Approach to Trauma Flashcards
___ leading cause of death in first 4 decades of life
trauma
trauma centers are level ___
1: 24 hour in house surgical coverage / OR
rapid access to all surgical specialities
if in bad shape want to go to a level one center!
what is a trauma pt critera
physiologic: SBP less than 90
Injury: chest wall unstable
Mechanism: fall over 2 times their height
Goal.. miss rate of less than 5% of the time where have to transfer pt
assume ___ in pts with multisystem trauma
c-spine injury
GCS less than 8
intubate
for breathing look for…
deviated trachea, flalal chest, absence of breath sounds, CXR to evaluate lung fields
if you can see white in the armpit fat on xray..
air has seeped superficially into the chest = subcutaneous emphysema
needle decompression if __
tension pneumothorax
___tube for pneumothorax/hemothorax
chest tube
what are 5 contraindications of foley catheter
signs of urethral injury: blood at meatus perineal ecchymosis blood in scrotum high riding prostate pelvic fractures
if thinking there is urethral injury what test prior to catheter insertion?
retrograde urethrogram
when is ED thoracotomy indicated?
witness loss of pulses
usually for penetrating trauma of chest only - typically when it was low velocity weapon
treat ICP
mannitol
head of bead elevated
hyperventilation
emergen decompression
E -exposure tips
log roll - always look at back!
rectal temp
complete disrobe of pt but then warming prvt hypothermia
high suspicion of abdominal trauma when there is what 3 things
hypotension, abdominal tenderness and tachy
___ most common injured organ in blunt trauma
spleen
second most common organ injury
liver - usually associated with other abdominal injureis as well
def hollow viscous injury
injury involves: stomach, bowel, or mesentery
symptoms are result of blood loss and peritoneal contamination
__ injuries can lead to bucket handle tears or mesentery
deceleration injureis
free fluid without solid organi injury is a ___ until proven otherwise
hollow viscus injury
what 4 views are included in FAST US?
cardiac, RUQ, LUQ, suprapubic
goal: looking for free fluid
trauma steps:
primary survey secondary survey (ample) FAST CT head to pelvis home or observation or non emergent OR
