Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ATLS > C - Circulation > Flashcards

C - Circulation Flashcards

1
Q

What signs would you notice in Class I of haemorrhage

A

Tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What signs would you notice in Class II of haemorrhage

A

Tachycardia
Decrease in pulse pressure
Agitation
20-30 ml urinary output / hour
BE -2 -> -6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What signs would you notice in Class III of haemorrhage

A

Tachycardia >120
Dropped BP
Dropped GCS
Increased RR
Base deficit 6 -> 10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What signs would you notice in Class IV of haemorrhage

A

Tachycardia +++
Dropped BP and GCS
Very low pulse pressures
NO urinary output
BE >-10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why does Obesity confound haemorrhage recognition

A

There can be extensive blood loss into tissues which would be more than in a normal BMI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What step differs in fluid resus in penetrative trauma than non-penetrative?

A

Delaying fluid resus or limiting it can DECREASE coagulopathy

Fluids dilute coag factors

NB: this is only a temporary measure until definitive surgical intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why might an NG tube be part of management of C

A

can assess for GI injuries if blood in NGT

Gastric dilation causes a vagal response causing hypotension and dysarrythmia meaning inadequate response to IVF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What factors may influence the body’s response to bleeding and change the clinical presentation

A

old age
obesity
bblockers / NSAIDS / diuretics / insulin use
ICD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why does insulin alter the body’s response to bleeding

A
  1. insulin enhances platelet. aggregation (Indirectly: high BMs cause platelt disfunction)
    1. insulin dependance means in bleed hypoglycaemia may occur
  3. due to glucose/potassium channels that are used in fluid balance hypoglycaemia causes disregulated fluid balance affecting bp
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In terms of thoracic trauma what may happen in C

A

Haemothorax
Cardiac tamponade
Thoracic trauma arrest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What structures are typically injured in hemothorax

A

systemic of hilarious vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the management of a massive haemothorax

A

Decompress with chest tube and give blood immediately

Thoracotomy may be needed (immediate return on 1.5L or more of bloodier continued bleeding needing transfusion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When is a Thoracotomy indicated in chest trauma

A

massive hemothorax: after chest drain if theres with large blood loss >1.5L / continued need for transfusions
OR
Penetrating injury to mediastinal box

mediatrinal box : clavicles -> medial nipple/scapula line -> costal margins/ T9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the usual cause of cardiac tamponade in trauma

A

penetrating trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What type of shock does cardiac tamponade cause

A

obstructive, decreased Flow to heart causing reduced CO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is kussmals sign

A

Increase in JVP on inspiration

17
Q

How do you treat cardiac tamponade

A

Emergancy thoracotomy / sternotomu + IVF

definitive surgical Mx then needed

18
Q

Define traumatic circulatory arest

A

Trauma patients who are unconscious with no pulse (PEA or systole)

19
Q

what is the management of traumatic circulatory arrest

A

closed loop CPR and Mx of A-C
ALS management
bilateral thoracostomy
definitive surgical mx or resus thoracotomy +/- pericardioscentesis

20
Q

What are signs of pelvic #

A

scotal / perineal bruising
Blood at urethra
Limb length discrepancy
Rotational deformities

unexplained hypotension may be only sign

21
Q

Should you test mechanical stability in pelvic #, why?

A

no
dislodges clots which can increase bleeding

22
Q

which type of impact typically causes pelvic #

A

falls from great height
motor vehicle typically lateral / TBone

23
Q

Surgical or conservative Mx?
Pelvic # haemodynamically stable

A

conservative

24
Q

Surgical or conservative Mx?
Pelvic # haemodynamically unstable

A

surgical

25
Q

what is the surgical management usually needed for pelvic #

A

angiography to stop bleed

or operative

26
Q

What is the affect of thermal burns on C how does it differ from normal trauma

A

leakage from capillary into extravascular aspact vs traditional haeorraghe

27
Q

What is the equation for adult resusitation in thermal burns

how quickly should this be given

A

2ml x kg x % TBSA
1/2 in first 8 hrs
1/2 in subsequent 8 hrs

28
Q

What is the equation for paeds resisitation in termal burns, how does this differ is the child weighs 25 kg?

A

3ml x kg x %TBSA

if under 30 kg add maintenence fluids with 5% dex.

29
Q

How doea hypovolaemia present differently in burns than in other causes

A

it thermal injuries tachycardia isnt reliable sign of fluid status

ATLS (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions