Case 1: RTA Flashcards
what are the different types of RTA injury?
deceleration/acceleration
ejection from vehicle
direct blow
what should be found out before calculating an RTA patient’s GCS score and why?
were substances involved eg alcohol/drugs
GCS score could be decreased from this instead
how should an RTA patient be managed pre-medically?
paramedic assessment - ABCDE
immediate care
in what order should an RTA patient be managed in A&E?
ABCDE, concurrent resus, secondary and tertiary
how would you immobilise the C spine?
collar and spinal board
where should you perform thoracocentesis in a suspected pneumothorax?
2nd intercostal space
how should the D of ABCDE be managed in an RTA patient?
GCS move limbs pupil size reduced movement? lateralising signs
maximum score for GCS?
15
a GCS score under what indicates a comatose state?
8
what are the 3 categories of the GCS?
eye opening response
vocal response
motor response
maximum GCS score for the eye opening response category?
4
maximum GCS score for the vocal response?
5
maximum GCS score for the motor response?
6
what acute treatment should be considered for RTA patients?
analgesia
urinary catheter
NGT
analgesia
what imaging should be carried out for RTA patients?
CXR CT pelvis lateral C spine CT full body with contrast (except head) XR of relevant #'s
when should you use contrast in a full body CT?
anywhere below the neck (DONT USE CONTRAST FOR THE HEAD)
name the 5 types of shock
hypovolaemic cardiogenic anaphylactic septic neurogenic
pathophysiology of hypovolaemic shock?
decreased venous return + preload = dec CO;
causes hypotension which decreases organ perfusion = organ failure
how should you investigate an RTA patient with bleeding?
- CT
2. if bleed, send to IR (interventional radiology) for embolisation or surgery for packing
how can you detect lacerations on contrast imaging?
they will appear darker in comparison to the lighter background of the organ
what kind of haematoma presents with blood all round the brain?
subdural
hollow/solid organs are more commonly damaged in blunt trauma
solid
most common hollow viscera damaged?
duodenum
how can you tell if a CT scan has contrast or not?
vessels appear white
