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reading years. All right, She got in here. Maybe it's just me again. I'm going to give that where the child bait and the trauma table And I kind of talked about how important the teammates and I'm gonna give you a better rest. Stop her. Of all the things that can happen during that in national kind of 30 minutes in the resuscitation room and all the different things that the team members will be doing and just kind of like just a front, back and high and everything convey a So that's why I want to talk about the team first and just having appreciation of every team member. What goes on because I was a blistery that she'll say just various different things that could be happening. So having a appreciation for your team members will help you with that and made a gram of gone three. A few other things that was on a child a much better than I ever kids. So and we could flush through them is well, so okay, business aids. You do your hands off 100 for my, uh, it's either you get them on the Charlie first or or know that that's up to you. Whatever you have here today, do your five seconds. Just make sure they're they're not arrested or there's nothing significant going on. Any urgent intervention you look for your significant external hemorrhage is played drag pressure hemostatic. Agent Ernie case AM was the first instance. And then we're gonna go on today and area control and apologies for the horrific Cut your hair. But, um, so you're gonna start your assessment of your airway or the doctor about the top is gonna start their sense to know their way. Is it clear? Is a new abnormal noise is is get airflow over the mice and know it Nose is a normal chest movements. They're gonna have to monitor that continuously, even if it does appear clear, because just because their race there doesn't mean ventilation is adequate, this gentleman clearly have Doesn't clear. Anyway, he's had multiple interventions there. So is there an obstruction? Has a partial? Is that complete? Is obstructive cause it got richest GCS Is there blood deserve all men in their mind? Is there a foreign body or is a trauma from burns? Are blast injuries? Is there really spots? Um bronchospasm you're a look, listen and failed, and you can consider to stand some basic maneuvers. But always keep in mind here. Your C spine precautions so and turn left might not be a STD about certainly control draw thrusts, and you've been nasal pharyngeal airways again. You might not do that in a trauma, and the word with the skull fractures certainly can try AM or a friend Dealer Airways in the first instance, maybe this session to interview it. And this can be for a lot of different reasons because they've got ridges. GCS count because of Primary Airway obstruction, because there's trauma and burns and you're worried about it and swelling happen in the future. Or just because there's all their significant and grace of patients, it's a bigger peeing, and you're being a few military and reasons he's got patients just not able to do You want him to sleep so they can and a bit more comfortable. So if the sex date aside interviewed at that time was drama team leader, I would hand over there and they kind of dictate what we're going to do. You have a skull. The team to kind of pay attention lesson to them. It's really am difficult. Situation is, it said before, there's lots of noise and traumatic for everybody and even the most experienced and then the stress confined. That's really difficult. And it can be a difficult area again for about two separation. So when I am a trauma team leader, it always ask the team demonstrator, difficult area society and kind of check list on both glaze their plan A Today, again, this is something about it in a couple of the wall. This is a check list there, any of them, or for people when they're going through that. So I asked that he's just even if they are more senior to me or you know, they do, you say that the really experienced just double glaze their plan a day and say that ultimately, things obviously remember from there access just everybody in the room because most people, the room, as I said, are aware of what's happening on the severity and the potential complications with this procedure. Another thing that they may ask you to do is a team member. He's not part of the A team. Is the journey intubation? They may ask you to have a DMiller, which is manual and line stabilization again with lots of acidic things. There's controversy over whether this is beneficial or not. The I would say in my experience that we always ask for this one. There had to be in the trauma. Patient is not is an anyone condition. So it's using your hands to kind of do the job of the of the caller because the color could be could get in the way when they're trying to contribute and your other gonna come above the patient and hold their neck from above, or even it from behind, which can be a bit more awkward. Just be aware. That may be something that the other side of doctor asks you did today for them. I'm not to be worried about so going on the bay. So the breathing doctor was just had a I did. It could be someone senior surgically, or it's in your 80 person the needle. Many consists lay threatening conditions, so your tension, your thorax, your open chest wonder opinion. With the extra massive hemothorax you feel chest cardiac tamponade. Let's see your eye on area of structure destruction. And the picture here just kind of shows a blunt trauma, most likely from an RTC and the impact that can have on the chest wall. So in a green 13 tension in the thorax is this isn't working liver the point, but it's something to be aware of. And Conley, Thio and respect your resting cardiac arrest. So you're gonna need your clinical am scale stable to work the site. You have any concern you're gonna be going the and chest decompression, so that also costing. He's followed by exertion. Chest tube can be bilateral if need be on begins, agree. And 13 try and go see if they on the procedure there. So don't go through that again with you. Feel chest isn't that that can happen again with that have gone trauma, and it's important to recognize that are lace Oh, a field test and whistle when we say a lot. But if you don't know where it's one tier, more decent ribs or fractured a tear, more places yes causes severe pee in with Robin Brave in you have tender chest wall crepitus breeze and abrasions on any kind of paradoxical test movement and could be associated low contagions. They're going to need a big dose. Is a little Jesus for this, and quite often we use catamenial be infusions. It also can coexist with a pneumothorax. So in the chest, right? And here's just precious. Quite often, these patients will be so so we're on. The reading will not be adequate. Um, so we'll have to think about it and to be getting them. And current guidelines will say and to be a a golf ball in falling pew to two. And they're exhausting. They're high respiratory or there's associate introduce can't raise in ventilation, but also go back to a gram said you may want to put your chest room. Then, before you start doing and ventilation cause changing pressure's contentedly detention. Cardiac tamponade is the one we will dry and really, so you suspect that Nana pit and penetrating blend of the chest neck or a problem and is last Call me and blunt trauma. But keep in mind, as I said before, with the elderly, were only people and throwing the card in it, and they're gonna be a higher risk of breast. The clinical signs that we talk about and that we learn for exams or any president. And the third of the trauma patients names you got backs triad, which is your hypertension. You're raised a BP and result into standard jugular veins and the whole heart signs. And also partner you get post is probably Oxus on occasional sine begin there in the context of a trauma with lots going around there gonna be very hard to tell, is it? You're not gonna hear muffled heart signs and busy trauma. So that's an ultrasound as much more and reliable. I'm I'm gonna try and show you a video of this. See if I get a tour, right? Not because my T cells aren't great. You probably just, uh, all right, for that's what I try to be found saying, Yeah, wasn't It's just an e comfortable like a girl. Sorry, guys. I was working the radio. You stopped going to her and jumping and just go. I start. Yeah, took all right. And I checked it like five times at work. Don't wait five minutes. It's okay. Just wait. Tries to get everybody to come on. And it's not been that many comments or questions coming up. So that really got any questions or comments so far, Be figuring just only a nostril or put in the child function. Um, cause I sure will be looked. Questions were there so far. I will compare. It's not working. Uh huh. Come on. Don't even know. That's right. That's the way. Okay, so it starts having a complete so standard and it just technology. So what we'll do is if we can put on ama and ask em a to do her retard neck, which is on our PSA and from the access. It's maybe not bad timing because it was just covered. Kind of A and B. So, um, if we give you a few minutes just yourself Friday. No pressure, thanks.