Tertiary PoCUS: Role in management of the Trauma patient
Presenter: Dr Kylie Baker
The primary survey of the trauma patient is a rapid clinical survey known by the mnemonic “A, B, C, D, E”. It is repeated regularly, when the patient is moved, or when vital signs worsen. It is useful because it focusses our attention, prioritises solutions, and reduces cognitive load during stress. As a protocol it is limited by insensitive examination skills and compounded by a noisy trauma scenario.
Point of care ultrasound can offer increased sensitivity over the clinical exam – and is repeatable, portable, measurable, comparable and auditable. Already the standard of care in many trauma interventions, it is well worth knowing how- and how not - to extend its use into monitoring of the unstable patient.
Using cases, this session shows how bedside ultrasound can be used in a rapid ‘A, B, C, D, E’ assessment to troubleshoot a lined and tubed patient, specifically considering pneumothorax, line and tube function, basic haemodynamic measures, GIT health and the ongoing controversy over IVC measurement.