Accidents and injuries Flashcards
Coagulopathy in relation to lethal trauma triad is;
Ineffective clotting cascade in the body
What is the Parkland formula used for?
Calculating the amount of IV fluids needed for fluid resuscitation
On an ECG what would you be looking for if a patient was having a myocardial infarction?
ST elevation >2mm in at least 2 chest leads
A complete fracture is where where
The entire cross section of the bone is involved
What defines a compound fracture?
The skin integrity is breached
What is a Mechanism of injury?
Explains how an injury has occured, e.g. falling from a great height and a GSW.
Why is understanding mechanism of injury important?
Because it can indicate/dictate unseen injuries, and dictates how serious an injury is
What are the four types of injuries?
Blunt trauma
Penetrating trauma
Blast injury
Inhalation injury
What is an example of a blunt trauma injury?
MVA, pedestrian trauma
What is an example of a Penetrating Trauma injury?
stabbing, impalement, GSW
What is an example of a Blast Trauma injury?
Explosion
What are the primary, secondary, and tertiary injuries associated with Blast Trauma injuries?
Primary - Shockwave, contusions
Secondary - blast -abrasions, lacerations, shrapnel
Tertiary - impact with ground/other surface
What is an example of a Inhalation Injury?
Carbon monoxide poisoning, Chemical inhalation/damage
C-spine immobolisation is a consideration at which step of the primary survey?
Airway
A “high pitched noise” on inspiration suggests
a. A lower airway obstruction
b. A eunuch
c. An upper airway obstruction
d. a pneumothorax
c. an upper airway obstruction
Tracheal Deviation is a sign of:
a. A tension Pneumothorax
b. An open Pneumothorax
c. Surgical emphysema
d. a haemothorax
a. A tension Pneumothorax
OP, NP, LMA, and ET are all abbreviations for:
Airway adjuncts
At what step is a glucose assessment a consideration for a primary survey?
D - Disability
What are the three components of the ‘Triad of Death?’
Acidosis, Hypothermia, Coagulopathy
What is Hypovolemic Shock?
Where a loss of blood volume leads to decreased oxygenation of vital organs, causing the bodies compensatory mechanisms (homeostatis) to fail and organs begin to shut down.
What can cause Hypovolemic shock?
Any condition or trauma causing significant loss of blood or plasma volume
e.g. Haemorrhage, traumatic injury, prolonged vomiting or diarrhea, Burns (due to plasma loss)
What are the signs and symptoms of Hypovolemic shock?
Early = tachycardic, tachypnoeic
Late stages = hypotension
Decreasing LOC = advancing shock
What is the intervention for Hypovolemic shock?
Blood products, IV fluids
What is the intervention for Hypovolemic shock?
Big bore IV then =
Blood products, crystalloids, colloids
Why is Hypothermia part of the triad of death?
Reduction in blood volume causes hypothermia
Why is coagulopathy part of the triad of death?
loss of blood volume and subsequent hypothermia halts the coagulation cascade
Why is metabolic acidosis part of the triad of death?
absence of blood bound O2 causes cells to produce ATP anaerobically, =produces lactic acid, keytones and other acidic compounds that are released into the blood stream
What is the most effective way of dealing with the lethal triad/ triad of death? (its a trick question…)
Recognition and prevention can be more effective than treatment.
‘do a primary survey and act early to prevent the cascade’
What is the pathology of compartment syndrome?
Compartment syndrome occurs when excess pressure in a limited space constricts the structures reducing circulation to muscle and nerves, e.g. muscles swelling into the fascia (lining) has nowhere to go.
Why is Compartment Syndrome dangerous? (what does it cause secondarily?)
Can cause Muscle ischaemia - leading to muscle and nerve necrosis
How much time does it take for compartment syndrome to appear?
between 2hrs and 6 days post trauma or surgery. (usually within 72hrs of surgery)
What are the signs and symptoms of compartment syndrome?
Swollen limb
Tender muscle
Pain that is out of preportion to the injury
What blood type is the universal donor?
O- (negative)
What blood type is the universal recipient?
AB+
What should a nurse check before administering blood products?
Type of blood, batch number, expiry date (and if female Rh status)
What are the signs and symptoms of reactions to blood products in a conscious patient?
SOB, “i feel funny”, itchy, redness, fever, chest pain
What are the signs and symptoms of reactions to blood products in an unconscious patient?
increased RR, HR, rash, fever, dark urine
What is the indication for giving Whole blood?
replaces volume, improves O2 carrying capacity
What is the indication for giving PRBC’s?
Restoration of intravascualr volume
Replacement of O2 carrying capacity
What is the indication for giving Platelets?
Continued Haemhorrage or thrombocytopenia (aids clot formation, stops bleeding)
What is the indication for giving Albumin?
Expands blood volume in tauma or shock
What is the indication for giving Fresh Frozen Plasma (FFP) to a patient?
Restoration of clotting factors if patient is coagulopathic
What is the indication for giving Cryoprecipitate to a patient?
Coagulopathy with low fibrinogen
Restoration of fibrinogen
What other types of blood can type A receive?
Can have A or O blood
What other types of blood can type B receive?
B or O
What other types of blood can type AB receive?
is the universal recipient
What other types of blood can type O receive?
Can only have O type blood, but is the universal donor
What is the most important consideration for a major burns patient? (over 20% TBSA)
Severe fluid loss
What occurs in Burns +20% TBSA that can result in hypovolemia?
Fluid shift from intravascular to interstitial spaces
combines with Oedema and insensible loss results in plasma loss and therefore hypovolemia
What is the Modified Parkland formula used for?
used to calculate the fluid volumes needed for resus and to generate desired urine output.
