1- Trauma- Airway And Assessment Flashcards
Kinematics equation and what has the most effect
K = 1/2Mass x Velocity^2
Velocity/speed has the biggest effect
What are the 3 types of collisions in a car vs object crash
1- Car vs Object
2- Body vs interior of vehicle
3- Organs vs body interior
What are secondary collisions in a vehicle collision
Contents of the car striking the victim
What are the 5 types of vehicle collisions from most to least common
1- Rotational 38% 2- Frontal 32% 3- Lateral 15% 4- Rear end 9% 5- Rollover 6%
What is down and under caused by and what happens
Frontal collisions
Knee, femur, hip fractures and dislocations from sliding under the steering column and hitting the dash
What is up and over caused by and what happens
Frontal collisions
Chest injuries, head injuries or ejection
What type of collision has a high incident of deaths
Lateral collisions
Injuries resulting from Lateral collisions
- Extremity, rib fracture, on side of impact
- Cspine and aorta injury
Explain paper bag syndrome
Rapid inhale right before impact, chest hits interior and punctures inflated lung
What is a main concern of rotational impact
Multiple impacts but less injury that vehicle suggests
3 step process of a rear end collision
1- Head snaps back, neck extends
2- Head snaps forward, neck flexes
3- Brain also moves inside the skull
Injury patterns from rollover crashes are
Unpredictable
Most life threatening injury from a vehicle collision is
Ejection
Proper position for a lap belt
Across pelvic girdle
Injuries from improper lap belt placement
T-12, L-1 and L-2
Injuries from improper shoulder harness position
Chest and head injuries
At what age can kids ride in the front seat
13 y/o
How is an airbag deployed
Electrical charge of impact
What from an airbag can cause what problem
Chemicals can irritate eyes and mouth
4 types of motorcycle collisions
- Frontal
- Angular
- Sliding
- Ejection
Common injury from frontal motorcycle collision
Bilateral femur fracture
Common injury from angular motorcycle collision
Trapped lower extremity
Common injury from a sliding motorcycle collision
Abrasions and minor fractures
3 types of motorcycle ejections
- Bike v Object
- Rider v Object
- Rider v Ground
What’s the main concern with sports injuries
C-spine
When should you remove a helmet (2)
- Too big/loose
- Inaccessible airway when needed
3 impacts of pedestrian accidents
1- Vehicle hits body
2- Body hits vehicle
3- Body hits ground
What is related to injury potential of falls
Height
At what height is a fall considered significant
3x the persons heights
What things should be considered with a fall (4)
- Height
- Surface
- Body part that hit first
- Path of energy displacement
How do adults typically land vs kids
Adults- Feet
Kids- Heads
5 types of blast injuries
- Primary
- Secondary
- Tertiary
- Qauternary
- Quinary
What primary blast injuries
Concussion of blast, hollow organs rupture
What are secondary blast injuries
Flying objects, can penetrate the body
What are tertiary blast injuries
From the body being thrown, musculoskeletal injuries
What are quaternary blast injuries
Injuries from the heat of the blast itself
What are quinary blast injuries
From a dirty bomb, the chemical injuries/effects
What do burn patients die from
HYPOXIA
What do most trauma patients die from other than hypoxia for burn victims
Blood loss
Cavitation in trauma is a result of what
Medium or high speed energy, spreads more energy outward
What is trajectory
The path of a projectile
What is drag
Force to slow trajectory
What is cavitation
Outward motion of tissue
2 important things to find with a penetrating trauma injury
The entrance and exit wounds
What is the Golden Hour/Period
- Begins at onset of injury
- No more than 10 minutes on scene
What is more important bleeding control or airway control
Bleeding control, if bleeding
What words indicate it is important to stop bleeding (4)
- Significant
- Profound
- Gushing
- Squirting
What is the result of prolonged scene times
- Increased death rate
- Prolonged hospital stays
- Inefficient care delivery
What is the main cause of prolonged scene times
Ineffective team management
3 reasons to stop an assessment
- Scene becomes unsafe
- Airway obstruction
- Cardiac arrest
Initial assessment should take how long and look for what
- Less than 2 minutes
- Identify any immediate life threats
What should you assess on the rapid trauma assessment (6)
- Head/neck
- Chest
- Abdomen
- Pelvis
- Extremities
- Back
What does DCAPBTLSIC stand for
Deformities Contusions Abrasions Penetrations Bruising Tenderness Lacerations Instability Crepitus
What should be done during a rapid trauma survey (4)
- Baseline vitals
- Brief neuro exam (Pupils, GCS, signs of cerebral herniation)
- Medical alert tags
- Consider other causes
Who is considered a priority patient (4)
- Dangerous MOI
- History (Loss of consciousness)
- High risk groups
- Abnormal initial assessment
- Abnormal perfusion, difficulty breathing, abnormal perfusion
Load and go situations
Significant MOI and/or poor general health
Name 7 load and go situations
- AMS
- Abnormal respiration’s
- Abnormal circulation
- Abnormal chest exam
- Tender, distended abdomen
- Pelvic instability
- Bilateral femur fractures
Interventions that can/should be done on scene with a critical patient
- Manage airway
- CPR
- Control major external bleeding
- Seal sucking chest
- Stabilize flail chest
- Decompress tension pneumo
- Stabilize impaled object
- Complete packaging
4 things to remember when contacting medical direction with a trauma patient
- Contact ASAP
- Give ETA
- Give condition of the patient
- State what’s needed before arrival
If there is a change in the patients condition what should you do (2)
- Redo primary assessment
- Check interventions
What is a Mallampati score
Conscious patient opens mouth, determine difficulty of an intubation
2 good reasons for RSI
Burns, Major facial trauma
SpO2 goal for a trauma patient
Greater than 95%, as high as possible
O2 % for Cannula, NRB, BVM and flow rate of each
Cannula, 2-6 Lpm, 25-30%
NRB, 12-15 Lpm, 60-90%
BVM, 12-15 Lpm, 90-100%
Normal TV for an adult
400-600 cc
Normal MV for an adult
6 Lpm
Hypoventilation pCO2 number
Above 40
Hyperventilation pCO2 number
Below 35
Ventilation rate for intubated vs non-intubated patients
Intubated- 8-10
Non intubated- 10-12
Suction immediately for (2)
- Avoid gastric distention
- Gurgling respiration’s
What does the difficult ventilation pneumonic BOOTS stand for
Beard Obesity Older patients Toothlessness Snores or stridor
What does hyperventilation result in (2)
- Decreased cerebral perfusion
- Alkalosis
What does hypoventilation result in (2)
- Builds up CO2
- Acidosis
As blood volume goes down what happens to CO2
CO2 goes down
When is immediate intubation required
Impeding airway closure