Care of the Multi-system Trauma Patient Flashcards
triage
process of rapidly determining patient acuity
2 phases of triage
primary assessment
secondary assessment
pediatric assessment triangle
appearance
work of breathing
circulation
what does the primary assessment focus on (letters)
ABCDEFG
primary assessment A
airway with c spine stabilization and/or immobilization
primary assessment B
breathing
primary assessment C
circulation
primary assessment D
disability
primary assessment E
Exposure/environmental control
primary assessment F
facilitate adjuncts and family
primary assessment G
get resuscitation adjuncts
what does the secondary survey assess (2)
H and I
H in secondary assessment
history and head to toe assessment
I in secondary assessment
inspect the posterior surfaces
when is the medical examiner called
if patient dies in hospital or within 24 hours after discharge
why are elderly patients at high risk for injury X4
decreased visual acuity and peripheral vision
hearing loss
pre-existing disease and medication use
dementia and cognitive impairment
what should you assess before assuming dementia
hypoxia
what is heat exhaustion
prolonged exposure to heat and the body is unable to cool itself
s/s of heat exhaustion X5
VAGUE
fatigue N/V extreme thirst diaphoresis mild fever d/t dehydration
heat exhaustion tx X4
move to a cool area
remove constrictive clothing
decrease core temp
IV fluids if oral not tolerated
how can you lower core temperature X5
moist sheet covering
cool IV fluids
ice to groin and axilla
immerse in bath of cool water
fan
what is CI in heat exhaustion tx
no salt tablets d/t gastric irritation and hyperNa
who is likely to get heat exhaustion
anybody outside for extended time
what is heat stroke
failure of the hypothalamic thermoregulatory processes
sweat glands stop functioning and core temperature rises
heat stroke s/s X6
hot, dry, ashen skin
hallucinations
combativeness
loss of muscle coordination
cerebral edema
hemorrhage
what is death from heat stroke related to
the amount of time the patients body temperature remains elevated
who is likely to get heat stroke X5
super young
super old
chronic illness
football players
farmers
what is chlorpromazine
a paralytic
why is chlorpromazine given in heat stroke
shivering increases core temperature
when does aggressive temperature reduction begin
102+ degrees
complications from heat stroke X3
rhabdomyolysis
myoglobinuria
DIC
rhabdomyolysis symptoms X2
tea colored urine
elevated CKMB
what is frostbite
damage to the skin from freezing
how is severity of frostbite determined
depth
temp
how long you were there
whether clothes were wet or dry
frostbite tx
take off jewelry - body might swell
immerse infected part in temp controlled water
do not cover with heavy blankets or sheets
water temperature for frostbite
98.6-104
mild hypothermia temps
93.2-96.8
core temp of <95
s/s of mild hypothermia X1
AMS
moderate hypothermia temps
86-93.2
core temp of <86
what happens to metabolism in hypothermia
decreases X3
when can you pronounce a hypothermic patient dead
when they are rewarmed to at least 90 degrees
what happens to the heart in moderate hypothermia
vulnerable to ventricle and atrial arrhythmia
severe hypothermia temp
<86
when does coma result in hypothermia
<82.4
when does death occur in hypothermia
<78
usual cause of death in hypothermia
usually refractory dysrhythmias
tx of mild hypothermia
passive or active external rewarming
tx of moderate-severe hypothermia
active core rewarming
when do you stop rewarming
when core temp reaches 95 degrees
what is a submersion injury
person becomes hypoxic due to submersion in water
what is drowning
death from suffocation after submersion in water
immersion syndrome
immersion in cold water which leads to vagus nerve stimulation and potentially fatal dysrhythmias
near drowning
survival from potential drowning
tx of submersion injuries X5
ABCD
mechanical ventilation
observe for a minimum of 4-6 hours
mannitol
c-collar
why do we observe submersion injuries for 4-6 hours
delayed pulmonary edema
who is at the greatest risk for animal bites
children
most common cause of animal bites
dog and cats
complications from dog bites X2
lots of muscle damage
usually on extremities
who looks at all dog bites
plastics
when are dog bites not sutured
after 6 hours
what do cat bites look like
puncture wounds
do dogs or cat bites have a greater infection risk
cat
X3 infections caused by cat bites
septic arthritis
osteomyelitis
tenosynovitis
what causes cat bite infections
pasturella
what is boxers fracture
fracture of the 4th/5th finger from punching teeth
complications from human bites X4
infection
hep
staph/strep
HIV
what could human bites be a sign of
sexual abuse
is a black widow bite neurotoxic or cytotoxic
neurotoxic
is a brown recluse bite neurotoxic or cytotoxic
cytotoxic
what is the venom in crotalidae/pit vipers
hemolytic
what is the venom in elapidae
neurotoxic
what is CO poisoning
CO binds to hbg which does not carry oxygen
s/s of CO poisoning X5
dizziness nausea HA impaired judgment, confusion
CO poisoning tx X2
fresh air immediately
100% O2
main intervention for intraocular foreign bodies
must remain in eye until OR
