Diagnosis in most settings, the initial evaluation and stabilization of traumatic injuries follows the same general principles of identifying and treating immediately lifethreatening injuries. Although the extent of the injury and the involved structures may necessitate surgical treatment, many injuries can be managed non operatively. The American College of surgeons publishes the advanced trauma life support guidelines in the United States. These guidelines codify this general principle and provide a step-by-step approach to the initial assessment, stabilization, diagnostic reasoning, and treatment of traumatic injuries. The assessment typically begins by ensuring that the subject's airway is open and competent, that breathing is unlabored and that circulation i.e., the presence of pulses that can be felt. This is the first step in any resuscitation or triage, and it is sometimes referred to as the A, B, C (Airway, Breathing and Circulation). Then the medical dietary and history of the accident or injury, as well as any information from family, friends, or previous treating physicians that may be available, are added to the information about the accident or injury.

The mnemonic sample is sometimes used to remember this approach. Before performing a laparotomy if necessary, a combination of clinical evaluation and the appropriate use of technology, such as Diagnostic Peritoneal Lavage (DPL) or bedside ultrasound examination, should be used to speed up the diagnosis process. A CT examination can be performed if time and the patient's stability permit. Its benefits include better definition of the injury, which can lead to grading the injury, and sometimes the confidence to avoid or postpone surgery. The patient is hidden from the immediate view of the emergency or surgical staff, despite the fact that the time it takes to acquire images decreases with each generation of scanners. After the initial assessment, a lot of providers use an algorithm like the ATLS guidelines to decide which images to get. Treatment When a patient sustains a blunt trauma that is significant enough to warrant the evaluation of a healthcare professional, treatment typically focuses on treating lifethreatening injuries, which necessitates ensuring that the patient is able to breathe and preventing on-going blood loss. These algorithms take into consideration the mechanism of the injury, the physical examination, and the vital signs of the patient. One or more intravenous lines may be inserted if there is evidence that the patient has lost blood, and crystalloid solutions and/or blood may be administered at rates sufficient to maintain circulation. Some patients may require an exploratory laparotomy to repair internal injuries.

With Regards,
Joseph Kent
Journal Manager
Journal of Trauma & Orthopedic Nursing