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Musculo-skeletal Trauma

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Musculo-skeletal Trauma

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Musculo-skeletal Trauma

Classification according to order Classification according to order of priority in management:of priority in management:

•Highest priority:

•Cervical spine injury.

•Respiratory impairment.

•Cardiovascular insufficiency.

•Severe external haemorrhage.Larkin J and Moylan J: (1973): Priorities in management of

trauma victims. Critical Care Medicine, 3: 192-195.

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Musculo-skeletal Trauma

Classification according to order Classification according to order of priority in management:of priority in management:(Cont.)(Cont.)

•High priority:

•Intraperitoneal injuries.

•Retroperitoneal injuries.

•Brain and spinal cord injuries.

•Severe burns, or extensive soft tissue injuries. (Larkin and Moylan, 1973)

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Musculo-skeletal Trauma

Classification according to order of Classification according to order of priority in management: priority in management: (Cont.)(Cont.)

•Low priority:

•Lower genito-urinary tract injuries.

•Peripheral vascular, nerve and tendon injuries.

•Fractures, dislocations.

•Facial and soft tissue injuries.

•Tetanus prophylaxis.(Larkin and Moylan, 1973)

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Musculo-skeletal Trauma

Injury Severity Score (ISS) Injury Severity Score (ISS) (Baker (Baker et al., 1997):et al., 1997):

Baker SP, O’neill B, Haddow W and Long WB (1974): The injury severity score : A method for describing patients with multiple injuries and evaluating emergency care. J.Trauma, 14:187-196.

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Musculo-skeletal Trauma

Triage Score Triage Score (Champion et al., 1980):(Champion et al., 1980):

Champion HR, Sacco WJ, Hannan DS, Lepper RL, Atzinger ES, Copes WS and Proll RH(1980): Assessment of injury severity: The Triage Index. Critical Care Medicine, 8: 201-208.

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Musculo-skeletal Trauma

Glasgow Coma Scale Glasgow Coma Scale (Teasdale and (Teasdale and Jennet, 1974)Jennet, 1974)

Teasdale G and Jennet B (1974): Assessment of coma and impaired consciousness. Lancet, 2: 81-84.

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•Polytraumatized or multiple injury patients possess the most critical decision and management.

•A trauma centre, well equipped, well staffed, highly experienced personnel, easy and fast accessibility with multi-system and multi-speciality medical care should be available.

Musculo-skeletal Trauma

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Dr. Soliman Fakeeh hospital has the full calibre of providing medical

services with all medical and surgical specialities, taking care of injured

patients.

Example of an advanced Example of an advanced trauma center:trauma center:

Musculo-skeletal Trauma

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•“Remember, we are human beings, having our own limitations, but fully responsible of providing our best care.

Supportive Care:Supportive Care:

•“I treated him . . . God cured him”

(Ambroise Pare’ 1510-90)

(A.Juma)

Musculo-skeletal Trauma

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•Pulmonary support.

•Cardiovascular support.

•Renal support.

•Hepatic support.

•Nutritional support.

•Metabolic support.

•Musculo-skeletal and rehabilitative support.

•Psychological support.

These supportive Care Include:These supportive Care Include:Musculo-skeletal Trauma

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Musculo-skeletal Trauma

Relationship Relationship between mean daily between mean daily

urine nitrogen urine nitrogen excretion for 7 days excretion for 7 days postoperatively, the postoperatively, the

blood level of blood level of branched chain a.a. branched chain a.a.

on the 7th after on the 7th after injury and the initial injury and the initial ketone body levels.ketone body levels.

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Musculo-skeletal Trauma

The concentrated The concentrated ketone bodies in the ketone bodies in the

blood of patients blood of patients after injuryafter injury

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Musculo-skeletal Trauma

Changes in the blood Changes in the blood brached chain a.a. brached chain a.a.

after injuryafter injury