Chapter 86 - Evaluation of the Trauma Patient

Question 1

most common cause of death within one hour of trauma

Answer 1

massive hemorrhage or massive neurologic injury

Question 2

what are the outcomes for pre-hospital blood transfusion

Answer 2

no improved outcomes for pre-hospital blood product transfusion compared to fluid infusion

Question 3

how is the injury severity score calculated

Answer 3

the sum of the square of the top three AIS scores

1 = minor injury, 6 = almost always fatal injury

if ANY body part is given a 6 - the patient is automatically assigned a score of 75, the highest possible score and non-survivable injury

Question 4

problem with ISS

Answer 4

does not take into consideration a multiply injured extremity patient - ie “extremities” is all one region, you dont get points for each extremity like both arms fractured or both legs

Question 5

What types of intra abdominal injuries is FAST not as good for?

Answer 5

retroperitoneal injuries, isolated bowel injuries

Question 6

classifications of hemorrhagic shock

Answer 6

I:<15% blood loss, ~750ml, minimal sx

II: 15-30% blood loss, ~750-1500ml, tachycardia, tachypnea, mild mental status changes, decreased pulse pressure

III: 30-40% los, 1500-2000ml, ***Decreased SBP

IV: >40%, >2L, severe mental status changes

Question 7

cardiogenic shock

Answer 7

heart literally cant pump enough blood, increased peripheral svp, decreased sbp, NO tachycardia, elevated trops

Question 8

neurogenic shock

Answer 8

complete loss of systemic vascular tone, profound hypotension, bradycardia

Question 9

what vital sign change on hospital arrival can be an indicator of mortality?

Answer 9

SBP <90 on arrival is independent risk factor of mortality