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A1 > ATLS Ch 1-2 > Flashcards

ATLS Ch 1-2 Flashcards

1
Q

under what GSC score is transport indicated for a trauma pt?

A

13

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2
Q

Under what SBP should you transport a trauma pt?

A

90

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3
Q

What RR indicates the need to transport for a trauma pt?

A

under 10 or over 29

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4
Q

Falls of over how high indicate the need to transport a pt? (adult and child)?

A 
Adult = 20 ft
Child = 10
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5
Q

Motorcycle crash over how many mph indicate the need for transport?

A

20 mph

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6
Q

Blows above what anatomic boundary should make you suspect cervical spine injury?

A

Calvicle

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7
Q

In whom should you assume cervical trauma?

A

AMS
Injury above the clavicle
Multi-system trauma

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8
Q

Why must you be careful when intubating a patient with neck trauma, in regard to their breathing?

A

May worsen a laryngeal laceration

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9
Q

What three clinical signs give a good indication of circulation?

A
  • LOC
  • Skin color
  • Pulse
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10
Q

What are the determinants of the flow of IVFs in a tube?

A

Internal diameter of the tubing, and inversely to its length

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11
Q

EKG changes in a patient with thoracic trauma may indicate what?

A

Cardiac contusion

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12
Q

What are the three major signs of urethral injury?

A
  • Blood at the meatus
  • Perineal ecchymosis
  • High-riding prostate
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13
Q

What lab test always follows intubation?

A

ABG

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14
Q

What tubes go into a trauma patient?

A
  • Two large bore IVs or central line
  • NG or OG
  • Foley
  • (art line)
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15
Q

When should you never insert something into the nose?

A

If you suspect cribiform plate fracture

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16
Q

What hand should the pulse ox never go on?

A

The one with the BP cuff

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17
Q

Normalization of hemodynamics in injured patients requires more than a normal blood pressure. What else?

A

Good peripheral perfusion

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18
Q

When does the secondary survey begin?

A

After ABCDEs, and normalization of vital functions has been demonstrated

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19
Q

What are the components of the AMPLE mnemonic?

A 
Allergies
Medications
Past illness/pregnancy
Last meal
Events
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20
Q

What information is important to obtain in a burn injury patient?

A
  • Where burn occurred (open or closed

- What was burned

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21
Q

What are the two major reasons it is important to know if a patient is exposed to hazardous/poisonous material?

A
  • treat patient

- prevent harm to healthcare team

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22
Q

What things should be assessed for with the eyes in a head trauma pt?

A
  • Visual acuity
  • Pupillary size
  • Hemorrhage
  • Penetrating injury
  • Contact lenses
  • Lens dislocation
  • Ocular entrapment
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23
Q

Why should you remove contact lenses from a patient?

A

Will causes problems with edema

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24
Q

Once a penetrating injury to the neck passes what anatomic structure should ED physicians no longer try to explore the wound?

A

Platysma

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25
Q

What is a major complication and emergent threat to life that may be present in neck trauma pts?

A

Expanding hematoma leading to airway obstruction

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26
Q

Why is it necessary to listen for a carotid bruit in patients with neck trauma?

A

Assess for carotid injury and risk for a hematoma

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27
Q

Where is auscultation performed to detect a PTX and a hemothorax?

A

PTX = upper air fields

Hemothorax =Lower air fields

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28
Q

Unexplained hypotension in a trauma patient is what until proven otherwise?

A

Intraabdominal or intrapelvic bleed

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29
Q

All women with a pelvic fracture should had what exam performed?

A

Vaginal

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30
Q

Where does ecchymosis appear with pelvic fractures?

A

Iliac wings
Pubis
Scrotum/labia

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31
Q

Who should rock the pelvis to assess for stability?

A

Orthopedic surgeon

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32
Q

Patients with head trauma and deteriorating mental status should first have what assessed, prior to calling the neurosurgeon for management of an intracranial bleed?

A

ABCDEs

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33
Q

Why should intubation be performed as quickly as possible in head trauma pts?

A

Intubation increases ICP

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34
Q

Why must a patient with a c=spine injury always be on a backboard?

A

If lower body is free to move, c-spine will too

35
Q

Why must a trauma patient be continuously re-evaluated?

A

New findings if waking up or deterioration if missed injury

36
Q

What is the maintenance urinary output rate in adults and children?

A 
Adults = 0.5 mL/kg/h
Children = 1 mL/kg/h
37
Q

What are the three major things to check with the diability part of the ABCDEs?

A

GSC score
Pupils
lateralizing signs

38
Q

What is the appropriate action if a trauma patient begins to vomit?

A

Suction and lay in the lateral position

39
Q

What is the clinical triad of a larynx injury?

A

Hoarseness
SQ emphysema
Palpable fracture

40
Q

Agitation and obtundation respectively may be signs of what in trauma patients?

A 
Agitation = hypoxia
Obtundation = hypercarbia
41
Q

Abusive and belligerant patients may have what underlying issue?

A

Breathing compromise

42
Q

True or false: all trauma patients receive oxygen

43
Q

What is the appropriate way to remove a helmet from a trauma patient?

A

One person maintains neck stabilization, while the other removes the helmet

44
Q

What are the components of the LEMON mnemonic?

A
  • Look externally
  • Evaluate 3-3-2 rule
  • Mallampati
  • Obstruction
  • Neck mobility
45
Q

Is the mallampati done with the tongue proturiding or kept in?

46
Q

What are the four major indications for placing a definitive airway?

A
  • Severe maxillofacial fractures
  • Risk for obstruction
  • Risk for aspiration
  • Unconcious
47
Q

True or false: getting a defintive airway always takes priority over clearing the c-spine

A

If no immediate need, then can clear the c-spine first. Otherwise airway problems must always be resolved first

48
Q

What is the BURP maneuver in attempting to visualize the vocal cords?

A

Backward, upward, and rightward pressure on the larynx

49
Q

True or false: any time an intubated patient is moved, you need to check if their ET tube is in place

50
Q

True or false: it is advisable to lower very high BG levels in patients with stroke

A

True, but only if greater than 185

51
Q

What is the role of anti epileptics in a stroke?

A

Given to prevent recurrent seizures, but only if one occurs–not given prophylactically

52
Q

What is the one time dose of IV labetalol given to emergently lower BP in cases of stroke tPA candidate?

A

10-20 mg IV over 1-2 minutes. may repeat once

53
Q

How often should blood pressure be monitored after tPA administration?

A
  • q15 minutes for first hour
  • q30 minutes for next 6 hours
  • q1 hour for next 16 hours
54
Q

What is the infusion rate of IV labetalol?

A

10 mg IV followed by 2-5 mg/min

55
Q

What are the 5 Hs?

A 
Hypovolemia
Hypoxia
Hydrogen Ions
Hypo/hyperthermia
Hypo/hyperkalemia
56
Q

What are the 5 Ts?

A 
Tension PTX
Tamponade
Toxins
Thrombosis, cardiac
Thrombosis, pulmonary
57
Q

If you have a biphasic defibrillator and it does not say what the recommended Joules are, what should you set it to?

A

Max dose for all doses

58
Q

What is the rate by which survival declines at a witnessed arrest with and without CPR?

A 
With = 4%
Without = 10%
59
Q

What is the dose and max dose of IV lidocaine for cardiac arrest?

A

1 mg/kg IV, to a max of 3 mg/kg IV

60
Q

What is the dose of MgSO4?

A

1-2 g IV/IO diluted in 10 mL, given over 5 minutes

61
Q

What is the normal range for central venous oxygenation?

62
Q

If you have a central line in and are able to measure central venous oxygenation during an arrest, what is the goal ScvO2?

63
Q

If waveform capnography slopes downward, what issue may be present?

A

Emphysema ot PTX

64
Q

If waveform capnography has an irregular peak early on, what could be wrong?

A

Airway issue

65
Q

What do capnography waveforms appear like with asthma?

A

slow rising “hills” rather than boxes

66
Q

True or false: insertion of a central line into a non-compressible vessel is an absolute contraindication to fibrinolytic therapy

A

False–relative

67
Q

What is the general process of administering drugs via the IV route during cardiac arrest?

A

Give in bolus, follow with 20 mL of NS, and raise extremity

68
Q

True or false: anything that is given via the IV route in cardiac arrest can be given via the IO route

69
Q

What is the dose of drugs given via the ET route, as compared to the IV route?

70
Q

Why must CPR be stopped when giving drugs via the ET route?

A

Drugs may regurgitate back up the ET tube

71
Q

What is the standard procedure to prepare an IV drug for ET route?

A

dilute in 1 mL of sterile water or saline

72
Q

What is the dose of etomidate for RSI?

73
Q

What is the dose of succinylcholine for RSI?

A

1-2 mg/kg (usual dose is 100 mg)

74
Q

What gauge needle is used for a needle cricoidotomy?

75
Q

What is the O2 flow rate when using a needle cricoidotomy?

76
Q

When using a needle for needle cricoidotomy, how long should you occuld and release the Y connector to simulate breathing?

A

Breathe in for 1 second, breathe out for 4

77
Q

How long can needle cricoidotomy be used to ventilate patients? Why not for longer?

A

30-45 minutes

CO2 is not fully exhaled with this so will build

78
Q

What diseases preclude the use of a needle cricoidotomy?

A

No pulmonary disease or chest injury

79
Q

What flow rates should be used with a needle cricoidotomy if there is suspected glottic obstruction? Why?

A

5-7 L/min to reduce barotrauma to the lungs

80
Q

What is the lower age limit for a surgical cricoidotomy, and why?

A

12 because there is not enough cartilaginous support before this age, and significant damage may occur

81
Q

What factors limit the reliability of pulse ox?

A

Anemia
Poor peripheral circulation
Methemoglobinemia

82
Q

How do you appropriately size an oropharyngeal airway?

A

Measure corner of mouth to the earlobe

83
Q

Why will a SpO2 monitor report a different result compared to the calculated result from a PaO2 on an ABG?

A

ABG will not take into account pH, temperature, or other factors

A1 (32 decks)

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