Mechanism of Injury
Primary Survey
Airway
Breathing
- Chest movement ,breath sound
- SpO2, ABG
Circulation
- IV access
Disability
Exposure
Needle thoracostomy
2nd ICS, MCL
Gush of air confirms diagnosis
Insert chest tube afterwards
5th ICS, anterior to MAL
Haemodynamic resuscitation
Aim for SBP 80-100 in patients without head or spinal injury
Intubation
Modified jaw thrust
Rapid sequence induction
- Preoxygenate for 3-5 minutes, 100% oxygen
- Cricoid pressure
- Gum elastic bougie
Anticipate failed intubation