B6-072 Trauma Flashcards
primary survey ABCDE
A-airway
B- breathing
C- circulation, is it shock?
D- deficit deformity, neuro status
E- exposure: where all the injuries are
most important part of secondary survey
reassessment
what is considered a definitive airway?
tube in trachea
what is an important consideration in trauma when establishing an airway?
C-spine stabilization
paradoxical movement of the chest indicates
flail chest
treatment for flail chest
positive pressure ventilation
in field treatment for open pneumothorax
three sided dressing
what is this?
tension pneumothorax
what is this?
tension hemothorax
treatment for pneum/hemothorax?
chest tube
bubbling in the fluid chamber of a chest tube when the patient coughs/breathes deeply indicates
air leak
Beck’s triad (hypotension, JVD, muffled heart sounds) indicates
pericardial tamponade
establish […] IVs to resuscitate with blood
2 large bore
most common cause of shock in trauma patient is
hemorrhage
define massive blood loss
loss of entire blood volume over 24 hours OR
50% acute loss within minutes of injury
define massive transfusion
> 10 unit PRBC OR
equivalent to blood volume has been given in 24 hours
by the time changes in the blood pressure are occurring, what stage of shock is the patient in?
class 3- need blood
triad of death
hemorrhage causing hypothermia, acidosis, coagulopathy
GCS < 8 means the patient is
in a coma, may need intubation but check ABC first
high spinal cord injury that affects the vagus nerve causes […] shock
neurogenic
what two broken bones pose an immediate danger to the patient?
pelvis
femur
the […] response of GCS is the most important predictor of outcome
motor
hypotension
bardycardia
warm extremities
neurogenic shock
treatment for neurogenic shock
volume resuscitation
vasopressors if needed
what 4 spaces does a FAST exam look at?
hepatorenal
perisplenic
pelvis
pericardial
black space on FAST exam indicates
fluid (assumed to be blood until proven otherwise)
why is it important to stabilize fractures?
diminishes blood loss
open book pelvic fractures should receive a […] to slow blood loss
binder
abdominal injury is most often found on […] survey
secondary
thoracic injury is most often found on […] survey
primary
[…] percentage of abdominal injuries require surgery
high
[…] percentage of thoracic injuries require surgery
low
aortic bifurcation is at the level of
umbilicus
any injury below the nipple line anteriorly and the scapulae posteriorly has potential for […] injury
intraabdominal
when perforated, “hallow” organs cause
contamination –> peritonitis
what main structures are in the retroperitoneal cavity?
solid organs (kidney, pancreas)
large vessels (aorta, vena cava)
differential movement of fixed and non-fixed structures is caused by
deceleration injuries (MVC)
treatment of extraperitoneal bladder rupture due to pelvic fx
Foley decompression
treatment of intraperitoneal rupture with a full bladder
requires surgery b/c is leaking into abdomen
“seat belt” sign can indicate injury to
bowel
guarding
rebound tenderness
percussion guarding
all sign of…
peritonitis
small bowel injury many not show signs of […] for several hours
peritonitis
rolling a pregnant patient to the […] will take pressure off the IVC
left
patients in hemorrhagic shock should receive […] and […] before vasopressors
warm fluids
blood products
Glascow coma scale is part of [primary/secondary] survey
primary
symptoms of massive hemothorax:
SOB
tachycardia
hypotension
decreased breath sounds
dullness to percussion
flat neck veins
symptoms of cardiac tamponade
muffled heart tones
shock
distended neck veins
symptoms of neurogenic shock/spinal cord injuries
flaccid paralysis
hypotension
bradycardia
best treatment for patient with blunt trauma that has a positive FAST exam
ex lap
signs of tension pneumothorax
SOB
diminished breath sounds
tympany to percussion
distended neck veins
is chest xray necessary for diagnosis of pneumothorax?
no, can go ahead with chest tube
laceration without active extravasation of contrast can be treated with
watchful waiting
laceration with active extravasation of contrast in a patient that is hemodymically stable can be managed with
embolization
laceration with active extravasation of contrast in a patient that is not hemodymically stable can be managed with
emergent laparatomy
treatment for neurogenic shock
initial volume resuscitation
followed by vasopressors as needed
spinal cord injury
low bp
bradycardia
neurogenic shock
