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a person had a severe accident with neck injuries. he is unconsious and apneic. what is the next step
1 first rule out cervical spine injury with xray then if negative u can do orotracheal intubation. i dont know if it is positive what should be done.......
2 nasotracheal intubation with fibre optic bronchoscopy without extending the neck then do neck xray.
PLEASE EXPLAIN UR ANSWER.
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if no facial trauma go ahead with nasal fibreoptic intubation. since the pt is unconscious/apenic...ABC...right!
since intubation is underdirect vision, u will not have to manupilate the neck in a pt with bad neck injuries...that is why fiberoptic.
then transport to radiology for the imaging.
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yes u r right cricoid. this is what kaplan says. but UW says first do xray and if it is neg then u can do orotracheal intubation. it did not explain what we should do if neck xray shows injury.
which one should we follow.
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kaplan...coz i am telling you real life management...
no matter how bad the injuries are....airway first in unconcious/apenic pt....
i have seen facial fracture...bad ones...unclear neck....unconscious pts getting intubated first and than x-ray etc...
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that sounds good. thanks. r u a resident?
what are u studying for surgery.
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Hey cricoid one more q.
in shock we use ringer lactate without sugar. can u explain why without sugar.
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i am a resident of my house...lol...
i have not studied surgery yet, but will review step 3 kaplan notes...they are good...
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trauma/stress....high adrenaline state....
adrenaline messe up the insulin's action on target receptors...thus you have hyperglycemia...
you do not want to potentiate that....
