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Clerkship - Trauma

  1. Describe the priorities and sequence of a trauma patient evaluation (ABC's).
  2. Describe the four classes of hemorrhagic shock and how to recognize them.
  3. Describe the appropriate fluid resuscitation of a trauma victim.
  4. Discuss choice of IV access.
  5. Discuss the choice of fluid and use of blood components.
  6. Discuss the differences between adult and pediatric resuscitation.
  7. Discuss the types, etiology and prevention of coagulopathies typically found in patients with massive hemorrhage.
  8. Describe the appropriate triage of a patient in a trauma system.
  9. Describe the diagnostic evaluation, differences between blunt and penetrating mechanisms of injury and the initial management of:
    • Spine injury (consider mechanism of injury, level of injury, use of steroids, immobilization, neuro exam, management of shock)
    • Thoracic injury (consider hemo / pneumothorax, tension pneumothorax, tamponade, pulmonary contusion, massive air leak, widened mediastinum, flail chest)
    • Abdominal injury (consider role of physical exam, ultrasound, CT, peritoneal lavage, operative vs. non-operative management of liver and spleen injury, which patients need urgent laparotomy, management of hematomas)
    • Urinary injury (consider operative vs. non-operative renal injury, ureteral injury, intraperitoneal and extraperitoneal bladder injury, urethral trauma, when not to place a Foley, candidates for cystogram, relationship to pelvic fracture)
  10. Describe the early management of a major burn.
  11. Discuss estimation of total body surface burn and burn depth.
  12. Discuss fluid resuscitation, choice of fluid and monitoring for adequacy of resuscitation (rule of 9's, differences in pediatric and adult management).
  13. Discuss options for topical antimicrobial therapy.
  14. Discuss inhalation injury, CO poisoning and triage of patients to burn centers.
  15. Discuss the basic principles of wound coverage, skin grafting, and timing.
  16. Discuss the assessment and need for escharotomy.

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