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Emergency care and transport of the sick and injured textbook > Chapter 24-trauma Overview > Flashcards

Chapter 24-trauma Overview Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Trauma emergencies

A

Occur as a result of force applied to the body

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2
Q

Medical emergencies

A

Include illnesses or conditions; not caused by an outside force

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3
Q

Index of suspicion

A

Your awareness and concern for potentially underlying unseen injuries

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4
Q

Mechanism of injury (MOI)

A

The way in which traumatic injuries occur, it describes the forces acting on the body that causes injury

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5
Q

What are the three concepts of energy typically associated with injury? Not including thermal energy)

A

Potential energy, kinetic energy, and the energy of work

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6
Q

Work

A

Force acting over a distance

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7
Q

Kinetic energy

A

The energy of a moving object

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8
Q

What is the kinetic energy formula

A

KE = 1/2 mass x velocity

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9
Q

How to find the force of something

A

F= mass x velocity

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10
Q

Potential energy

A

The product of mass, force of gravity, and height and is mostly associated with the energy of falling objects

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11
Q

Mustisystem trauma

A

An injury to more than one body system

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12
Q

Blunt trauma

A

The result of force to the body that causes injury without any penetrating of the soft tissues or internal organs of cavities

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13
Q

What are the three collisions involved in a car crash

A

The first collision is a vehicle against another object, the second collision is the passenger against the interior of the car, the third collision is the passengers internal organs against the solid structures of the body

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14
Q

Coup contrecoup brain injury

A

Compression injury to the anterior and posterior part of the brain

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15
Q

Significant moi’s are suggested by what findings

A
  • death of an occupant in the vehicle
  • sever deformity of the vehicle or intrusion in the vehicle
  • severe deformities to the frontal part of the vehicle, with or without intrusion
  • moderate intrusion in lateral crash
  • severe damage from the rear
  • crashed in which rotation is involved
  • ejecction from the vehicle
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16
Q

What three Likely areas of injury can a significant MOI and condition of vehicle suggest

A

A. The knees can strike the dashboard, resulting in hip dislocation or fracture
B. Serious chest and abdominal injuries can occur from the steering wheel
C. Head and spinal injuries can occur from collision with the window

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17
Q

What injuries do rear end crashes typically cause?

A

Whiplash

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18
Q

What injury can happen from a lateral car crash? (T bone)

A

The passenger can get a lateral whiplash injury in the shoulders and the head moves towards intrusion

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19
Q

Car vs pedestrian

A

Often results in broken bones, but may also have serious unseen injuries to underlying body systems.
Estimate speed of the vehicle, then whether the patient was ejected, the surface landed on, and what distance or if the patient was pulled under the vehicle
Multi system injuries are common

20
Q

Car vs bike

A

Examine position and damage of bicycle.

If Helmet is damaged, expect head/spinal trauma

21
Q

Car vs motorcycle

A

Make sure to undergo cervical spine checking

Examine the motorcycle, the distance of skid on the road, the car, and the helmet

22
Q

What are the four types of motorcycle impacts?

A
  • head on crash
  • angular crash; usually results in direct crushing injury between motorcycle and secondary force to the lower extremities
  • ejection: can suffer from sever road rash to bone
  • controlled crash: the biker lays the bike down to ultimately avoid injury
23
Q

How many feet of a fall is considered significant

A

20 feet

24
Q

What two things are considered a significant moi for a child

A
  1. Falls of greater then 10 feet (2 to 3 times the height)

2. Medium to high speed vehicle crash (>25 mph)

25
Q

When a patient falls, what factor should you account for?

A

The height of the fall
The type of surface struck
The part of the body that hit first, followed by the path of energy displacement

26
Q

Trajectory

A

The path the projectile takes

27
Q

Cavitation

A

A phenomenon in which speed causes a bullet to generate pressure waves, which caused damage distance from the bullets path

28
Q

Drag

A

Air resistance

29
Q

What are signs and symptoms of blunt or penetrating trauma to the neck? What would the index of suspicion be?

A 
Noisy or labored breathing
Increased respiratory rate
Swelling of the face or neck
Altered gag reflex
Decreasing/low Glasgow, scale
Rapid weak pulse
Decreasing/low blood pressure

IOS:

  • significant bleeding or foreign bodies in the upper or lower airway, causing obstruction
  • be alert for airway compromise
30
Q

What would the signs and symptoms be for significant chest wall blunt trauma from motor vehicle crashes, car versus pedestrian, and other crashes (as well as penetrating trauma)
What would the IOS be?

A 
Significant chest pain
Shortness of breath
Increased respiratory rate
Asymmetric chest wall movement
Subcutaneous emphysema
Presence of JVD
Rapid, weak pulse or decreasing/low blood pressure
Loss of peripheral pulses during inspiration
Narrowing pulse pressure's
IOS: *cardiac or pulmonary contusions 
* pneumothorax or hemothorax
* broken ribs, causing respiratory compromise
31
Q

Signs and symptoms of any significant blunt force trauma from motor vehicle crashes or penetrating injuries
Along with index of suspicion

A

Blunt or penetrating trauma to the neck, chest, abdomen, or groin
Blows to the head sustain doing motor vehicle crashes, falls, or other incidents, producing loss of consciousness, altered mental status, inability to recall events, combativeness, or changes in speech patterns
Difficulty moving extremities, headache, especially with nausea and vomiting
Rapid weak pulse, and decreasing/low blood pressure
IOS: injuries in these regions may tear and cause damage to the large blood vessels located in these body areas, resulting in bad bleeding
Be alert to the possibility of bruising to the brain and bleeding in and around the brain tissue

32
Q

Signs and symptoms and index of suspicion of any significant blunt or penetrating trauma from falls or a significant height

A

*Severe back and or neck pain, history of difficulty moving extremities, loss of sensation or tingling in extremities
* decreasing GCS
* rapid, weak pulse
IOS: injury to the bones of the spinal column of the spinal cord

33
Q

Describe primary blast injuries

A

These injuries are due entirely to the blast itself: damage to the body happens by the pressure wave generated by the explosion

34
Q

Secondary blast injuries

A

Damage to the body results from being struck by flying debris such as shrapnel from the device or from glass or splinters which may have been set in motion by the explosion

35
Q

Tertiary blast injuries

A

These injuries occur when the patient is hurled by the force of the explosion against a stationary object

36
Q

Quaternary blast injuries

A

This category of miscellaneous injuries includes burns from hot gases, respiratory injury from healing toxic gases, suffocation, poisoning, medical emergencies incurred as a result of the explosion, crush injuries, contaminations of wounds

37
Q

Tim panic membrane

A

The eardrum, the thin membrane in the middle ear that transmit sound vibrations to the internal ear. This can be damaged in blast injuries and you can use it to help you triage patients

38
Q

Pulmonary blast injuries

A

Pulmonary trauma resulting from short range exposure to the destination of explosives

The patient may report tightness or pain in the chest and may cough up blood and have tachapnia or other signs of respiratory distress. Subcutaneous emphysema can be detected over the chest through palpation

39
Q

Arterial air embolism

A

Air bubbles in the arterial blood vessels

40
Q

Level one trauma center

A

Original resource center in general he serves large cities are heavily populated areas. Level one facilities must be capable of providing every aspect of trauma care from prevention through rehabilitation

41
Q

Level two trauma facility

A

Typically located in less populated areas. Level two centers are expected to provide initial definitive care, regardless of injury severity. These facilities can be academic institutions or public/private community facilities.

42
Q

Level III trauma center

A

Able to provide prompt assessment, resuscitation, and stabilization of injured patients in emergency operations

43
Q

Level IV trauma center

A

Able to provide advanced , Life-support before transportations to a higher level trauma center

44
Q

Trauma score

A

Calculator number from 1 to 16. It takes into account the Glasgow coma scale score, respiratory rate, respiratory expansion, systolic blood pressure, and capillary refill

45
Q

Glasgow, scale: Eyeeye-opening, verbal, motor

A 
Eye opening 
*spontaneous: 4
* Voice: 3
* pain stimulation: 2
*none: 1
VERBAL
* oriented conversation: 5
* confused conversation: 4
* inappropriate words: 3
* incomprehensible sounds: 2
*none: 1
MOTOR: 
* obeys commands: 6
* localizes pain: 5
* with drawls from pain: 4
* abnormal flexion 3
Abnormal extension 2
None: 1
46
Q

Revised trauma score

A

Commonly used for patients with head trauma because it’s a weighted to compensate for major head injury without multi system injury or a major physiological changes

47
Q

Revised trauma score

A

GCS: 13-15. SBP. > 80 9MMHG. RR 29 bpm

Emergency care and transport of the sick and injured textbook (37 decks)

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