than 10%

EDUCATIONAL GOALS REGARDING ABDOMINAL INJURIES

Based on the injury mechanism, abdominal trauma is distinguished between a blunt trauma, which is caused by direct percussion, steep deceleration or shear forces and penetrating trauma, more often caused by a knife or a bullet.

The evaluation of the abdomen is of great significance to the first diagnosis, while a blunt injury meets more complications when diagnosing than a penetrating one. The goal is to evaluate if there is an abdominal cavity injury, that needs surgical treatment and not which organ may be injured specifically.

An undiagnosed abdominal injury, comprises a significant cause of death, following trauma.

EDUCATIONAL GOALS REGARDING HEAD INJURIES

Head injury, is the fourth most common cause of death and at the same time the leading one during the first four decades of life. The leading causes of head injuries are car accidents, falls and criminal actions, while fewer are caused by work accidents, sports, hobbies and other recreational activities. Head injuries, depending their severity, may be life threatening, moreover they can get worse due to other injuries. Early head injury evaluation which requires knowledge on the pathophysiology of the trauma and right treatment can greatly improve a patient's condition.

EDUCATIONAL GOALS REGARDING INJURIES OF THE SPINAL CORD

Trauma of the spine is very common nowadays and can lead to severe permanent disabilities. For every individual that an injury has occurred anywhere above the clavicles or one with multiple injuries, it must be taken into consideration that the probability of a spinal injury is high, therefore the patient must be handled with great care even if symptoms are absent. Around 55% of spinal trauma is a cervical spinal cord injury, 15% thoracic, 15% thoracic-lumbar, 15% in the sacral vertebrates. 5% of head injuries are accompanied by a spinal injury while 25% of spinal injuries come with a head injury.

EDUCATIONAL GOALS REGARDING MUSCULOSKELETAL TRAUMA

Musculoskeletal trauma despite occurring in 85% of patients who have suffered a blunt trauma, is rarely life threatening or threatens the livability of a body part, if evaluation and treatment has been made promptly. For this reason, patients having a single musculoskeletal trauma must be cared for in the same way as a patient with a multisystemic trauma.

EDUCATIONAL GOALS REGARDING BURNS AND COLD INJURIES

Burns are frequent injuries, that are often caused by exposure to high temperature (thermal burns) or rarely to chemical substances (chemical burns) or after body connection to an electrical source of high voltage (electrical burns). On the opposite, cold injuries are less frequent in our country, because of the climate. They are distinguished in local burns (frostbite) and systemic (hypothermia). On 85% of incidents, burns are simple (low severity) and can be treated in an outpatient clinic. Extensive burns and hypothermia are a significant cause of morbidity and mortality. Knowledge and practice of the principals of resuscitation and the final treatment of these injuries minimizes complications and mortality.

Reading Material

ATLS: Advanced Trauma Life: Support for Doctors
Litera - John Boukouvalas 2010 ISBN: 9789605444716