abordaje inicial del pt traumatico Flashcards
what are the ABCDE’s of trauma care
Airway maintenance with cervical spine protection
Breathing and ventilation
Circulation with hemorrhage control
Disability: neurologic status
Exposure / Environmental control: completely undress the patient, but prevent hypothermia
What is the first priority in an emergency setting
airway management, including clearing the airway, suctioning, administering oxygen, and securing the airway
what is the initial maneuver recommended to achieve airway patency
chin-lift
jaw-thrust
what are some injuries that severely impair ventilation in the short term
pneumothorax, flail chest with pulmonary contusion, massive hemothorax, open pneumothorax
what are some major circulatory issues to consider when assessing circulation
blood volume
cardiac output
bleeding
what are some elements of clinical observation that yield important information about pts blood volume and cardiac output
level of consciousness
skin color
pulse - must be assessed bilaterally for quality, rate, and regularity
what should the rapid neurologic evaluation etablish
level of consciousness
pupillary size and reaction
lateralizing signs
spinal cord injury
what should be done during the “E” in the ABCDE’s of ATLS
completely undress the pt to facilitate thourough examination and assessment afterwards cover the pt with warm blankets of an external warming device to prevent hypothermia in the trauma receiving area
what is the secondary survey, and when does it start
the secondary survey doesn’t begin until the primary survey (ABCDE’s) is completed, resuscitative efforts are underway, and the normalization of vital functions has been demostrated
the is the AMPLE history
is us a useful mnemonic to use when you want to get the pts history
Allergies Medications currently used Past illnesses / Pregnancy Last meat Event / Environment related to the injury
characteristics of blunt trauma
often results from automobile collisions, falls and other injuries related to transportation, recreation, and occupations
imp. info to obtain about automobile collisions: seat-belt use, steering wheel deformation, direction of impact, damage to automobile in terms of major deformation or intrusion into the passenger compartment, and whether the pt was ejected from the vehicle
characteristic of penetrating trauma
injuries from firearms, stabbings, and impalement
factors that determine the type of extent of injury and subsequent management include: region of body that was injured, organs in the path of the penetrating object, velocity of the missile
sequence of the physical exam during the secondary survey
head, maxillofacial structures, cervical spine and neck, chest, abdomen, perineum/rectum/vagina, musculoskeletal system, neurologic system
what route is indicated when planning a gastric intubation in a pt with cribiform plate fracture
the oral route
when should a vaginal examination be performed
in pt who are at rick of vaginal injury, including women with a pelvic fracture
what the desirable urinary output in adult patients
0.5 ml/kg/hr
what the desirable urinary output in pediatric patients
1ml/hg/hr
characteristics of the glasgow coma scale
Eye opening: 1 none 2 to pressure 3 to speech 4 spontaneous
Verbal response 1 none 2 sounds 3 words 4 confused 5 orientated
Motor response 1 none 2 extension 3 abnormal flexion 4 normal flexion (withdrawal) 5 obeying commands
GCS interpretation
3 - 8: severe brain injury, intubate
9 - 12: moderate brain injury
> 13: mild brain injury
