11 - Trauma Flashcards
When a trauma comes in what are some important questions to ask the ambulance crew?
- Location of injury
- Events before injury
- Mechanism of injury
- Ability to walk after injury?
- Last meal eaten?
- PMHx?
- Tetanus status?
- Normal mobility status?
- Occupation?
- Dominant hand?
What are some questions to ask paramedics specifically if there has been a RTA?
- Collision speed?
- Airbags deployed?
- Wearing seatbelt?
- What seat in car?
- Injuries/fatalities of other passengers?
- What stopped the car?
- Was the patient trapped?
What are some worrying signs with trauma?
- Shock
- Tachypnea
- Reduced GCS
- Significant mechanism
Before/during examination of trauma patients what is important to consider?
Pain relief!!!!
What is a significant mechanism of injury in trauma?
- Fall >1m or 5 stairs
- Axial load to head e.g diving
- High speed RTA
- Rollover RTA
- Ejection from a vehicle
- Bicycle collision
What trauma injuries require immediate senior input?
- Neurovascular compromise
- Involving deep structures e.g tendons
- Wounds in cosmetic/sensitive areas
- Open fracture
- Displaced fractures
- Fractures with skin tenting
- Dislocation of major joints
What is the likely cause of death following trauma?
Immediately: brain or high spinal injuries, cardiac or great vessel damage.
Early hours:splenic rupture, sub dural haematomas and haemopneumothorax
Days: sepsis or multi organ failure
Before inserting an NG tube or nasopharyngeal airway, what contraindication do you need to check for?
Basal skull fracture
What are the different ways of describing simple wounds?
- Puncture
- Incisional (sharp objects)
- Laceration(blunt trauma)
- Abrasion
When taking a history for a simple wound what are some questions to ask?
- Mechanism
- Foreign bodies
- Contamination with naure
- Tetanus status
What do you need to look at when examining a simple wound?
- Site, size, type of wound
- Distal senssation
- Cap refill
- Movements
- Depth
- Foreign bodies
Use local anaesthetic when examining
What investigation should be done if you suspect a foreign body in a wound?
X-ray
How should you manage a simple wound?
- Clean with saline or sterile water
- Consider antibitoics and tetanus boost
- Primary closure (glue, steristrips, sutures)
- Delayed primary closure (if likely infected)
What are some common thoracic injuries in trauma patients?
How do you treat a haemothorax in a trauma patient?