Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3. E Med & Surgery > 1- Eval of the Trauma Patient > Flashcards

1- Eval of the Trauma Patient Flashcards

1
Q

Immediate trauma mortality is defined as death at the scene due to what?

A

Disruption of the great vessels, heart, lungs, or moajor body cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Early trauma mortality is defined as death how long following injury?

A

1-4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Early trauma mortality (1-4 hours post injury) is usually a result of what?

A

CV or pulmonary collapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Late trauma mortality is defined as death how long following injury?

A

Days to weeks (less common)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Late trauma mortality (days to weeks post injury) is primarily due to what?

A

Sepsis and multiple organ failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the most common cause of preventable mortality?

A

Hermorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the top two causes of trauma mortality?

A

CNS injury, exsangunation/hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the standard of care for trauma patients and the standardized protocol for pt eval?

A

Advanced Trauma Life Support (ATLS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does SALT stand for? (SALT mass casualty triage algorithm)

A

Sort, Assess, Lifesaving Interventions, Treatment/Transport

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In Step 1 of SALT, you sort pt based on severity of sx. In what order would you assess pts?

A

1st = still/ obvious life threat, 2nd= purposeful movement, 3rd= walk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What life saving interventions might be used as part of SALT?

A

Control major hemorrhage, open and position airway (if child given 2 rescue breaths), chest decompression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What level trauma center provides highest level of care, leaders in research, clinical care and education?

A

Level 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What level trauma center provides definitive care in a wide range of complex traumatic patients?

A

Level 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What level trauma center provides initial stabilization and tx. and may care for uncomplicated trauma pts?

A

Level 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What level trauma center provides initial stabilization and transfers all trauma patients for definitive care?

A

Level 4/5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Trauma triage utilizes what? (3)

A

SALT, tags, trauma center levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Stabilizing a trauma pt, identifying life threatening injuries/ initiating adequate supportive therapy, rapidly organizing definitive therapy/ transfers to facility for definitive txs all fall under what evaluation of a trauma pt?

A

Initial evaluation/ primary survey

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does ABCDE stand for? (part of primary eval)

A

Airway, Breathing, Circulation, Disability, Exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a FAST exam? (part of primary eval)

A

Focused Assessment with Sonography for Trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is included in A-airway? (primary eval)

A

Assess for signs of respiratory distress and protection of airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is included in B-breathing? (primary eval)

A

Maintain adequate oxygenation and ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is included in C-circulation? (primary eval)

A

Control hemorrhage, maintain adequate end-organ perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is included in D-disability? (primary eval)

A

Neuro eval AVPU (alert, verbal, pain, unresponsive), eyes, motor, GCS. Search for all possible injuries while preventing hypothermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is included in E-exposure? (primary eval)

A

Undress and redress patient, search for possible injuries/ prevent hypothermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Airway inspect of an unconscious patient should include what?

A

Protect airway immediately, C-spine protection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Suction of secretions, chin lift/ jaw thrust, nasopharyngeal airway, and definitive airway are all examples of what?

A

Maintenance of airway patency as part of an airway intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Oxygen, NRBM, bag valve mask, and establishing a definitive airway are all examples of what?

A

Airway support as part of an airway intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the 2 types of definitive airway interventions?

A

Endotracheal intubation (protects airway) and surgical crichothyroidotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Oropharyngeal, laryngeal mask, and nasopharyngeal airways are all adjuncts, but not definitive txs. Why?

A

Pt can still vomit, choke, and aspirate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What should be done for all blunt trauma patients?

A

Cervical spine immobilization (via cervical collar or manual in-line stabilization)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What should be attempted before a cricothyroidetomy?

A

ET intubation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

A successful croithyroidotomy should later be converted to what?

A

Orotracheal tube, tracheostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What 3 things are considered immediate threats to life when evaluating B-breathing?

A

Tension pneumothorax, massive hemothorax, cardiac tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

In pts w/ unstable breathing what imaging is recommended?

A

CXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

The following are signs of what and should be presumptively treated? Hypotension, dyspnea, ipsilateral decreased breath sounds

A

Pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the tx for a PTX (pneumothorax)?

A

Needle decompression [4th or 5th (adults) or 2nd intercostal space in mid-axillary line], immediately followed by tube thoracostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What should be anticipated in an unstable trauma patient and what should be performed)

A

Hemothorax and pneumothorax, should perform tube thoracostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is determined and placed at time of circulation assessment?

A

Blood type and cross match. IV catheters placed (16 guage or larger)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

The following are used to control what type of hemorrhage? Manual pressure, proximal compression, elevation, hemostatic agents

A

Arterial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Direct pressure is used to control what type of hemorrhage?

A

Venous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

When do you perform an emergency throactomoy?

A

Pt w/o central pusles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the base deficit for a class I hemorrhage and is there a need for blood?

A

0 to -2, monitor need for blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the base deficit for a class II hemorrhage and is there a need for blood?

A

-2 to -6, possible need for blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the base deficit for a class III hemorrhage and is there a need for blood?

A

-6 to -10, yes need for blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the base deficit for a class IV hemorrhage and is there a need for blood?

A

-10 or less, massive transfusion needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the TX for shock?

A

Step down if pt continues to be in shock:
1L crystalloids NS or LR →
1-2 units O Neg PRBCs →
MTP (massive transfusion protocol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the ratio for PRBC: FFP: platelets with MTP (massive transfusion protocol)?

A

1:1:1 ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

A rapid infuser works at what rate?

A

Over 1000 mL/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is evaluated as part of the disability/ neuro eval?

A

LOC (GCS score), pupils, motor/sensory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

When is imaging performed as part of the disability/ neuro eval?

A

Motor deficit, spinal cord sensory level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

For GCS ≤ 8 what do you need to do?

A

Intubate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is the scale for GCS?

A

3-15 points (Eyes 4, Verbal response 5, Motor response 6)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What are commonly missed regions as part of the exposure full body eval?

A

Scalp, axillary folds, perineum, abd folds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

The following are given to a pt under what circumstances? Warm blankets, warm IV fluids and blood, external warming devices, warm room

A

Hypothermia, < 35C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

How is a pt to be evaluated as part of the exposure eval (primary survey)?

A

Completely undressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is considered the lethal triad of trauma/ shock?

A

Hypothermia, coagulopathy, acidosis

57
Q

What is the treatment for hypothermia?

A

Remove wet clothing and warm pt

58
Q

What is the treatment for coagulopathy?

A

Permissive hypotension and give blood products > crystalloids

59
Q

What is the treatment for acidosis?

A

Stop bleeding and treat shock

60
Q

A head to toe exam, detailed hx, thorough PE, adjunct studies (avoiding tests you can’t do anything about) is part of what?

A

Secondary survey

61
Q

What is AMPLLE history as part of the secondary trauma survey?

A

Allergies, Meds (blood thinners?), PMH, Last meal, LMP (pregnant?), Events that led to trauma

62
Q

What are the two broad catergories of trauma as part of hx for mechanism related info?

A

Blunt trauma vs penetrating trauma

63
Q

In reference to the NEXUS cervical spine rule, radiography is unnecessary if a patient satisfies ALL of what low risk criteria? (5)

A

No midline spinal tenderness, no focal neuro deficits, normal alertness, no intoxication, no painful distracting injury

64
Q

When is a CT head recommended for a pt younger than 2 yo?

A

AMS or GCS < 15 or palpable skull fx

65
Q

When is CT head recommended for pt > 2 yo?

A

AMS, GCS < 15, Signs of basilar skull fx

66
Q

What are the reversal agents for antiplatelets?

A

Platelets, +/- desmopressin (DDAVP)

67
Q

What are the reversal agents for Coumadin?

A

FFP, Vit K, PCC (Prothrombin complex concentrate), factor VIIa

68
Q

What are the reversal agents for Heparin?

A

Protamine sulfate

69
Q

What are the reversal agents for Pradaxa?

A

Praxbind, PCC (Prothrombin complex concentrate)

70
Q

What are the reversal agents for Xarelto/ Eliquis?

A

PCC (Prothrombin complex concentrate)

71
Q

What dx modalities are might be used for secondary survey of the chest?

A

CXR, US lung, CT w/ contrast, chest CTA (if vascular injury suspected)

72
Q

What diagnostic modalities might be used for secondary survey of abdomen?

A

Contrast abdomen/ pelvis CT, US

73
Q

How long does it take for Cullen’s sign to appear? (superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus)

A

24-48 hrs

74
Q

What is Grey Turner’s sign?

A

Bruising of the flanks (between last rib and top of hip)

75
Q

What can result from a shoulder belt injury/trauma?

A

Blunt carotid injury, strangle injury

76
Q

What is the most frequently injured organ in penetrating trauma and 2nd most frequently injured organ in blunt abd trauma?

A

Liver

77
Q

What is the most frequently injured organ in blunt trauma in adults and most important to save in kids?

A

Spleen

78
Q

What three things dose a rectal exam assess for?

A

spinal cord injury, pelvic fx, penetrating abd trauma

79
Q

How does a rectal exam assess for spinal cord injury?

A

Assess for sacral sparing

80
Q

How does a rectal exam assess for a pelvic fx?

A

Assess for open fx

81
Q

How does a rectal exam assess for a penetrating abd trauma?

A

Assess for gross blood

82
Q

During the pelvis exam, what should you do if you suspect fx?

A

Bind pelvis, check for blood at the meatus (urethral injury)

83
Q

When putting in a foley tube, you should beware of what type of injury?

A

Urethral injury

84
Q

When putting in an NG tube, you should beware of what type of injury?

A

Mid face fracture (OG tube better)

85
Q

What are the soft signs of an extremity penetrating trauma?

A

Small non expanding hematoma, venous oozing, hx of pulsatile bleeding, unexplained neuro deficit (sensory or motor)

86
Q

Active or pulsatile bleeding, expanding hematoma, pulseless limb, shock (due to vascular injury), compartment sundrome, and bruit thrills are all signs of what?

A

Hard signs of vascular injury

87
Q

What is considered to be a normal/ abnormal ankle-brachial index (ABI)? (used to indicate lower extremity injury)

A

Normal > 0.9, abnormal < 0.9

88
Q

What is considered to be a normal brachial-brachial index? (used to indicate upper extremity injury)

A

Normal > 0.9

89
Q

If pt presents with hard signs od extremity penetrating trauma what is the course of action?

A

To OR

90
Q

If patient presents with soft signs of penetrating trauma and has an ABI < 0.9, what is the next step?

A

CT angiography extremity

91
Q

If pt presents w/ no signs of extremitiy penetrating trauama what is the course of the action?

A

XR

92
Q

If pt presents with soft signs of vascular injury but ABI > 0.9, what does this indicate?

A

No arterial injury

93
Q

What performed first if pt presents with open or closed fx?

A

Assess neuro/vascular status

94
Q

What is used for bleeding with open or closed fractures?

A

Pressure or tourniquet

95
Q

What should be done if a pt presents with an open or closed fracture to prevent further injury?

A

Immobilize

96
Q

If pt presents with fx and area is cold or pulseless, what is the next step?

A

Reduce to get better aligment if

97
Q

If pt presents with an open fracture, what should they be given?

A

Tetanus and abx

98
Q

What are the 6 P’s of compartment syndrome?

A

Pain (worse w/ passive stretch), paresthesia, pallow, poikilothermia-polar, paralysis, pulselessness (late finding)

99
Q

What specific imaging studies should be ordered with potential vascular injury?

A

CT angiogram neck/ extremity

100
Q

In trauma “PAN SCAN” non-contrast CT is mostly used. What areas of the body utilized CT w/ contrast?

A

Chest/Abdomen/Pelvis

101
Q

What are the tetanus prone wound characteristics?

A

> 6 hrs old, configuration- stellate, avulsion, abrasian, >1cm in depth, mechanism of injury- crush, burn, missile wound

102
Q

Signs of what are often present on a tetanus prone wound?

A

Infection, devitalized tissue, contamination, ischemic/ denervated tissue

103
Q

If pt w/ clean or minor wound but has unknown or received < 3 tetanus containing vaccines. Do you give the pt DTaP, Tdap, or Td? What about TIG?

A

Yes DTap, Tdap, Td. No TIG

104
Q

If pt w/ clean or minor wound but has received ≥ 3 tetanus contain vaccines. Do you give the pt DTaP, Tdap, or Td? What about TIG?

A

No vaccine or TIG given

105
Q

It pt presents with a wound contaminated w/ dirt, feces, saliva, a puncture wound, avulsion, or wound resulting from missiles, crush injury, burns or frost bite and has unknown tetnus vaccine recoord or received < 3 tetanus containing vaccines. Do you give them DTaP, Tdap, Td? What about TIG?

A

Yes DTap, Tdap, Td. Yes TIG

106
Q

It pt presents with a wound contaminated w/ dirt, feces, saliva, a puncture wound, avulsion, or wound resulting from missiles, crush injury, burns or frost bite and has received ≥ 3 tetnus containing vaccines. Do you give them DTaP, Tdap, Td? What about TIG?

A

No vaccine or TIG given

107
Q

It HIV+ or severely IMC pt presents with a minor or contaminated wound should you give TIG regardless of their tetanus immunization?

A

Yes

108
Q

If pt w/ ≥ 3 tetanus immunization presents with clean/minor wound but last vaccine was received ≥ 10 yrs ago, do you give tetanus vaccine?

A

Yes

109
Q

If pt w/ ≥ 3 tetanus immunization presents w/ contaminated/complicated wound but last vaccine was received ≥ 5 yrs ago, do you give tetanus vaccine?

A

Yes

110
Q

What is the rule of palms helpful to assess?

A

Assess TBSA < 15%

111
Q

What is the rule of palms for a peds pt?

A

Entire palmar surface- 1%, palm only- 0.5%

112
Q

What is the rule of palms for an adult pt?

A

Entire palmar surface- 0.8%, palm only- 0.5%

113
Q

When can the modified Brooke/ Parkland formula be used for burns?

A

> 15% TBSA in peds, >20% TBSA in adults

114
Q

What is the modified Brooke/ Parkland formula/ volume of RInger’s Lactate?

A

2mL- 4mL x %BSA x weight (kg) → give half in first 8 hrs and half in next 16 hrs

115
Q

What is considered a 1st degree burn?

A

Superficial thickness

116
Q

What is considered a 2nd degree burn?

A

Superficial partial thickness to deep partial thickness

117
Q

What is considered a 3rd degree burn?

A

Full thickness

118
Q

What is the management for a deep partial thickness burn (2nd) or full thickness (3rd) burn?

A

Needs grafting

119
Q

Pt presents with a burn that is erythematous. What stage is it?

A

1st- superficial thickness

120
Q

Pt presents with a burn that is wet, pink, and with blisters. What stage is it?

A

2nd- superficial partial thickness

121
Q

Pt presents with a burn that is less wet, red, +/- blisters. What stage is it?

A

2nd- deep partial thickness

122
Q

Pt presents with a burn that is dry and white. What stage is it?

A

3rd- full thickness

123
Q

What is the Broselow pediatric emergency tape used for?

A

A reference at each color bar on the tape informs you of equipment sizes to perform emergency resuscitation on the child

124
Q

In what position are pregnant females > 20 wks placed s/p trauma?

A

LLD @ 30˚

125
Q

A perimortem C-section should be initiated when?

A

Within 4 minutes post maternal arrest

126
Q

What is the goal of a perimortem C-section?

A

To remove fetus and continue resuscitation of both mother and fetus (maternal CPR should be continued during procedure)

127
Q

What is the #1 cause of death of Americans under age 50?

A

OD

128
Q

When treating pain in outpatient trauma pt, what is important for naive opioid pts?

A

Keep them opioid naive

129
Q

What is the max duration that opioids should be prescribed for pain in outpatient trauma pt?

A

3 days (throw away any remaining)

130
Q

Caution with what tx should be taken for medication in pain for inpatient trauma pts?

A

NSAIDs

131
Q

What is the goal of managing pain for inpatient trauma pts?

A

Augment opiates w/ non-opoiods

132
Q

What is the range for BP in permissive hypotension?

A

SBP 80-100

133
Q

What is the tx for an open PTX?

A

3 way seal (blocks are from entering but allows air to escape)

134
Q

When is an occlusive dressing used?

A

When you want to create an air and water tight seal, designed to stick to patients regardless of blood, sweat, hair or anything else that might be on them

135
Q

A combat application tourniquet (CAT) or quick clots are used to help control what?

A

Bleeding

136
Q

GCS of ≤10 means what?

A

Maximun GCS for intubation

137
Q

Pt in a coma will have a GCS score of what?

A

< 8

138
Q

Battle’s sign, raccoon eyes, & hemotympanum are all signs of what?

A

Head trauma

139
Q

When performing a secondary survey of the lower abdomen/pelvis. How many people are required to roll a pt?

A

Minimum of 3

3. E Med & Surgery (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions