Thanks to this Professional master’s degree you will be able to combine your medical responsibilities with a first level update in Trauma”

In recent years, the improvement and technical progress in diagnostic devices such as computed tomography, portable ultrasound or advanced monitoring mark the evaluations of trauma patients in the ICU. At the same time, there have been notable advances in the medications used, all supported by scientific-medical studies. This scenario leads professionals to carry out daily multidisciplinary work and employ new therapeutic strategies.

Faced with this reality, doctors are constantly updating their skills and abilities to deal with complex clinical situations. For this reason, TECH has developed this Professional master’s degree of 1,500 teaching hours, created by an excellent team of specialists with experience in hospitals.

This is a program that will lead the graduate to delve into the approach to emergent situations, rapid decision making and precise coordination with the different teams of specialists. It will also delve into the planning of rehabilitation and recovery of traumatized patients or the latest technology used in life support devices and advanced assessment tools.

A syllabus that acquires greater dynamism thanks to the multimedia pills and the wide variety of didactic resources such as specialized readings or case studies. In addition, the Relearning methodology used by this academic institution will allow the professional to achieve a much more effective update in a shorter period of time.

A unique opportunity to keep up-to-date through an online and flexible teaching option, which favors the compatibility of the most demanding daily responsibilities with a university proposal that is at the forefront.

Do you want to be aware of the most effective strategies for dealing with traumatized patients in special situations? Do it thanks to this program”

This Professional master’s degree in Severe Trauma in the ICU contains the most complete and up-to-date scientific program on the market. The most important features include:

• The development of practical cases presented by experts in Severe Trauma in ICU
• The graphic, schematic, and practical contents with which they are created, provide scientific and practical information on the disciplines that are essential for professional practice
• Practical exercises where self-assessment can be used to improve learning
• Its special emphasis on innovative methodologies
• Theoretical lessons, questions to the expert, debate forums on controversial topics, and individual reflection assignments
• Content that is accessible from any fixed or portable device with an Internet connection

Delve into the prevention of complications and pain management in trauma with the best multimedia content”

The program’s teaching staff includes professionals from the field who contribute their work experience to this educational program, as well as renowned specialists from leading societies and prestigious universities.

Its multimedia content, developed with the latest educational technology, will allow the professional a situated and contextual learning, that is, a simulated environment that will provide an immersive education programmed to learn in real situations.

This program is designed around Problem-Based Learning, whereby the professional must try to solve the different professional practice situations that arise during the academic year For this purpose, the students will be assisted by an innovative interactive video system created by renowned and experienced experts.

Delve into the latest emergency response protocols, injury severity assessment and stabilization techniques”

Upgrade through the most comprehensive Severe Trauma ICU program created by the world's largest digital university”

The syllabus of this Professional master’s degree has been developed by a multidisciplinary teaching team that will bring the physician up to date on the methods of diagnosis, evaluation and the most effective strategies to address severe traumatic injuries in ICU. All this, over 12 months and with the best teaching materials, available in a virtual library, accessible 24 hours a day, 7 days a week and from any electronic device with internet connection.

A syllabus that will keep you up-to-date on the most advanced ICU technologies for trauma patient care”

Module 1. Traumatic Disease in Public Health

1.1. Epidemiology of traffic accidents

1.1.1. Traffic Accidents
1.1.2. Definition
1.1.3. Importance
1.1.4. Epidemiology
1.1.5. Prevention

1.2. Influence of the consumption of medicines, alcohol, drugs and certain pathologies on driving

1.2.1. Drug and alcohol use
1.2.2. Influence of drug use on driving
1.2.3. Action of health professionals when prescribing medication to the driving patient
1.2.4. Action to be taken by driver-patients
1.2.5. Alcohol and driving

1.2.5.1. Legal regulations on alcohol and driving
1.2.5.2. Pharmacokinetics of alcohol and factors determining its concentration in blood
1.2.5.3. Effects of alcohol on driving

1.2.6. Illegal drugs and driving

1.2.6.1. Types of drugs and their effects on driving

1.3. Biomechanics of Accidents

1.3.1. Accidents
1.3.2. Historical Aspects
1.3.3. Fases de la colisión
1.3.4. Principles of biomechanics
1.3.5. Biomechanics of injuries according to anatomical area and type of accident

1.3.5.1. Automobile accidents
1.3.5.2. Motorcycle, moped and bicycle accidents
1.3.5.3. Truck and bus accidents

1.4. Organization of care in severe traumatic pathology

1.4.1. Configuration of the trauma team
1.4.2. Characteristics of a successful team
1.4.3. Roles and responsibilities of the team leader

1.4.3.1. Team perception
1.4.3.2. Receiving the report
1.4.3.3. Team management and reaction to information
1.4.3.4. Team feedback
1.4.3.5. Communication with the patient's family

1.4.4. Effective leadership

1.4.4.1. Qualities and behavior of an effective team leader
1.4.4.2. Culture and climate

1.4.5. Roles and responsibilities of team members

1.4.5.1. Team members
1.4.5.2. Responsibility of the members

1.4.5.2.1. Prepare for the patient
1.4.5.2.2. Receive report
1.4.5.2.3. Assess and manage the patient
1.4.5.2.4. Participate in feedback

1.5. Severity indexes in trauma

1.5.1. Valuation indexes
1.5.2. Glasgow Scale
1.5.3. Abbreviated injury scale
1.5.4. Injury severity assessment
1.5.5. Characterization of the severity of the traumatized patient

1.6. Records, severity and avoidable mortality scales

1.6.1. Scales
1.6.2. Physiological scales

1.6.2.1. Glasgow
1.6.2.2. Revised trauma score (RTS)
1.6.2.3. Pediatric trauma score or pediatric trauma index (ITP)

1.6.3. Anatomical scales

1.6.3.1. Abbreviated injury sclae (AIS)
1.6.3.2. Injury severity score (ISS)
1.6.3.3. New Injury severity score (NISS)
1.6.3.4. Organ injury scales (OIS)
1.6.3.5. Penetrating abdominal trauma index (PATI)

1.6.4. Combined scales

1.6.4.1. TRISS scale or model
1.6.4.2. International Classification of Diseases Injury Severity Score (ICISS)
1.6.4.3. Trauma Mortality Predition Model (TMPM)
1.6.4.4. Trauma Risk Adjustment Model (TRAM)
1.6.4.5. Sequential Trauma Score (STS)

1.6.5. Avoidable mortality and errors in trauma

1.7. Quality and safety in trauma care?

1.7.1. Quality and Safety
1.7.2. Definition of concepts, quality and safety
1.7.3. Ensuring effective team communication
1.7.4. Record keeping, protocols, checklists, etc
1.7.5. Risk Management
1.7.6. Conflict Management

1.8. Simulation-based trauma team training

1.8.1. Team building
1.8.2. Simulation-based training concepts
1.8.3. Development of a FEBS (Simulation Based Team Building) program

1.8.3.1. Comprehensive needs analysis
1.8.3.2. Simulation design: Event-based team building

1.8.3.2.1. Selection of competencies
1.8.3.2.2. Training Objectives

1.8.3.3.2.3. clinical context

1.8.3.2.4. Development of the scenario
1.8.3.2.5. Expected responses
1.8.3.2.6. Measurement Tools
1.8.3.2.7. Scenario script

1.8.3.3. Debriefing

1.8.3.3.1. Debriefing
1.8.3.3.2. Briefing-prebriefing 
1.8.3.3.3. Objectives
1.8.3.3.4. Conventional techniques and support for debriefing
1.8.3.3.5. Evaluation Systems

1.9. Bibliographic resources

1.9.1. New paths for training

1.9.1.1. Use of innovative teaching resources

1.9.1.1.1. Learning based on clinical cases
1.9.1.1.2. Inverted classroom model
1.9.1.1.3. Clinical simulation
1.9.1.1.4. Gamification
1.9.1.1.5. Clinical discussions

1.9.1.2. Adaptation to the current cognitive model

1.10. Trauma-related social networks

1.10.1. Use of new digital resources for training

1.10.1.1. FODMed and social networks
1.10.1.2. Twitter as an educational tool

1.10.2. Impact of digital transformation on research

1.10.2.1. Dissemination in social networks
1.10.2.2. Big Data

1.10.3. Impact of social networks on healthcare

1.10.3.1. Introduction
1.10.3.2. Use of social networks by health care professionals and organizations
1.10.3.3. Use of social networks and digital media by patients and their environment
1.10.3.4. Impact on the user
1.10.3.5. Impact on the relationship with health professionals

1.10.4. Good practices in social networks

Module 2. Prehospital Trauma Management

2.1. General activation recommendations

2.1.1. Recommendations
2.1.2. What should I do?
2.1.3. Golden rules for a polytraumatized patient
2.1.4. Useful recommendations in case of traveling

2.2. Care priorities in on-site care and in medical transport

2.2.1. Scene assessment

2.2.1.1. Approach to the scene of intervention
2.2.1.2. Scene management and handling
2.2.1.3. Triage
2.2.1.4. Management of additional resources

2.2.2. Primary assessment and urgent actions

2.2.2.1. Initial estimate (General impression)
2.2.2.2. Control of exsanguinating hemorrhages
2.2.2.3. Airway and Ventilation
2.2.2.4. Circulatory status
2.2.2.5. Neurological Status
2.2.2.6. Exposure and transition to secondary assessment

2.3. Life support and integral coordination in traffic accidents

2.3.1. Definitions
2.3.2. Objectives of life support
2.3.3. Basic and advanced life support sequences in adults
2.3.4. Analysis of the main changes in the recommendations
2.3.5. Risk of disease transmission for the resuscitator during CPR
2.3.6. Lateral Safety Position
2.3.7. Algorithm of BLS/AVS in adults

2.4. General self-protection and safety measures

2.4.1. Scope
2.4.2. Identification of the licensees and the site of the activity
2.4.3. Description of the activity and physical environment

2.4.3.1. Description of the activity that is the subject of the self-protection plan
2.4.3.2. Description of the establishment, premises and facilities
2.4.3.3. Description of the surroundings
2.4.3.4. Description of accesses

2.4.4. Inventory, analysis and risk assessment

2.4.4.1. Description and location of risks
2.4.4.2. Analysis and evaluation of risks specific to the activity and external risks

2.5. Wound Classification

2.5.1. Classification
2.5.2. Skin Anatomy
2.5.3. Concept, classification and clinic of wounds
2.5.4. Treatment of Wounds
2.5.5. Wounds caused by stab wounds and firearms

2.5.5.1. Stab Wounds

2.5.5.1.1. Definition and classification of stabbing weapons

2.5.5.1.1.1. Stab wounds
2.5.5.1.1.2. Sharp stab wounds
2.5.5.1.1.3. Stab wounds due to a sharp stabbing weapon
2.5.5.1.1.4. Wounds due to sharp and blunt stab wounds

2.5.5.1.2. Gunshot Wounds

2.5.5.1.2.1. Morphology of firearm wounds
2.5.5.1.2.2. Clinical aspects and treatment

2.6. Activation of rescue teams

2.6.1. Activation
2.6.2. Traffic Accident Victims Unit
2.6.3. Emergency coordinating center

2.6.3.1. Reception and control phase of the warning call
2.6.3.2. Phase of assessment or medical regulation of data
2.6.3.3. Phase of assistance response, follow-up and control
2.6.3.4. Health action phase

2.6.3.4.1. Arrival and assessment of the incident
2.6.3.4.2. Organization of the scene and its environment
2.6.3.4.3. Location of affected persons and triage (classification)
2.6.3.4.4. Assistance and evacuation of the injured

2.7. Techniques of deescarcelation and extrication

2.7.1. Preparation
2.7.2. Response and recognition
2.7.3. Control
2.7.4. Vehicle stabilization
2.7.5. Boarding: access to the victim
2.7.6. Stabilization of the victim and de-escarceration
2.7.7. Extraction and termination
2.7.8. Necessary Material
2.7.9. The airbag

2.8. Immobilization of the severely traumatized patient

2.8.1. Extrication
2.8.2. Who should we perform RME?
2.8.3. With what means do we perform the RME?
2.8.4. How do we perform the EMR?

2.9. Assessment of the injured patient in the out-of-hospital setting

2.9.1. Patients
2.9.2. Initial Assessment

2.9.2.1. Airway, cervical spine control
2.9.2.2. Ventilation
2.9.2.3. Circulation
2.9.2.4. Neurological Status
2.9.2.5. Patient exposure
2.9.3. Second Evaluation

2.10. Pathophysiology of medical transport and recommendations during patient transport

2.10.1. Concept
2.10.2. History
2.10.3. Classification

2.10.3.1. Transporte aéreo
2.10.3.2. Transporte terrestre

2.10.4. Pathophysiology of out-of-hospital transport

2.10.4.1. Accelerations
2.10.4.2. Mechanical and acoustic vibrations

2.10.5. Indications and contraindications of the helicopter
2.10.6. Prevention of disturbances due to transport
2.10.7. Destination
2.10.8. Means of transport
2.10.9. Assistance during transfer
2.10.10. Transfer
2.10.11. Assistance material

Module 3. Initial Trauma Care in the ICU Hospital

3.1. Indications for transfer to a trauma center

3.1.1. Indications
3.1.2. Determine the need to transfer the patient

3.1.2.1. Relocation factors

3.1.2.1.1. Primary screening: Airway
3.1.2.1.2. Primary screening: Breathing
3.1.2.1.3. Primary screening: Circulation
3.1.2.1.4. Primary screening: Neurological Deficit
3.1.2.1.5. Primary screening: Exhibition
3.1.2.1.6. Secondary review: Head and Neck
3.1.2.1.7. Maxillofacial

3.1.2.2. Timing of transfer

3.1.2.2.1. Evaluate anatomy of the injury
3.1.2.2.2. Evaluate mechanisms of injury and evidence of high energy impact
3.1.2.2.3. Evaluate special patients, pediatrics, elderly, obese, pregnant women

3.2. Assistance in the Vital Box of the hospital. Organization and care team

3.2.1. Objectives
3.2.2. Organization of the care team
3.2.3. Characteristics of the Vital Trauma Care Box
3.2.4. Recommended protective measures

3.3. Primary assessment and initial resuscitation

3.3.1. Primary screening with simultaneous resuscitation

3.3.1.1. Airway with restriction of cervical spine motion
3.3.1.2. Breathing and ventilation
3.3.1.3. Circulation with hemorrhage control

3.3.1.3.1. Blood volume and cardiac output
3.3.1.3.2. Bleeding

3.3.1.4. Neurological evaluation (deficit)
3.3.1.5. Exposure and environmental monitoring

3.3.2. Life threatening injuries

3.3.2.1. Airway problems

3.3.2.1.1. Airway obstruction
3.3.2.1.2. Bronchial tree injury

3.3.2.2. Respiratory Problems

3.3.2.2.1. Hypertensive pneumo
3.3.2.2.2. Open pneumothorax
3.3.2.2.3. Massive hemothorax

3.3.2.3. Circulatory problems

3.3.2.3.1. Massive hemothorax
3.3.2.3.2. Cardiac Tamponade
3.3.2.3.3. Traumatic circulatory arrest

3.4. Second Evaluation

3.4.1. History

3.4.1.1. Mechanism of injury and suspected patterns
3.4.1.2. Environment
3.4.1.3. Previous state of injury and predisposing factors
3.4.1.4. Pre-hospital care observations

3.4.2. Physical Examination

3.4.2.1. Introduction
3.4.2.2. Look and ask
3.4.2.3. Assess head, neck, thorax, abdomen and pelvis
3.4.2.4. Circulatory evaluation
3.4.2.5. Radiological Examination

3.5. Anti-tetanus and antibiotic prophylaxis

3.5.1. Indications
3.5.2. Guidelines
3.5.3. Dosage

3.6. Airway and ventilatory management

3.6.1. First Steps
3.6.2. Recognition of the Problem

3.6.2.1. Maxillofacial trauma
3.6.2.2. Laryngeal trauma

3.6.3. Objective signs of airway obstruction
3.6.4. Ventilation

3.6.4.1. Recognition of the Problem
3.6.4.2. Objective signs of inadequate ventilation

3.7. Prediction of difficult airway management

3.7.1. Airway
3.7.2. Potential difficulties
3.7.3. LEMON evaluation for difficult intubation

3.7.3.1. External look
3.7.3.2. Evaluates the 3-3-2 rule
3.7.3.3. Mallampati
3.7.3.4. Obstruction
3.7.3.5. Neck mobility

3.8. Airway Management

3.8.1. Airway Management

3.8.1.1. Predict the management of a difficult airway
3.8.1.2. Airway decision scheme

3.8.2. Airway maintenance techniques

3.8.2.1. Chin lift maneuver
3.8.2.2. Mandibular traction maneuver
3.8.2.3. Nasopharyngeal airway
3.8.2.4. Oropharyngeal airway
3.8.2.5. Extra glottic or supraglottic devices

3.8.2.5.1. Laryngeal mask and laryngeal mask for intubation
3.8.2.5.2. Laryngeal tube and laryngeal tube for intubation
3.8.2.5.3. Multilumen esophageal airway

3.8.3. Definitive airways

3.8.3.1. Orotracheal Intubation
3.8.3.2. Surgical airway

3.8.3.2.1. Needle cricothyroidotomy
3.8.3.2.2. Surgical cricothyroidotomy

3.9. Errors and occult injuries in trauma. Tertiary recognition

3.9.1. Tertiary recognition

3.9.1.1. Indicators of Quality of Care

3.9.2. Errors in initial care

3.9.2.1. Most frequent errors in the different phases of initial care
3.9.2.2. Types of Error

3.9.3. Occult injury or undiagnosed injury (NLI)

3.9.3.1. Definition. Incidence
3.9.3.2. Confounding variables contributing to the occurrence of NLD

3.9.3.2.1. Unavoidable factors
3.9.3.2.2. Potentially avoidable factors

3.9.3.3. Most frequent NLD

3.9.4. Tertiary recognition

3.9.4.1. Definition
3.9.4.2. Importance of continuous revaluation

3.10. Registration and transfer

3.10.1. Referring physician
3.10.2. ABC-SBAR for trauma patient transfer
3.10.3. Receiving Physician
3.10.4. Mode of transport
3.10.5. Transfer protocol

3.10.5.1. Referring physician information
3.10.5.2. Information for transfer personnel
3.10.5.3. Documentation
3.10.5.4. Treatment during transfer
3.10.5.5. Data for relocation

Module 4. Management of Severe Trauma in ICU

4.1. Severe trauma

4.1.1. Severe trauma
4.1.2. Indications
4.1.3. Conclusions

4.2. Mechanism of injury and suspicious lesion patterns

4.2.1. Mechanism of injury
4.2.2. Frontal impact (vehicular collision)

4.2.2.1. Cervical spine fracture
4.2.2.2. Unstable anterior thorax
4.2.2.3. Cardiac contusion
4.2.2.4. Pneumothorax
4.2.2.5. Traumatic rupture of the aorta
4.2.2.6. Splenic or hepatic laceration
4.2.2.7. Fracture, posterior dislocation of the knee and/or hip
4.2.2.8. TBI
4.2.2.9. Facial Fractures

4.2.3. Lateral impact (vehicular collision)

4.2.3.1. Contralateral cervical sprain
4.2.3.2. TBI
4.2.3.3. Cervical spine fracture
4.2.3.4. Lateral unstable thorax
4.2.3.5. Pneumothorax
4.2.3.6. Traumatic rupture of the aorta
4.2.3.7. Diaphragmatic rupture
4.2.3.8. Splenic/hepatic and/or renal laceration depending on the side of the impact

4.2.4. Rear impact (vehicular collision)

4.2.4.1. Cervical spine injury
4.2.4.2. TBI
4.2.4.3. Cervical soft tissue injury

4.2.5. Vehicle ejection

4.2.5.1. Ejection, prevents true prediction of injury patterns, higher risk patient

4.2.6. Vehicle impacts pedestrian

4.2.6.1. TBI
4.2.6.2. Traumatic rupture of the aorta
4.2.6.3. Visceral abdominal injuries
4.2.6.4. Fractures of lower extremities

4.2.7. Fall from height

4.2.7.1. TBI
4.2.7.2. Axial spine trauma
4.2.7.3. Visceral abdominal injuries
4.2.7.4. Fracture of the pelvis or acetabulum
4.2.7.5. Bilateral fracture of lower extremities (including calcaneal fracture)

4.2.8. Stab wound

4.2.8.1. Anterior thorax

4.2.8.1.1. Cardiac Tamponade
4.2.8.1.2. Hemothorax
4.2.8.1.3. Pneumothorax
4.2.8.1.4. Hemopneumothorax

4.2.8.2. Left thoracoabdominal

4.2.8.2.1. Injury of the left diaphragm, injury of the spleen, hemothorax
4.2.8.2.2. Abdomen, possible abdominal visceral injury if peritoneal penetration 

4.2.9. Wounded by firearm

4.2.9.1. Trunk

4.2.9.1.1. High probability of injury
4.2.9.1.2. Retained projectiles help predict injury

4.2.9.2. Extremity

4.2.9.2.1. Neurovascular injury
4.2.9.2.2. Fractures
4.2.9.2.3. Compartment Syndrome

4.2.10. Thermal burns

4.2.10.1. Circumferential eschar on extremity or thorax
4.2.10.2. Occult trauma (mechanism of burn/means of escape)

4.2.11. Electrical burns

4.2.11.1. Cardiac arrhythmia
4.2.11.2. Myonecrosis / Compartment syndrome

4.2.12. Inhalation burns

4.2.12.1. Carbon Monoxide Poisoning
4.2.12.2. Airway edema
4.2.12.3. Pulmonary Edema

4.3. Importance of triage

4.3.1. Triage
4.3.2. Definition
4.3.3. Relevance

4.4. Resource mobilization

4.4.1. Resources
4.4.2. Configuration of the trauma team
4.4.3. Receiving the report

4.4.3.1. Mechanisms
4.4.3.2. Lesions
4.4.3.3. Signs
4.4.3.4. Treatment and travel

4.4.4. Direct the team and reacting to information: Assess and manage the patient

4.4.4.1. Airway control and cervical spine motion restriction
4.4.4.2. Breathing with ventilation
4.4.4.3. Circulation with hemorrhage control
4.4.4.4. Neurological Deficit
4.4.4.5. Exposure and environment
4.4.4.6. Record keeping

4.5. Dual Response Trauma Care

4.5.1. Triage as severe trauma. Definition
4.5.2. Triage as potentially severe trauma. Definition
4.5.3. Dual Response Trauma Care Teams

4.5.3.1. High level response
4.5.3.2. Low-level response

4.5.4. Dual-response attention management algorithm

4.6. Treatment of the potentially critically ill patient

4.6.1. Severe patient
4.6.2. Criteria for potentially severe patient

4.6.2.1. Physiological criteria
4.6.2.2. Anatomical criteria
4.6.2.3. Injury mechanism
4.6.2.4. Circumstances to take into account

4.7. Complementary tests in the screening for occult lesions

4.7.1. Tests
4.7.2. Initial Assessment

4.7.2.1. Airway
4.7.2.2. Ventilation
4.7.2.3. Circulation
4.7.2.4. Neurology
4.7.2.5. Exhibition

4.7.3. Second Evaluation

4.7.3.1. Head and face
4.7.3.2. Neck
4.7.3.3. Chest
4.7.3.4. Abdomen
4.7.3.5. Perineum
4.7.3.6. Back
4.7.3.7. Extremities

4.7.4. Nexus/CRR criteria for cervical injury screening
4.7.5. Duty criteria for cervical vascular lesion screening

4.8. Laboratory Data

4.8.1. Laboratory
4.8.2. Request for Tests
4.8.3. Systematic review

4.9. Imaging Techniques

4.9.1. Image
4.9.2. TBI
4.9.3. Cervical Trauma and detection of cervical vascular injury
4.9.4. Thoracic Trauma
4.9.5. Dorsolumbar Spinal Trauma
4.9.6. Genitourinary Trauma
4.9.7. Pelvic and Orthopedic Trauma

4.10. Registration and transfer

4.10.1. Referring physician
4.10.2. ABC-SBAR for trauma patient transfer
4.10.3. Receiving Physician
4.10.4. Transfer protocol

4.10.4.1. Referring physician information
4.10.4.2. Information for transfer personnel
4.10.4.3. Documentation
4.10.4.4. Data for relocation

Module 5. Advanced ICU care

5.1. The role of care in the trauma care team

5.1.1. Caregiving
5.1.2. Out-of-hospital care, a field in its own right
5.1.3. Care nucleus
5.1.4. Research
5.1.5. Teaching
5.1.6. Administration and management
5.1.7. Bioethical Aspects
5.1.8. Legal aspects
5.1.9. Techniques, skills, signs and symptoms in emergency care

5.2. Pre-hospital care in severe trauma care

5.2.1. Pre-hospital care
5.2.2. Nursing care in TBI

5.2.2.1. Nursing care in the emergency phase

5.2.2.1.1. Neurologic
5.2.2.1.2. Hemodynamic
5.2.2.1.3. Respiratory
5.2.2.1.4. Renal

5.2.2.2. Nursing care in acute spinal cord trauma

5.2.2.2.1. Hemodynamic complications
5.2.2.2.2. Respiratory Complications

5.2.2.3. Nursing care in thoracic trauma
5.2.2.4. Nursing care in abdominal and pelvic trauma
5.2.2.5. Nursing care in orthopedic trauma

5.3. Phases of prehospital care

5.3.1. Pre-hospital care
5.3.2. Scene assessment

5.3.2.1. Approach to the scene of intervention
5.3.2.2. Scene management and handling
5.3.2.3. Triage
5.3.2.4. Management of additional resources

5.4. The process of initial care in severe trauma

5.4.1. Review and preparation of the reception area
5.4.2. Activation of the team
5.4.3. Reception of the patient
5.4.4. Patient transfer

5.5. Development of actions in the initial assessment

5.5.1. Nurse A: airway

5.5.1.1. Airway and Ventilation

5.5.2. Nurse B: circulation

5.5.2.1. Control of exsanguinating hemorrhages

5.5.3. Assessment of neurological status

5.6.  Secondary examination

5.6.1. Assessment
5.6.2. Concomitant management in initial care

5.6.2.1. Controlling Temperature
5.6.2.2. Bladder catheterization and oropharyngeal gastric catheterization
5.6.2.3. Analgesia and techniques requiring sedation
5.6.2.4. Tetanus prophylaxis and antibiotherapy

5.6.3. Coordination with the trauma team leader and team for intrahospital transfer after imaging tests or urgent therapeutic actions
5.6.4. Assessment and sterile dressing of traumatic or postoperative wounds
5.6.5. Initiation of pharmacological treatment as appropriate

5.7. Systematic review

5.7.1. Reassessment of life-threatening emergency priorities
5.7.2. Record sheet completed and signed
5.7.3. Secondary examination
5.7.4. Continued re-evaluation during the initial hours

5.7.4.1. Vital signs
5.7.4.2. Pupils, level of consciousness, GCS
5.7.4.3. Control of catheters, perfusions, drains and catheters
5.7.4.4. Monitoring: EKG, pulse oximetry, respirator, etc

5.8. Family Care

5.8.1. Family
5.8.2. Information division

5.8.2.1. Current Situation
5.8.2.2. Evolution and Prognosis

5.8.3. Accompaniment: Explain operation and schedules

5.9. Management of psychic trauma

5.9.1. Psychic trauma
5.9.2. How to understand psychic trauma
5.9.3. Families
5.9.4. How To Act
5.9.5. Attitude in the out-of-hospital and hospital environment
5.9.6. How to communicate
5.9.7. Prevention

5.10. Intrahospital Transport

5.10.1. Intrahospital Transport
5.10.2. ABC-SBAR for patient transfer
5.10.3. Intrahospital transfer protocol

5.10.3.1. Transfer checklist
5.10.3.2. Transfer nurse report
5.10.3.3. Documentation

Module 6. Radiology, complications and rehabilitation in trauma in the ICU

6.1. Radiology in ICU

6.1.1. Definition
6.1.2. Structure
6.1.3. Conclusions

6.2. Imaging management and protocols in the severely polytraumatized patient

6.2.1. Assessment of clinical criteria

6.2.1.1. Criteria for severity and suspicion of severe trauma

6.2.1.1.1. Vital Signs
6.2.1.1.2. Obvious injuries
6.2.1.1.3. High energy injury mechanism

6.2.1.2. Assessment according to signs and vital signs

6.2.1.2.1. Dynamically stable hemo: Complete CT scan
6.2.1.2.2. Dynamically unstable hemo: Echo-fast

6.2.2. Standard CT Protocol: Patients with severity criteria without signs of shock

6.2.2.1. Cranial CT without contrast
6.2.2.2. Cervical spine CT without contrast

6.2.2.2.1. Bone window
6.2.2.2.2. Soft tissue window

6.2.2.3. Thorax-abdomen-pelvis CT with contrast

6.2.2.3.1. Arterial phase study
6.2.2.3.2. Portal phase study
6.2.3. Shock protocol: Severity criteria and with signs of shock

6.2.3.1. CT without VSD: Chest, abdomen and pelvis

6.2.3.1.1. Arterial and venous phase
6.2.3.1.2. Late phase

6.2.4. Protocol for high suspicion of bladder-urethral injury

6.2.4.1. CT scan without VSD of the abdomen and pelvis

6.2.5. Other situations

6.2.5.1. Suspicion of cervical vessel lesion
6.2.5.2. Clinical suspicion of large complex facial fractures
6.2.5.3. Suspected traumatic rupture of the esophagus

6.3. Ultrasound in the initial care of the polytraumatized patient

6.3.1. Ultrasound
6.3.2. What is Echo-fast?
6.3.3. Indications
6.3.4. Information provided and attitude derived according to findings

6.4. TBI

6.4.1. TBI
6.4.2. Study Protocol
6.4.3. Systematic search for findings

6.4.3.1. Intra-extraxial hematomas
6.4.3.2. Mass effect exerted by these hematomas: ventricular or sulcus collapse, obstruction of basal cisterns, signs of cerebral herniation
6.4.3.3. Traces of bone fracture, calotte and skull base
6.4.3.4. Fracture traces and alignment of vertebral somas in sagittal plane

6.5. Cervical trauma

6.5.1. Cervical trauma
6.5.2. Study Protocol
6.5.3. Systematic search for findings

6.5.3.1. Lesions of large cervical vessels
6.5.3.2. Cervical vertebral fractures, assess signs of instability, assess possible extravasation of associated contrast

6.6. Trauma of the dorsolumbar spine

6.6.1. Dorsolumbar spine
6.6.2. Study Protocol
6.6.3. Systematic search for findings

6.6.3.1. Thoracoabdominal great vessels lesions
6.6.3.2. Dorsolumbar vertebral fractures, assess signs of instability, assess for possible extravasation of associated contrast

6.7. Thoracic Trauma

6.7.1. Chest
6.7.2. Study Protocol
6.7.3. Systematic search for findings

6.7.3.1. Injury of great thoracic vessels
6.7.3.2. Hemo or pneumomediastinum
6.7.3.3. Hemo or pneumothorax: Secondary mediastinal deviation
6.7.3.4. Pulmonary laceration, pulmonary contusive foci, airway lesion
6.7.3.5. Single/multiple costal fracture traces
6.7.3.6. Dorsal vertebral fractures, assess if listhesis, signs of instability

6.8. Abdominal Trauma

6.8.1. Abdomen
6.8.2. Study Protocol
6.8.3. Systematic search for findings

6.8.3.1. Lesion of great abdominal vessels
6.8.3.2. Hemo or pneumoperitoneum, high/low density free fluid
6.8.3.3. Splenic or hepatic visceral lesion
6.8.3.4. Lumbar vertebral fractures, assess signs of instability, assess possible points of associated contrast extravasation

6.9. Pelvic Trauma

6.9.1. Pelvis
6.9.2. Study Protocol
6.9.3. Systematic search for findings

6.9.3.1. Pelvic great vessels lesion
6.9.3.2. Hemo or pneumoperitoneum, high/low density free fluid
6.9.3.3. Renal injury

6.10. Endovascular techniques and the hybrid operating room

6.10.1. Operating Theatre
6.10.2. Intervention Techniques

6.10.2.1. Interventionism in pelvic trauma

6.10.2.1.1. Indications

6.10.2.2. Interventional procedures in liver trauma

6.10.2.2.1. Indications

6.10.2.3. Interventional procedures in splenic and renal trauma

6.10.2.3.1. Indications

6.10.2.4. Interventional procedures in thoracic trauma
6.10.2.5. Indications

6.10.3. What is the hybrid operating room?
6.10.4. Present and future of the hybrid OR

Module 7. Management of shock in ICU trauma

7.1. Objectives end points of trauma resuscitation

7.1.1. Resuscitation
7.1.2. Pathophysiology
7.1.3. Global parameters

7.1.3.1. Clinical parameters, physical examination, vital signs
7.1.3.2. Hemodynamic parameters: Optimization of volemia
7.1.3.3. Hemodynamic parameters: Cardiac work
7.1.3.4. End-expiratory CO2 values (End-tidal CO2)
7.1.3.5. Oximetric values
7.1.3.6. Measurement of tissue metabolism anaerobiosis

7.1.4. Regional parameters

7.1.4.1. Gastric mucosal tonometry
7.1.4.2. Sublingual capnography
7.1.4.3. Tissue oximetry and capnometry
7.1.5.4. Near Infrared Spectrometry (NIRS)

7.1.5. Conclusions

7.2. Multi-organ dysfunction in trauma

7.2.1. Dysfunction
7.2.2. Pathophysiology
7.2.3. Classification

7.2.3.1. Early Onset
7.2.3.2. Late Onset

7.2.4. Diagnosis

7.2.4.1. Scales
7.2.4.2. Risk Factors

7.2.5. Therapeutic Approach

7.2.5.1. Cardiorespiratory support
7.2.5.2. Damage control surgeries
7.2.5.3. Surgeries for debridement of infectious foci
7.2.5.4. Blood volume and blood products supply
7.2.5.5. Others: Protective mechanical ventilation and nutrition

7.2.6. Conclusions

7.3. Hemorrhagic shock

7.3.1. Recognition of the state of shock
7.3.2. Clinical differentiation of shock etiology

7.3.2.1. General description of hemorrhagic shock

7.3.3. Physiological classification

7.3.3.1. Grade I hemorrhage >15% blood volume loss
7.3.3.2. Hemorrhage grade II 15-30% of blood volume loss
7.3.3.3. Hemorrhage grade III 31-40% of blood volume loss
7.3.3.4. Hemorrhage grade IV >40% blood volume loss

7.3.4. Initial management of hemorrhagic shock

7.3.4.1. Physical Examination

7.3.4.1.1. Airway and Breathing
7.3.4.1.2. Circulation, hemorrhage control
7.3.4.1.3. Neurological Deficit
7.3.4.1.4. Exposure: complete examination

7.3.4.2. Vascular Access
7.3.4.3. Initial treatment with liquids
7.3.4.4. Blood restitution

7.3.4.4.1. Crossmatching tests
7.3.4.4.2. Prevention of hypothermia
7.3.4.4.3. Autotransfusion
7.3.4.4.4. Massive transfusion
7.3.4.4.5. Coagulopathy
7.3.4.4.6. Calcium administration

7.4. Systemic inflammatory response syndrome and sepsis in severe trauma

7.4.1. Systemic inflammatory response
7.4.2. CNS

7.4.2.1. Common infections
7.4.2.2. Treatment
7.4.2.3. Antibiotic prophylaxis for CNS infections

7.4.3. Pneumonia
7.4.4. Fracture-related infections

7.4.4.1. Introduction
7.4.4.2. Factors associated with infection
7.4.4.3. Diagnosis of fracture-related infection
7.4.4.4. Infection-related treatment

7.5. Coagulation disorders in trauma

7.5.1. Coagulation
7.5.2. Coagulopathy associated with trauma

7.5.2.1. Trauma-associated coagulopathy (TAC)

7.5.2.1.1. Tissue damage and inflammation
7.5.2.1.2. Endothelial Dysfunction
7.5.2.1.3. Shock and hypoperfusion
7.5.2.1.4. Platelet dysfunction
7.5.2.1.5. Coagulation factor consumption and dysfunction
7.5.2.1.6. Hyperfibrinolysis

7.5.2.2. Coagulopathy Secondary to Trauma (CST)

7.5.2.2.1. Associated with the patient's situation

7.5.2.2.1.1. Hypothermia
7.5.2.2.1.2. Acidosis

7.5.2.2.2. Dilutional
7.5.2.2.3. Added

7.5.2.2.3.1. Comorbidities
7.5.2.2.3.2. Concomitant Drug

7.5.3. Diagnosis

7.5.3.1. Conventional tests

7.5.3.1.1. Conventional coagulation tests

7.5.3.1.1.1. Platelet count
7.5.3.1.1.2. Fibrinogen levels

7.5.3.1.2. Viscoelastic test

7.5.3.1.2.1. Reactions and parameters
7.5.3.1.2.2. Interpretation
7.5.3.1.2.3. Advantages and Limitations

7.5.3.2. Evaluation of CIT and prediction of massive transfusion

7.5.4. Management of coagulopathy

7.5.4.1. Management of CIT/HECTRA

7.5.4.1.1. Red blood Cell Concentrates
7.5.4.1.2. Fresh frozen plasma
7.5.4.1.3. Platelets
7.5.4.1.4. Fibrinogen
7.5.4.1.5. Protombinic Concentrate Complexes (PCC)
7.5.4.1.6. Tranexamic Acid
7.5.4.1.7. Other hemostatic drugs
7.5.4.1.8. Other Measures

7.5.4.2. Management of hypercoagulability

7.6. Massive transfusion

7.6.1. Transfusion
7.6.2. Definition
7.6.3. Transfusion management guidelines in severely traumatized patients
7.6.4. Associated risks

7.6.4.1. Coagulopathy
7.6.4.2. TRALI
7.6.4.3. Infections

7.7. Cardiac arrest in trauma

7.7.1. Stop
7.7.2. Etiopathogenesis of traumatic CRA
7.7.3. Cardiopulmonary resuscitation algorithm in traumatic CRA
7.7.4. Prognosis of traumatic CRA
7.7.5. Emergency thoracotomy

7.7.5.1. Indications and Contraindications
7.7.5.2. Role of ultrasound
7.7.5.3. Objectives

7.7.6. Surgical Technique

7.7.6.1. Emergency sternotomy
7.7.6.2. Left thoracotomy

7.7.7. Material and monitoring

7.8. Neurogenic shock in trauma

7.8.1. Shock
7.8.2. Memory Clinical differentiation of shock etiology

7.8.2.1. General description of hemorrhagic shock

7.8.3. Classification of spinal cord injury

7.8.3.1. Level
7.8.3.2. Severity of neurological deficit
7.8.3.3. Spinal Cord Syndromes

7.9. Thromboembolic disease in trauma and post-traumatic fat embolism syndrome

7.9.1. Thrombo
7.9.2. Venous Thromboembolic Disease

7.9.2.1. Pathophysiology
7.9.2.2. Prophylaxis and pharmacology

7.9.2.2.1. Onset
7.9.2.2.2. Anticoagulation and posology

7.9.2.3. Mechanical Prophylaxis
7.9.2.4. Diagnosis
7.9.2.5. Treatment of venous thromboembolic disease
7.9.2.6. Prognosis

7.9.3. Fat Embolism Syndrome

7.9.3.1. Pathophysiology
7.9.3.2. Clinical Symptoms
7.9.3.3. Diagnosis
7.9.3.4. Treatment
7.9.3.5. Prevention

7.10. Compartment syndrome and crushing

7.10.1. Compartment Syndrome

7.10.1.1. Definition and localizations
7.10.1.2. Etiology and Clinic
7.10.1.3. Treatment and Prophylaxis

7.10.2. Crush Syndrome

7.10.2.1. Introduction
7.10.2.2. Pathophysiology
7.10.2.3. Evolution
7.10.2.4. Clinical Management

Module 8. Management of mild trauma in ICU

8.1. Mild TBI

8.1.1. TBI
8.1.2. Anatomical review
8.1.3. Physiological review
8.1.4. TBI Classification
8.1.5. Medical treatment of traumatic brain injuries

8.2. Severe TBI

8.2.1. Management of severe TBI
8.2.2. ICP monitoring
8.2.3. PIC Treatment
8.2.4. Severe hyperventilation
8.2.5. Decompressive techniques
8.2.6. Barbiturate coma
8.2.7. Hypothermia and anticonvulsants

8.3. Facial Trauma

8.3.1. Classification
8.3.2. Diagnosis
8.3.3. Treatment

8.4. Thoracic Trauma

8.4.1. Thorax
8.4.2. Anatomic and physiologic memory of the Thorax
8.4.3. Classification of thoracic traumas
8.4.4. Initial evaluation of thoracic trauma
8.4.5. Initial treatment of thoracic trauma

8.4.5.1. Injuries with imminent risk of death

8.4.5.1.1. Airway obstruction
8.4.5.1.2. Tension pneumothorax
8.4.5.1.3. Open pneumothorax
8.4.5.1.4. Massive hemothorax
8.4.5.1.5. Costal volet, unstable thorax
8.4.5.1.6. Cardiac Tamponade
8.4.5.1.7. Severe lesion of great vessels of the mediastinum

8.4.5.2. Injuries with low risk of death

8.4.5.2.1. Rib fractures
8.4.5.2.2. Fractures of the clavicle, sternum and scapula

8.5. Abdominal Trauma. Damage control surgeryDamage control surgeries

8.5.1. Ultrasound
8.5.2. Anatomy of the abdomen
8.5.3. Mechanism of injury

8.5.3.1. Blunt trauma
8.5.3.2. Penetrating trauma
8.5.3.3. Blast trauma

8.5.4. Evaluation and Management

8.5.4.1. Physical Examination

8.5.4.1.1. Inspection
8.5.4.1.2. Pelvic evaluation
8.5.4.1.3. Urethral and perineal examination

8.5.5. Diagnosis, complementary tests in the examination

8.5.5.1. Peritoneal lavage puncture
8.5.5.2. Ultrasound
8.5.5.3. Radiography
8.5.5.4. CAT
8.5.5.5. Diagnostic laparoscopy

8.5.6. Damage control surgery

8.5.6.1. Indications
8.5.6.2. Phases of damage control surgery

8.6. Pelvic trauma

8.6.1. Pelvis
8.6.2. Anatomical Review
8.6.3. Evaluation and Management

8.6.3.1. Urethral, perineal, rectal, vaginal and buttocks examination

8.6.4. Complementary Diagnostic Tests

8.6.4.1. Simple radiology
8.6.4.2. CAT SCAN

8.7. Orthopedic trauma

8.7.1. Orthopedics
8.7.2. Primary review and resuscitation of patients with potentially life-threatening extremity injuries

8.7.2.1. Severe arterial hemorrhage and traumatic amputation
8.7.2.2. Bilateral femur fracture
8.7.2.3. Crush syndrome, catastrophic limb or complex limb injury

8.7.3. Secondary revision, limb-threatening injuries

8.7.3.1. History
8.7.3.2. Physical Examination
8.7.3.3. Open fractures and joint injuries
8.7.3.4. Vascular injuries
8.7.3.5. Compartment Syndrome
8.7.3.6. Neurological lesion secondary to fracture or dislocation

8.7.4. Other Lesions

8.7.4.1. Contusions and lacerations
8.7.4.2. Joint and ligament injuries
8.7.4.3. Fractures

8.7.5. Principles of Immobilization

8.7.5.1. Introduction and Indications
8.7.5.2. Femur Fracture
8.7.5.3. Knee injuries
8.7.5.4. Tibia fracture
8.7.5.5. Ankle Fracture
8.7.5.6. Injuries of upper extremity and hand

8.7.6. Rehabilitation

8.7.6.1. Introduction and justification of rehabilitation in the ICU
8.7.6.2. Training of the Teaching Staff
8.7.6.3. Rehabilitation therapies

8.7.6.3.1. General care guidelines

8.7.6.3.1.1. Nursing: general care
8.7.6.3.1.2. Orthotic corrections

8.7.6.3.2. Rehabilitative treatment

8.7.6.3.2.1. Immobility syndrome

8.7.6.3.2.1.1. Level 0
8.7.6.3.2.1.2. Level 1
8.7.6.3.2.1.3. Level 2
8.7.6.3.2.1.4. Level 3
8.7.6.3.2.1.5. Level 4
8.7.6.3.2.1.6. Electrotherapy

8.7.6.3.2.2. Respiratory techniques

8.7.6.3.2.2.1. Secretion Drainage
8.7.6.3.2.2.2. Ventilatory Techniques
8.7.6.3.2.2.3. Occupational Therapy

8.8. Vertebro-spinal cord trauma

8.8.1. Vertebro-spinal cord
8.8.2. Anatomy Recap
8.8.3. Injury mechanism
8.8.4. Evaluation of the spinal cord injury

8.8.4.1. Neurological evaluation of the spinal cord injured person
8.8.4.2. Rectal Examination

8.8.5. Management of the spinal cord injury

8.9. Vertebro-spinal cord trauma

8.9.1. Classification of spinal cord injury
8.9.2. Treatment
8.9.3. Complications in spinal cord injury
8.9.4. Treatment of skin alterations
8.9.5. Prevention and treatment of joint contractures
8.9.6. Treatment of spasticity
8.9.7. Treatment of gastrointestinal disturbances
8.9.8. Treatment of genitourinary disorders
8.9.9. Sexuality and fertility
8.9.10. Occupational therapy and physiotherapy
8.9.11. Psychology
8.9.12. Functional outcomes

8.10. Penetrating trauma

8.10.1. Penetrating trauma
8.10.2. Definition
8.10.3. Evaluation of specific penetrating injuries

8.10.3.1. Introduction
8.10.3.2. Thoracoabdominal injuries
8.10.3.3. Anterior abdominal wounds, non-surgical management
8.10.3.4. Flank and dorsal injuries, non-surgical management
8.10.3.5. Evaluation of other specific injuries

8.10.3.5.1. Diaphragmatic lesions
8.10.3.5.2. Duodenal lesions
8.10.3.5.3. Pancreatic lesion
8.10.3.5.4. Urogenital lesions
8.10.3.5.5. Hollow viscera lesions
8.10.3.5.6. Solid organ injuries

8.10.4. Management and Treatments

Module 9. Trauma Pharmacology and Nutrition

9.1. Indications for sedation

9.1.1. Sedation
9.1.2. Physiological response to pain

9.1.2.1. Pain Control
9.1.2.2. Control of sedation

9.2. Drugs commonly used in the care of the severely traumatized patient

9.2.1. Drugs:
9.2.2. Hypnotics: intravenous sedatives

9.2.2.1. Thiopental
9.2.2.2. Etomidate
9.2.2.3. Ketamine
9.2.2.4. Propofol
9.2.2.5. Benzodiazepines

9.2.3. Muscle relaxants

9.2.3.1. Depolarizing neuromuscular relaxants
9.2.3.2. Non-depolarizing neuromuscular relaxants
9.2.3.3. Anticholinesterase drugs

9.2.4. Opioid Analgesics

9.2.4.1. Pure Agonists
9.2.4.2. Pure antagonists

9.2.5. Inotropic agents

9.2.5.1. Adrenaline
9.2.5.2. Dopamine
9.2.5.3. Dobutamine

9.3. Sedation analgesia guidelines

9.3.1. Short-duration sedo analgesia
9.3.2. Prolonged Sedo analgesia guideline
9.3.3. Conclusions

9.4. Minor analgesics

9.4.1. Analgesia
9.4.2. Drugs and dosage

9.4.2.1. NSAIDS
9.4.2.2. Nonsteroidal Anti-Inflammatory Drugs
9.4.2.3. Patient-controlled analgesia

9.5. Regional Thorax and Abdomen Analgesia

9.5.1. Indications
9.5.2. Classification

9.5.2.1. Central Blocks
9.5.2.2. Peripheral blocks
9.5.2.3. Fascicular blocks

9.5.3. Procedures used in Thorax and Abdomen
9.5.4. Procedures used on the Upper Limb and Lower Limb

9.6. Neuromuscular Blockade

9.6.1. Blockade
9.6.2. Indications
9.6.3. Classification

9.6.3.1. Depolarizing agents
9.6.3.2. Non-depolarizing

9.6.4. Monitoring

9.7. Delirium

9.7.1. Delirium
9.7.2. Definition and scales
9.7.3. Risk Factors
9.7.4. Classification and clinical

9.7.4.1. Hyperactive delirium
9.7.4.2. Hypoactive delirium
9.7.4.3. Mixed delirium

9.7.5. Management and Treatments
9.7.6. Prevention of delirium in ICU

9.8. Monitoring. Analgesia and sedation scales

9.8.1. Scales
9.8.2. Causes of pain
9.8.3. Clinical Symptoms
9.8.4. Analgesia Scales

9.8.4.1. Pain assessment in the conscious patient

9.8.4.1.1. EVA Scale
9.8.4.1.2. Numerical verbal scale

9.8.4.2. Pain assessment in the intubated patient with non-deep sedation

9.8.4.2.1. EVA Scale
9.8.4.2.2. Numerical verbal scale

9.8.4.3. Assessment of pain in the non-communicative patient or under deep sedation

9.8.4.3.1. Campbell Scale
9.8.4.3.2. ESCID Scale

9.8.5. Sedation scales

9.8.5.1. Ramsay Scale
9.8.5.2. RASS Scale
9.8.5.3. BIS monitoring

9.9. Prophylaxis and antimicrobial treatment in the polytraumatized patient

9.9.1. Prophylaxis
9.9.2. Indications for Prophylaxis

9.2.2.1. Most frequent antibiotic guidelines in polytraumatized patients

9.9.3. Infections related to fractures
9.9.4. Pneumonia
9.9.5. Infections related to cranioencephalic traumatism

9.10. Nutrition

9.10.1. Nutrition
9.10.2. Indications for nutritional support in trauma

9.10.2.1. When to initiate nutritional support
9.10.2.2. Assessment of requirements
9.10.2.3. Micronutrients
9.10.2.4. Type of diet and follow-up

9.10.3. Complications
9.10.4. Monitoring

9.10.4.1. Introduction
9.10.4.2. Monitoring
9.10.4.3. Nutritional risk analysis
9.10.4.4. Imaging technique

9.10.5. Nutrition in Special Situations

9.10.5.1. Abdominal Trauma
9.10.5.2. Spinal trauma
9.10.5.3. Barbiturate coma
9.10.5.4. ECMO

Module 10. Trauma in special situations

10.1. Recommendations for Child Trauma Care  

10.1.1. Introduction  
10.1.2. Types and Patterns of Injury  
10.1.3. Unique Characteristics of the Pediatric Patient 
10.1.4. Airway  
10.1.5. Breathing  
10.1.6. Circulation and Shock  
10.1.7. Cardiopulmonary resuscitation
10.1.8. Thoracic Trauma  
10.1.9. Abdominal Trauma  
10.1.10. TBI  
10.1.11. Spinal cord injury 
10.1.12. Musculoskeletal trauma
10.1.13. Abdominal trauma   
10.1.14. Child Abuse

10.2. Trauma in the Elderly 

10.2.1. Introduction  
10.2.2. Effects of Aging and Impact of Prevalent Diseases  
10.2.3. Mechanisms of Injury 
10.2.4. Primary Screening and Resuscitation
10.2.5. Specific injuries
10.2.6. Specific Circumstances 

10.3. Trauma in the Anticoagulated Patient  

10.3.1. Introduction  
10.3.2. Patient with Antiplatelet Therapy   
10.3.3. Patient with Warfarin Treatment   
10.3.4. Patient with Heparin Treatment  
10.3.5. Patient with Treatment with Low Molecular Weight Heparin  
10.3.6. Patient Treated with Direct Thrombin Inhibitors (Dabigatran Etexilate)
10.3.7. Patient with Treatment with Rivaroxaban  

10.4. Trauma in Pregnant Women   

10.4.1. Introduction 
10.4.2. Anatomical and Physiological Alterations during Pregnancy  
10.4.3. Anatomical Differences  
10.4.4. Mechanisms of Injury  
10.4.5. Injury Severity  
10.4.6. Assessment and Management  
10.4.7. Perimortem Cesarean Section  
10.4.8. Domestic Violence

10.5. Aggressions by External Agents. Immersion Accidents. Hypothermia. Electrocution. Burns   

10.5.1. Thermal Injuries: Burns  

10.5.1.1. Primary Assessment and Resuscitation of the Burn Patient  

10.5.1.1.1.1. Stopping the Burn Process 
10.5.1.1.1.2. Establish Airway Control
10.5.1.1.1.3. Ensure Adequate Ventilation
10.5.1.1.1.4. Management of Circulation with Burn Shock Resuscitation  
10.5.1.1.1.5. Patient Assessment  
10.5.1.1.1.6. Secondary Assessment  

10.5.1.1.1.6.1. Documentation  
10.5.1.1.1.6.2. Baseline Determinations for the Severely Burned Patient  
10.5.1.1.1.6.3. Peripheral Circulation in Circumferential Burns of the Limbs 
10.5.1.1.1.6.4. Placement of Nasogastric Tube  
10.5.1.1.1.6.5. Narcotics, Analgesia and Sedatives  

10.5.1.1.6.7. Antibiotics  
10.5.1.1.6.8. Tetanus  

10.5.2. Specific Burn Injuries  

10.5.2.1. Chemical Burns  
10.5.2.2. Electrical Burns  
10.5.2.3. Tar burns 

10.5.3. Cold Exposure Injuries: Local Tissue Effects  

10.5.3.1. Types of Cold Injuries  

10.5.3.3.1. Frostbite Injuries  
10.5.3.3.2. Non-freezing Injuries 
10.5.3.3.3. Systemic Hypothermia 

10.6. Trauma due to Hanging

10.6.1. Introduction  
10.6.2. Anatomical Recollection  
10.6.3. Mechanism of Injury  
10.6.4. Management  
10.6.5. Prognostic Factors and Associated Injuries 10.6.5.  
10.6.6. Treatment

10.6.6.1. Surgical Treatment
10.6.6.2. Treatment by Organs  

10.6.6.2.1. Airway Injuries  
10.6.6.2.2. Esophageal Injuries  
10.6.6.2.3. Vascular Injuries   

10.7. Injuries by Chemical and Biological Agents  

10.7.1. Introduction  
10.7.2. Explosion Injuries  
10.7.3. Chemical Injuries and Diseases  

10.8. Disaster Management   

10.8.1. Mass Casualty Event Management  
10.8.2. Tools for Effective Mass Casualty Management
10.8.3. Management Priorities  
10.8.4. Challenges  
10.8.5. Security and Communication   
10.8.6. War Wounds (Military Trauma)   

10.9. Organization of Multiple Casualty and Disaster Assistance   

10.9.1. Introduction  
10.9.2. Casualty Triage Card: Approach and Preparation
10.9.3. Patient Transport, Evacuation
10.9.4. Destination  
10.9.5. Transfer  
10.9.6. Decontamination  

10.10. Management of the Polytraumatized Patient as a Potential Organ Donor  

10.10.1. Introduction  
10.10.2. Etiopathogenesis, Most Frequent Causes  
10.10.3. Clinical  
10.10.4. Diagnosis  
10.10.5. Treatment 

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