ATLS and Chest injuries Flashcards
Assume cervical spine injury in multi system trauma patients except when x5
N- no Neurological deficit
S- no Spinal deficit
A- alert
I- no intoxication
D- no painful Distracting injuries
State 3 ways to establish a patent airway
Jaw thrust
Simple suctioning
Nasopharyngeal/ oropharyngeal airway
State 3 ways to establish a definitive airway
1.Tracheal intubation
2.Cricothyroidectomy - needle and surgical
3.Tracheostomy
State 6 life threatening conditions affecting breathing
Airway obstruction
Tension pneumothorax
Open pneumothorax
Massive hemothorax
Flail chest
Cardiac tamponade
State 3 ways of assessing breathing in ATLS
1.Expose the neck and chest
2.Inspect and palpate neck and chest for tracheal deviation, chest movements and signs for injury
3.Determine rate and depth of respiration
Management of breathing in ATLS x2
Attach pulse oximeter
Administer high concentration of oxygen - non rebreather mask
State 4 ways of assessing organ perfusion
1.Skin color
2.Blood pressure
3.Level of consciousness - secondary to reduced cerebral perfusion
4.Pulse rate and character
Management of circulation in ATLS x5
1.Apply direct pressure to external site of bleeding
2.Insert 2 large bore catheters
3. Initiate vigorous IV fluid therapy with warmed crystalloids
4. Insert indwelling catheters
5. Prevent hypothermia
State 4 contraindications of a urinary catheter
Blood at the meatus
High riding prostate
Perineal hematoma
Scrotal hematoma
State 3 types of intra abdominal injury in blunt trauma
Solid organ injury
Hollow viscus injury with rupture
Vascular injury with bleeding
Define FAST scan and its components x4
Focused assessment with sonography in trauma
1.Subxiphoid/ pericardium
2.RUQ- perihepatic space or Morrisons pouch
3.LUQ- perisplenic regions
4.Pelvis- pouch of Doughlas or suprapuboc window
State the Becks triad present in cardiac tamponade
Muffled heart sounds
Distended neck veins
Hypotension
Define flail chest and 3 diagnostic clues
2 or more ribs fractured at 2 points
1. Paradoxical chest movements
2. Respiratory distress
3. External evidence of chest trauma
Define massive hemothorax
Blood more than 1500ml or on going hemorrhage of more than 200ml/hr over 3-4 hours
Define tension and open pneumothorax
Tension pneumothorax develops when air is trapped in the pleural cavity displacing mediastinal structures
Open pneumothorax occurs in a large chest wall defect causing equilibrium between intrathoracic and atmospheric pressure resulting in a sucking chest wound
