43 trauma resus

Question 1

3 main times of trauma deaths

Answer 1

1. immediate -seconds to minutes
2. early - salvagabel -golden hour
3. late - days to weeks, often in hospital due to complications

Question 2

5 parts of ATLS care

Answer 2

1. primary survey
2. resuscitaion
3. secondary survey
4. investigations
5. definitive care

Question 3

5 parts of primary survey

Answer 3

Airway and Cspine
Breathing
Circulation
Disability (neuro eval)
Exposure

Question 4

potential causes of airway obstrucion

Answer 4

• teeth
• emesis
• blood
• fracture
• soft tissue swelling

Question 5

what to do for mandible fracture

Answer 5

sux for intubation

Question 6

what to avoid is C-spine fracture

Answer 6

head tilt

Question 7

main trauma intubation method

Answer 7

RSI

- only do if confident that airway can be secured

Question 8

2 main reasons for surgical airway

Answer 8

1. failed RSI

2. severe facial trauma

Question 9

how to protect C-spine in intubation

Answer 9

one person whose sole job is to hold the head

Question 10

what is rule out in breathing

Answer 10

tension pneumo

Question 11

indications of tension pneumo

Answer 11

1. absent breath sounds
2. trachea deviation
3. bulging neck veins

Question 12

Tx of tension pneumo

Answer 12

needle decompression followed by chest tube insertion

Question 13

7 parameters to assess circultion

Answer 13

1. LOC
2. pulse
3. HR
4. BP
5. skin color
6. urine output
7. base deficit

Question 14

real DDx for hypotensive trauma PT

Answer 14

1. HEMORAGE
2. obstructive
3. neurogenic - high spinal
4. cardiogenic
5. other

Question 15

main system to think about hypotension by

Answer 15

by region

Question 16

head causes of hypo

Answer 16

compression of brainstem - accomanied by brady

Question 17

neck causes of hypo

Answer 17

• penetration - blood loss

Question 18

chest reasons for hypo - 5

Answer 18

1. tension pneumo
2. hemothorax - CXR and low breath sounds
3. aortic arch - rare for for patiets to survive to ER
4. ruptured diaphragm - rare
5. penetration of heart or large vessel

Question 19

abdo causes of hypo (4)

Answer 19

FAST is essential

1. spleen 50% - LUQ free fluid
2. liver 40% - RUG and FAST in morrison’s pouch
3. retroperitoneum 15% - renal laceration
4. other - IVC, pancreas, bladder

Question 20

2 main divisions of pelvic bleed

Answer 20

veins and arteries (worse)

Question 21

3 main steps for pelvic bleeds

Answer 21

1. tightly wrapped
2. palvic angio with embolization
3. OR f or pelvic packing

Question 22

most effective Tx of external bleeds

Answer 22

direct pressure

Question 23

Tx of shock

Answer 23

1. 2 large bore IVs - 2L NS
2. after 2L start PRBCs
3. transexemic acid - fibrinolytic

Question 24

blood types to give

Answer 24

O+ in male and O- in female

Question 25

what is mneumonic for Disability

Answer 25

AVPU
Alert
Verbal stim response
Painful stim response
Unresponsive
- also look at pupils and general muscle functions

Question 26

what is needed in enviroment

Answer 26

keep patient warm amd dry

Question 27

3 initial investigations

Answer 27

1. CXR
2. AP pelvis
3. FAST exam