Body trauma Flashcards
Trauma body parts-General (4)
1) Chest trauma
2) Spinal trauma
3) Head trauma
4) Stomach trauma
Chest trauma-Injuries
Skeletal (2)
Pulmonary (4)
Cardiac (2)
1) Rib fracture
2) Flail Chest
3) Pulmonary contusion
4) Pneumothorax
- Closed/open/tension
5) Hemothorax
6) Trachea-bronchial disruption
7) Cardiac tamponnade
8) Myocardial contusion
Rib fracture-Signs (2)
Signs
- Swollen chest
- Assisted breathing/rapid breathing
Flail Chest-Signs (2)
Signs
- Two adjacent ribs broken in two places.
- Paradoxical breathing
Pulmonary/Cardiac contusion, Hemothorax/Cardiac tamponnade-Signs
Contusion-burst blood vessels.
Tamponnade-bleeding in between muscle layer and membrane.
Hemothorax-blood seeps into muscle fibres/fills trachea and bronchia.
Signs
- Hypovolemic shock
- Breathing difficulty/Chest pain
- Signs of entry/shock
Pneumothorax
Closed/open/pressure-Signs (2)
Plastic bag syndrome,
lungs collapse, in pressure pneumothorax ruptured lung, pressure on veins and heart.
Signs
- Pain during breathing
- Whistling noise and bloody foam from puncture wound (open pneumothorax)
Chest Trauma-Treatment
PHTLS scheme
S-kinematics, Call ICU.
A-Jaw thrust
B-Check for chest trauma, oxygen/Artificial breathing
C-Radial pulse impression
D-Check
E-Inspection of wound
-Splint (skeletal)
-Bandage (asherman-remove if worsens, nylon)
-Position of patient (p.p place on side of trauma)
T&T-Emergency evacuation/ICU
Second round-Monitor breathing and consciousness-very important.
Head trama-Concepts and Injuries (6)
Concussion Head fracture -Linear (80%) -Depressed (11%) -Basilar (4%) Intracranial Haemorrhage (ICH) Cranial contusion Intracranial pressure (ICP)-Cushing's triad -Foramen Magnum
Head concussion-Signs
Physical (3)
Neurological (2)
Psychological (3)
Result of movement (coup/contrecoup) of brain within the skull.
Signs Physical: -Headaches -Nausea -Sensual impairments (visual, audio, coordination)
Neurological:
- Amnesia
- Disorientation
Psychological:
- Crankiness
- Lost of interest
- Unproportional emotional reactions
Intracranial Haemorrhage (ICH), Cranial Contusion-Signs
Cushing’s Triad (3)
Physical (4)
Psychological (1)
ICH:
1) Epidural
- progresses quickly (arterial)
- lucid interval (30%)
2) Subdural
- progresses slowly (venous)
3) Subarachnoid
- Blood enters CSF
Signs
Cushing’s Triad (minutes until death)
- Hypertension
- Bradycardia
- Irregular breathing
Physical:
- Unstable consciousness
- Unresponsive pupils
- Nausea
- Seizures (common)
Psychological
-Restless/violent
Head Fracture-Signs
Linear (1)
Depression (1)
Basilar (2)
Head fracture can cause concussions, ICH and Cranial contusions
Signs Linear (80%) -Crack on skull Depression (11%) -Soft skull under skin Basilar (4%) -CSF haemorrhage (clear/red oily) -Racoon eyes/Battle signs (behind ears)
Head trauma-Treatment
PHTLS scheme
S(Scene)-kinematics
A-Jaw thrust
B-Oxygen/artificial breathing
C-I.V if necessary (haemorrhaging)
D-Monitor level of consciousness (lucid interval/amnesia)
E-Attack to back splint.
T&T-Notify relevant hospital to open a trauma theatre.
Second time-Monitor, blood sugar/drugs and alcohol, anamnesis.
Spinal trauma
Symptoms (2)
Treatment (2)
Symptoms:
- Motor disability (tingling, weakness, lack of feeling)
- Neurogenic Shock (pulse, BP, breathing, skin colour and temperature, erection)
Treatment:
- PHTLS scheme
- Fixture to back splint (even if patient can walk)
Stomach Trauma-Signs (4)
Important note (1)
Signs:
- Hard stomach (peritoneal irritation)
- Foetus position
- Bleeding from orifices (urine, faeces, vomit)
- Hypovolemic shock (with no known cause)
- Suspect internal bleeding and/or infection.
Stomach Trauma-Treatment (exceptions) (3)
PHTLS scheme
- Bandage any protruding internal organs
- Back splint
- Fast (pre operation)
