ATLS Ch 1-2 Flashcards
under what GSC score is transport indicated for a trauma pt?
13
Under what SBP should you transport a trauma pt?
90
What RR indicates the need to transport for a trauma pt?
under 10 or over 29
Falls of over how high indicate the need to transport a pt? (adult and child)?
Adult = 20 ft Child = 10
Motorcycle crash over how many mph indicate the need for transport?
20 mph
Blows above what anatomic boundary should make you suspect cervical spine injury?
Calvicle
In whom should you assume cervical trauma?
AMS
Injury above the clavicle
Multi-system trauma
Why must you be careful when intubating a patient with neck trauma, in regard to their breathing?
May worsen a laryngeal laceration
What three clinical signs give a good indication of circulation?
- LOC
- Skin color
- Pulse
What are the determinants of the flow of IVFs in a tube?
Internal diameter of the tubing, and inversely to its length
EKG changes in a patient with thoracic trauma may indicate what?
Cardiac contusion
What are the three major signs of urethral injury?
- Blood at the meatus
- Perineal ecchymosis
- High-riding prostate
What lab test always follows intubation?
ABG
What tubes go into a trauma patient?
- Two large bore IVs or central line
- NG or OG
- Foley
- (art line)
When should you never insert something into the nose?
If you suspect cribiform plate fracture
What hand should the pulse ox never go on?
The one with the BP cuff
Normalization of hemodynamics in injured patients requires more than a normal blood pressure. What else?
Good peripheral perfusion
When does the secondary survey begin?
After ABCDEs, and normalization of vital functions has been demonstrated
What are the components of the AMPLE mnemonic?
Allergies Medications Past illness/pregnancy Last meal Events
What information is important to obtain in a burn injury patient?
- Where burn occurred (open or closed
- What was burned
What are the two major reasons it is important to know if a patient is exposed to hazardous/poisonous material?
- treat patient
- prevent harm to healthcare team
What things should be assessed for with the eyes in a head trauma pt?
- Visual acuity
- Pupillary size
- Hemorrhage
- Penetrating injury
- Contact lenses
- Lens dislocation
- Ocular entrapment
Why should you remove contact lenses from a patient?
Will causes problems with edema
Once a penetrating injury to the neck passes what anatomic structure should ED physicians no longer try to explore the wound?
Platysma
What is a major complication and emergent threat to life that may be present in neck trauma pts?
Expanding hematoma leading to airway obstruction
Why is it necessary to listen for a carotid bruit in patients with neck trauma?
Assess for carotid injury and risk for a hematoma
Where is auscultation performed to detect a PTX and a hemothorax?
PTX = upper air fields
Hemothorax =Lower air fields
Unexplained hypotension in a trauma patient is what until proven otherwise?
Intraabdominal or intrapelvic bleed
All women with a pelvic fracture should had what exam performed?
Vaginal
Where does ecchymosis appear with pelvic fractures?
Iliac wings
Pubis
Scrotum/labia
Who should rock the pelvis to assess for stability?
Orthopedic surgeon
Patients with head trauma and deteriorating mental status should first have what assessed, prior to calling the neurosurgeon for management of an intracranial bleed?
ABCDEs
Why should intubation be performed as quickly as possible in head trauma pts?
Intubation increases ICP