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Thoracic Trauma

The document compares the classifications of thoracic trauma injuries between the ITLS 2008 and ATLS 2018 guidelines. Some key differences include: - ATLS 2018 now classifies tracheobronchial tree injuries and traumatic circulatory arrest as primary survey/life-threatening injuries, whereas ITLS 2008 did not. - For tension pneumothorax management, ATLS 2018 advises against needle decompression due to lower success rates and recommends alternative methods like finger thoracostomy. - Cardiac tamponade diagnosis is no longer based on Beck's trias under ATLS 2018, instead using focused assessment with sonography for trauma (FAST). Pericardiocentesis can also be performed for life

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Niarti Ulan Sari Siarnu
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130 views12 pages

Thoracic Trauma

The document compares the classifications of thoracic trauma injuries between the ITLS 2008 and ATLS 2018 guidelines. Some key differences include: - ATLS 2018 now classifies tracheobronchial tree injuries and traumatic circulatory arrest as primary survey/life-threatening injuries, whereas ITLS 2008 did not. - For tension pneumothorax management, ATLS 2018 advises against needle decompression due to lower success rates and recommends alternative methods like finger thoracostomy. - Cardiac tamponade diagnosis is no longer based on Beck's trias under ATLS 2018, instead using focused assessment with sonography for trauma (FAST). Pericardiocentesis can also be performed for life

Uploaded by

Niarti Ulan Sari Siarnu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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THORACIC TRAUMA

I T L S 2 0 0 8 v s AT L S 2 0 1 8
1. LIST PROBLEM
ITLS 2008 ATLS 2018
Airway Obstruction Airway Obstruction
Open Pneumothorax Tracheobroncial Tree Injury
Flail Chest Tension Pneumothorax
Tension Pneumothorax Open Pneumothorax
Massive Hemothorax Massive Hemothorax
Cardiac Tamponade Cardiac Tamponade
Myocardial Contusion Traumatic Circulatory Arrest
Traumatic Aortic Rupture Simple Pneumothorax
Tracheal or Bronchial Tree Injury Hemothorax
Diaphragmatic tear Flail Chest
Esophageal Injury Pulmonary Contusion
Pulmonary Contusion Blunt Cardiac Injury
Traumatic Aortic Disruption
Traumatic Diaphragmatic Injury
Blunt Esophageal Rupture
2.
C L A S S I F I C AT I O N
Point ITLS 2008 ATLS 2018
Airway Obstruction Airway Obstruction
Open Pneumothorax Tracheobronchial Tree Injury
Flail Chest Tension Pneumothorax
Primary Survey
Tension Pneumothorax Open Pneumothorax
(Life Threatening Injuries)
Massive Hemothorax Massive Hemothorax
Cardiac Tamponade Cardiac Tamponade
  Traumatic Cirulatory Arrest
Myocardial contusion Simple pneumothorax
Traumatic aortic rupture Hemothorax
Tracheal or bronchial tree injury Flail chest
Secondary Survey Diaphragmatic tears Pulmonary contusion
(Potentially Life Threatening Injuries) Esophageal injury Blunt Cardiac Injury
Pulmonary contusion Traumatic Aortic Disruption
  Traumatic diaphragmatic injury
  Blunt esophageal rupture
ATLS
2018 Airway Obstruction
Airway Problem Tracheobronchial Tree
Injury
Tension Pneumothorax

Breathing Problem Open Pneumothorax


PRIMARY SURVEY
Massive Hemothorax
Massive Hemothorax
Cardiac Tamponade
Circulation Problem
Traumatic Cirulatory
Arrest
2. DIFFERENCE
TENSION PNEUMOTHORAX

ITLS 2008 ATLS 2018

Penanganan awal menggunakan needle Needle decompression diyakini memiliki


decompression untuk life saving kemungkinan tidak berhasil yang lebih
besar sehingga pendekatan alternative
dengan finger thoracostomy
CARDIAC TAMPONADE

ITLS 2008 ATLS 2018

Beck’s trias (hipotensi, distended neck Dikatakan bahwa trias tersebut tidak
vein, dan muffled heart sound) digunakan selalu ada. Diagnosis menggunakan FAST
untuk diagnosis (focus assessment with sonography for
trauma)

Pericardiocentesis bisa dilakukan untuk


life saving
TRACHEOBRONCHIAL TREE INJURY

ITLS 2008 ATLS 2018

Bukan dijadikan sebagai life threatening Dijadikan life threatening injury karena
injury sebagian besar pasien akan meninggal di
tempat kejadian
FLAIL CHEST AND PULMONARY
ITLS 2008
CONTUSION ATLS 2018

Flail chest merupakan life threatening Flail chest bukan lagi life threatening
problem tetapi potentially life threatening
THANK YOU

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