Trimodal distribution 80 Triage Field Triage Decision Schema

Trimodal distribution 80%

Triage Field Triage Decision Schema (Advanced Trauma Life Support Student Course Manual 10 th edition)

Primary Survey A B C D E Breathing Circulation Airway Exposure Disability Identify life-threatening condition Simultaneously manage

Size and Shape Skeleton Surface area Long-term effect

Anatomical change Physiologic change Early fetal assessment

Decreased physiologic reserve Comorbidities →Fatal outcome Prompt, aggressive resuscitation

Primary Survey • 현장안전!!! • Airway maintenance with restriction of cervical spine motion • Breathing and Ventilation • Circulation with hemorrhage control • Disability(assessment of neurologic status) • Exposure/Environmental control 10초

Airway maintenance with restriction of cervical spine motion • 의식 P이하 : OPA, NPA : Advanced airway? • 경추고정 • 구강 내 흡입

Breathing and Ventilation • 출혈성 쇼크가 의심되면? : 비재호흡마스크 15 L • 숨을 안쉬면? : BVM(with or without advanced airway) • Pulse oximetery : 정확하지 않을 수 있다!!

Circulation with hemorrhage control • Hemorrhage control : 직접 압박 : Tourniquette 적용

Disability • Level of consciousness(AVPU, GCS) • Pupil(size and reaction) • Lateralizing sign • Spinal cord injury • Drug, Alcohol, BST • Lucid interval

Disability Severe TBI: <9 Moderate TBI: 9~13 Mild TBI: 13>

Exposure and Environmental control • Completely undressed • Prevent hypothermia

Secondary survey • Head- to-toe evaluation • Complete history : AMPLE history • Complete patient examination