Chest, GU, Abdomen

Question 1

What is a blunt trauma?

Answer 1

Skin unbroken

Hidden injuries

Question 2

What is penetrating trauma?

Answer 2

Wound present, may or may not have entrance and exit wound

Low, medium, and high velocity

Question 3

What is cavitation with a gunshot?

Answer 3

The bullet rapidly forces a large gas pocket in the body which then rapidly collapses as the organs collide

Question 4

What are we doing when we apply pressure to a bleeding wound?

Answer 4

Squash the vasculature

Question 5

What to do for an open chest wound?

Answer 5

ABC management
High flow O2
BVM ventilations
chest seal/occlusive dressing

Question 6

What is a sucking chest wound? How do you identify it?

Answer 6

Air goes through a wound into the thoracic pleural space

Sucking sounds from the wound

Question 7

Major bleeding

________ the limbs
________ the junctions
________ the box

Answer 7

tourniquet
pack
seal

Question 8

What injury causes flail chest?

Answer 8

Break of two or more ribs in two or more places

Question 9

What to do for flail chest?

Answer 9

Assist ventilations with BVM
High flow O2

Question 10

When are the only two scenarios to remove an impaled object?

Answer 10

Interferes significantly with airway management

Interferes with CPR

Question 11

What do we do to stabilize a small impaled obect?

Answer 11

Place a rolled gauze on each side of the object and wrap it up

Question 12

What’s the difference between a pneumothorax and a hemothorax? S/S of each?

Answer 12

Pneumothorax is air in the pleural space
JVD, hollow to percussion, tension pneumothorax ->hypotension

Hemothorax is blood in the pleural space
Flat neck veins, dull to percussion

Common to both
Respiratory distress
Diminished/absent lung sounds

Question 13

What does Beck’s triad refer to? What is it?

Answer 13

Cardiac tamponade

JVD, muffled heart sounds, narrowing pulse pressure (hypotension)

Question 14

What causes cardiac tamponade?

Answer 14

Pressure on the pericardial sack

Question 15

What is a more significant MOI and why, a high rib fracture or a low rib fracture?

Answer 15

High rib fracture. This takes a larger force

Question 16

What is subcutaneous emphysema?

Answer 16

Air is leaking from the lung to the tissue underneath the skin, causing a rice-crispy feeling when the skin is pressed on

Question 17

What is commotio cordis?

Answer 17

Sudden cardiac arrest following a blunt force to the chest

Question 18

What to do for commotio cordis?

Answer 18

High quality CPR and early defibrillation

Question 19

What is eviceration?

Answer 19

Organs and intestines leaving the abdomen through a large laceration

Question 20

What is the largest concern with eviceration (besides the organs outside of the body) and how do we combat it?

Answer 20

Infection

Flush with normal saline (NS) or sterile water
Cover with wet gauze
Cover with a bandage or occlusive dressing (to keep moist and to keep body fluids from dripping)
Transport with legs flexed to relax chest wall and abdominal wall

Question 21

Why is injury to the solid organs more serious than with hollow organs?

Answer 21

Solid organs are more vascular and will result in more bleeding

Question 22

What is a consideration with genitalia trauma?

Answer 22

Very vascular

Question 23

What do we need to remember for bleeding control of the genitalia (especially females)?

Answer 23

Only control bleeding with gauze from the outside. Never pack wounds (NEVER the vaginal cavity)

Question 24

What is reffered pain?

Answer 24

Pain in a site different than the affected area

Question 25

What is Kehr’s sign?

Answer 25

Left shoulder pain from diaphragm irritation (specifically splenic laceration)

Question 26

What is a primary blast injury from?

Answer 26

Blast wave

Question 27

What is a secondary blast injury from?

Answer 27

Fragments

Question 28

What is a tertiary blast injury from?

Answer 28

Bodily displacement

Question 29

What is a quaternary blast injury from?

Answer 29

Burns