Initial Assessment & Resuscitation

A: airway (ability to speak)

• current or impending airway obstruction

B: breathing (RR, SpO2)

• flail chest

• tension pneumothorax

• massive hemothorax

• cardiac tamponade

C: circulation (HR, BP)

• x2 ≥ 16g IV/IO access

• life-threatening hemorrhage

• severe hypotension/shock

• reversal of AC

D: disability (GCS, pupillary exam)

• ↑ICP

E: exposure (completely undress)

• missed injuries

• hypothermia

Extended Focused Assessment w/Sonography for Trauma (eFAST)

1. pitfalls

   • can reliably detect > 250 cc fluid

   • user dependability

2. assesses for

   • pericardial fluid

   • intra-abdominal fluid

   • hemo/pneumothorax

3. probe, position & indicator orientation

   • cardiac: phase array probe, subxyphoid, right

     1. alternatively: left parasternal w/indicator towards left hip)

   • RUQ: phase array probe, right MAL, head

   • LUQ: phase array probe, left MAL, head

   • pelvis: phase array probe, just superior to pubis, head & right

   • lung: linear probe, right & left MCL, head

4. must visualize

   • cardiac: anterior & posterior pericardium

   • RUQ: above diaphragm (into chest), liver/kidney (the sweep), inferior tip of liver/kidney

   • LUQ: above diaphragm (into chest), diaphgram/spleen (the sweep), inferior tip of spleen/kidney

   • pelvis: bladder in long view (then sweep), bladder in trans view (then sweep)

   • lung: pleural line at 3 spaces

Airway Management

Resuscitation Fluids

Resuscitative Thoracotomy

Focused Assessment with Sonography for Trauma

Interventional Radiology

Endpoints of Resuscitation