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ER > 3) Trauma > Flashcards

3) Trauma Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

FAST exam

A

Focused assessment w/ sonography for trauma

  • Morison pouch (hepatorenal)
  • splenorenal recess
  • pouch of douglas (pelvis)
  • pericardium
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2
Q

Raccoon eyes

A

periorbital ecchymosis (may represent basilar skull fracture)

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3
Q

Battle sign

A

ecchymosis over the mastoid (may represent basilar skull fracture)

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4
Q

Things that represent urethral injury

A

blood at urethral meatus
perineal hematoma
scrotal hematoma

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5
Q

Cushing Triad

A

-hypertension
-bradycardia
-respiratory pattern irregularity
(signs of markedly elevated ICP)

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6
Q

Central Cord Syndrome

A

Typically due to cervical hyperextension when the ligamentum flavum buckles into the spinal canal and pinches the cord
-weakeness that is greater in the upper extremities than the lower extremities

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7
Q

Brown Sequard Syndrome

A

Lateral half of the spinal cord is injured at a specific level (penetrating trauma)

  • ipsilateral motor paralysis and contralateral sensory loss distal to the injury
  • bowel and bladder function is usually maintained
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8
Q

Anterior Cord Syndrome

A

Anterior aspect of the spinal cord is injured by bone fragment compression, disc hernaition or ischemia resulting from anterior spinal artery compromise

  • paralysis and loss of pain and temperature sensation distal to the injury
  • posterior columns are unaffected so position, touch, and vibration sense is usually preserved
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9
Q

If cervical spine f(x) is suspected and NEXUS criteria can not be met

A

AP, lateral and open-mouth odontoid views should be obtained

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10
Q

Views of the cervical spine to help identify ligamentous injury

A

-flexion and extension views of the cervical spine

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11
Q

What is the most sensitive imaging modality for detecting spinal cord injury, ligamentous injury and hematomas?

A

MRI

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12
Q

Correct way to describe a fracture

A

1: open or closed
2: type
3: displacement
4: angulation
5: location
6: other

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13
Q

Wound examination should include

A
  • location
  • size
  • shape
  • margins
  • depth
  • damage to underlying adjacent tissues
  • foreign bodies
  • wound contamination
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14
Q

Anesthesia dose in wound repair

A
  • can give single dose of locally infiltrated lidocaine in a quantity up to 5mg/kg not to exceed 300mg
  • if epinephrine is included may be administered in larger quantities up to 7mg/kg
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15
Q

Lidocaine anesthesia effects

A
  • develops w/in seconds

- lasts 20-60 min

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16
Q

Bupivicaine/Marcaine anesthesia effects

A
  • onset w/in seconds

- lasts 1hr20min-80hrs

17
Q

What wounds should receive antibiotic prophylaxis

A
  • dog
  • cat
  • human
  • full thickeness oral lacerations
  • wounds contaminated by fresh water
  • planat puncture wounds
18
Q

Rabies

A

bullet shaped rhabdovirus

  • transmitted by bite of infected carnivorous animal or bat (raccoons, bats, skunks, foxes)
  • dogs and cats less common
  • rodents and rabbits rarely
19
Q

Instructions after wound closure

A
  • keep wounds clean and ry for 24-48hours until there is enough epithelialization protect from contamination
  • after 24-48hpatients may wash their wounds gently w/ mild soap and water
  • topical abx ointment may help reduce the risk of infection and improve cosmoses
  • wounds at high risk for infection should be reevaluated within 24-48h
  • return if erythema, warmth, swelling,drainage, and dehiscence of the wound occur (suggest infection)
20
Q

First degree burn

A

superficial involving the epidermis

-erythematous and painful

21
Q

2nd degree burn

A

partila thickness

  • extending into the dermis
  • erythematous w/ classic blistering of the skin
  • deeper injuries have mottles or white color changes
  • exquisitely tender
22
Q

3rd degree burn

A

full thickness

  • destruction of epidermis and dermis
  • white, leathery and in some cases charred skin
  • insensate
23
Q

4th degree burn

A

extends into the subcutaneous tissue and may involve adjacent muscle, bones and neuromuscular structures

24
Q

Which burns need to be hospitalized?

A

Adults w/ >25% BSA involvement

Children w/ >10% BSA involvement

25
Q

Treatment of significant oral lacerations

A

Should be considered contaminated and treated with antibiotic like penicillin

26
Q

Most common site of site of traumatic aortic tears

A

in the descending aorta just distal to the take off of the led subclavian artery

27
Q

Sprain vs Strain

A 
sprain = abnormal joint motion leads to ligament injury
strain = injury to the muscle-tendon unit from stretching or overexertion

ER (11 decks)

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