04-10-21 - Secondary Survey

Question 1

What is the definition of shock?

What does it cause?

Answer 1

• Shock is a life-threatening condition of circulatory failure
• This causes inadequate oxygen delivery to meet cellular metabolic needs and oxygen consumption requirements, which causes cellular and tissue hypoxia.

Question 2

What are the possible causes of shock?

Answer 2

• Trauma
• Blood loss
• Heatstroke
• Poisoning
• Allergic reaction
• Severe infection
• Severe burns

Question 3

What are the clinical signs and symptoms of shock?

Answer 3

• Cool, clammy skin
• Pale or ashen skin
• Bluish tinge to lips or fingernails (or gray in the case of dark complexions)
• Rapid pulse
• Rapid breathing
• Nausea or vomiting
• Enlarged pupils
• Weakness or fatigue
• Dizziness or fainting
• Changes in mental status or behavior, such as anxiousness or agitation

Question 4

What is meant by an open fracture and a closed fracture?

Answer 4

• Open fracture (compound fracture) – bones poke through the skin, or deep wound exposes bone through the skin
• Closed fracture (simple fracture) – The bone is broken, but the skin is still intact

Question 5

What are the signs and symptoms of a fracture?

Answer 5

• Sudden pain
• Trouble using or moving nearby joints
• Unable to bear weight
• Swelling
• Obvious deformity
• Warmth bruising or redness.

Question 6

6) How do you perform a capillary refill test? How long does capillary refill take? What if it it longer than this

Answer 6

• Remove finger rings and nail polis
• Compress nail bed until it turns white and records the time taken the colour to return to the nail bed
• Normally takes 2 seconds or less.
• Always compare to the normal side of the hands and fingers
• When it takes longer, arterial insufficient is suspected

Question 7

Why is it important to understand the situation in which the casualty is found?

Answer 7

• To know the kind of injuries to look for
• Could look for a potential cause of the event e.g. fainting in a bar vs fainting in the bathroom can give potential insight into what caused the fainting
• To avoid further injury e.g. if a spinal injury is suspected then jaw tilt, chin lift would cause further injury

Question 8

What are the clues you might look for?

Answer 8

• The surroundings of the casualty and if there is anything that could have harmed them
• Surroundings can also give an insight into the kind of activities they might have been doing when they sustained the injury.
• Medical bracelets or an EpiPen can indicate injury from allergic reaction.
• Inhalers or walking sticks can also give insight
• Looking to see if they potentially carry any medication in their bag.