Chapter 67- Principles of Trauma

Question 1

AMPLE history

Answer 1

Allergy 
Meds
PMHx
Last PO
Events leading to trauma

Question 2

Colors of capnography insert

Answer 2

purple to yellow means CO2 being returned

Question 3

Anatomical locations for tension pneumothorax decompression

Answer 3

suspect if low BP, dec breath sounds
MCL 2nd ICS just above rib (14g needle)
Incision Ant Axillary line 5th ICS (nipple)

Question 4

Class I shock

Answer 4

<750cc blood loss, <15% BL, NL HR/BP/RR

Question 5

Class II shock

Answer 5

750-1500 cc/15-30% BL, INC HR/RR, NL BP

Question 6

Class III shock

Answer 6

1500-200cc/30-40% BL, INC HR/RR, DEC BP

Question 7

Class IV shock

Answer 7

> 2000cc/40% BL, very high HR/RR, very low BP

Question 8

Glascow Coma Scale

Answer 8

eye (4), verbal (5), motor (6)

13-15 minor, 9-12 moderate, 3-8 severe

Question 9

Ideal IV for trauma patient

Answer 9

Two 14-16 gauge peripheral IV

Other options: IO tibia/sternum, saphenous vein cutdown, CVL (femoral/subclavian/jugular)

Question 10

Blood product for trauma patient

Answer 10

If HR >100, SBP <90 despite 2L crystalloid, suspect ongoing hemorrhage, give:
uncrossed, O- PRBC while type and cross performed

Question 11

Bloody Vicious Cycle

Answer 11

coagulopathy, acidosis, hypothermia contribute to each other

Question 12

4 views on FAST

Answer 12

pericardial
LUQ
RUQ (morrison’s pouch, most dependent area)
pelvis

Question 13

3 zones of neck

Answer 13

1- up to cricoid
2- up to angle of mandible
3- superior to angle of mandible

Question 14

When to get CTA of neck in trauma patient

Answer 14

Cervical seat-belt sign
blunt anterior neck trauma
displaced midface fx
basilar skull frac involve carotid canal
diffuse axonal injury
near hanging with anoxia
cervical vert body or transverse foramen injury (or any injury to C1-3)
cervical spine ligament injury
bruit in pt <50
facial fx w/ upper thoracic or clavicle fx
scapular fx
any neck injury from direct force causing significant pain/swell/AMS

Question 15

When to openly explore neck for carotid/vertebral injury

Answer 15

pulsatile bleeding, expanding neck hematoma, penetrating trauma through platysma if surgically accessible
If stable and inaccessible zone 1/3 area, may do CTA

Question 16

Key aspects of burn pt eval

Answer 16

low threshold for intubation
fluids (Parkland formula)
UOP monitor
TBSA measurement
escharotomy for circumferential burns especially if chest

Question 17

4 triage elements for mass casualty event

Answer 17

can they walk?
airway compromise?
respiratory rate?
pulse/cap refill?