胸腹联合伤现场急救Onsiteemergencyt课件讲解

OnsiteemergencytreatmentforcombinedchestandabdominalinjuriesSpeaker:HuangLing胸腹联合伤现场急救主讲人：黄灵《应急救护技术》EmergencyrescuetechniqueLearningObjectivesMastertheclinicalmanifestationsandon-siteemergencytreatmentofcombinedchestandabdominalinjuriesFamiliarwiththeconceptofthoracoabdominalcombinedinjuryUnderstandtheclassificationofthoracoabdominalcombinedinjuries学习目标掌握胸腹联合伤的临床表现与现场急救熟悉胸腹联合伤的概念了解胸腹联合伤的分类TheconceptofthoracoabdominalcombinedinjuryChestandabdominalcombinedinjury:mainlycausedbyexternalforcedirectlyorindirectlyactingonthehead.胸腹联合伤的概念胸腹联合伤：主要是外力直接或者间接作用于头部所造成的损伤。ClinicalmanifestationsofthoracoabdominalcombinedinjuryThemainmanifestationsofcombinedchestandabdominalpainarechestpain,cough,hemoptysis,shortnessofbreath,cyanosis,abdominalpain,vomiting,increasedpulse,dizziness,palecomplexion,andweakness.Thethoracoabdominaljointinjuryissevereandcomplex,withahighrisk.Theincidenceofshockisashighas60%,andthemortalityrateis25%to35%.ChestpaincoughhemoptysisShortnessofbreathbecomepurplePalecomplexionvomitabdominalpainPulserateincreasesdizzyunable胸腹联合伤的临床表现窒胸腹联合伤主要表现为胸痛、咳嗽、咯血、呼吸急促、发紫、腹痛、呕吐、脉搏加快、头晕、面色苍白、无力等表现。胸腹联合伤情严重而复杂，危险性较大，其休克发生率高达60%，死亡率25%～35%。EmergencytreatmentforcombinedchestandabdominalinjuriesStep1:GetoutofthedangerousenvironmentIfthepatientisfoundtohaveobviouschestandabdominalinjuries,immediatelycalltheemergencynumber,Seekhelpfromthesurroundingpopulationwhileconductinganenvironmentalassessment.ThencheckfirstPatient'sspontaneousbreathingandarterialpulsation,whiledialing120,Seekhelpfromthepeoplearoundyou.胸腹联合伤的急救第一步:脱离危险环境发现患者有明显的胸腹受伤，马上拨打急救电话，寻求周围人群的帮助，同时进行环境评估。之后先检查患者的自主呼吸以及大动脉的搏动情况，同时拨打120，寻求周围人群的帮助。EmergencytreatmentforcombinedchestandabdominalinjuriesStep2:CheckforsurfaceinjuriesUsebandagestoeffectivelyfixthepatient'schest,covertheabdominalwoundwithsterilegauze,andapplypressuretobandageandstopbleeding.Checkifthereareanyinjuriestothecervicalspine.Ifthereareinjuriestothecervicalspine,useaneckbracetofixittopreventfurtherinjuryduringneckmovement;胸腹联合伤的急救第二步:检查体表损伤情况

使用绷带将患者胸部进行有效的固定，使用无菌纱布覆盖腹部伤口，并加压包扎止血，检查颈椎是否合并有损伤，如合并有颈椎损伤，应用颈托固定避免患者颈部活动发生再损伤；EmergencytreatmentforcombinedchestandabdominalinjuriesStep3:InitialRecoveryABCDCheckforcombinedinjuriestootherorgans:Traumapatientsmayhavecombinedinjuriestoorgansinthechestandabdominalcavityandwaitforemergencypersonneltoarriveatthescene胸腹联合伤的急救第三步:初期复苏ABCD

检查是否有合并其它脏器的损伤：外伤患者可合并有胸腹腔内器官的损伤并等待急救人员抵达现场LearningSummaryChestabdominaljointinjurycanoccurinanylocationwithdirectorindirectimpactforce.Learningfirstaidforcombinedchestandabdominalinjuriescanimprovethesurvivalrateoftheinjuredinthefirstplace.