Chest Injury

Question 1

2+ ribs fx in 1+place; no longer attached to the thoracic cage.

Answer 1

Flail chest

Question 2

Pt. breathes in, the intact chest wall expands & injured part is sucked in. Pt exhales: the chest wall moves in and the flail section moves out.
Usual cause: blunt trauma

Answer 2

Flail chest

Question 3

Usual cause of Flail Chest and Rib Fractures

Answer 3

blunt trauma

Question 4

Fx of ribs 1-3 take significant –> increased risk to

Answer 4

CNS, tracheobronchial, and vascular injuries

Question 5

Most common ribs fractured

Answer 5

Ribs 5-9

–>Pos. laceration from fragments and jagged edges

Question 6

On Scene Tx of Open Pnuemothorax

Answer 6

sterile occlusive dressing, 1-side untapped

Question 7

Becks Triad

Answer 7

Decreased BP,
Muffled heart sounds
Distended neck veins

Question 8

Acute widespread process of impaired cellular metabolism.

Answer 8

Shock (general)

Question 9

Imbalance btwn supply & demand of O2 & nutrients

Answer 9

Shock (general)

Question 10

Low Blood Flow Shocks

Answer 10

Cardiogenic

Hypovolemic

Question 11

Left Sided Systolic Cardiogenic Shock–>

Answer 11

decreased systemic circulation

Question 12

SCI @ T5 or above–>loss of SNS compensation/ vasoconstriction–>massive vasodilation leading to pooling of blood in vessels

Answer 12

Neurogenic Shock

Question 13

Systemic inflammatory response to infection

Answer 13

Sepsis

Question 14

Sepsis + hypotension despeite fluid resuscitation & inadequate tissue profusion

Answer 14

Septic Shock

Question 15

Leading cause of death in non-coronary ICU

Answer 15

Septic Shock

Question 16

4 stages of shock continuum

Answer 16

Initial
Compensatory
Progressive
Irreversible

Question 17

Early S/S of Compensatory Stage of Shock

Answer 17

∆ in L.O.C. including: Restless, irritability, apprehension

Question 18

HR Progressive stage shock

Answer 18

Tachycardia 100-150 bpm

Question 19

Trauma Triad of Death

Answer 19

greatest risk of death in the first 24h d/t Hypothermia, Acidosis, Coagulopathy

Question 20

MSOF

Answer 20

Multi-System Organ Failure aka MODS

Question 21

MODS

Answer 21

Multi Organ Dysfunction Syndrome aka MSOF

Question 22

Hallmark manifestation of overt GI bleeding

Answer 22

Hematemesis

Question 23

Hematochezia

Answer 23

maroon-colored stools

Question 24

Classic response to metabolic stress

Answer 24

use of protein for fuel

Question 25

Prevacid, Nexium, Protonix

Answer 25

Proton pump inhibitors

Question 26

Acute Gastrointestinal Ulceration=

Answer 26

Medical emergency

If unrecognized/TX too late = GI hemorrhage → hypovolemia

Question 27

produce diffuse mucosal oozing

Answer 27

Stress ulcers

Question 28

Zantac, Pepcid, Tagamet

Answer 28

H2 histamine blockers

Question 29

Stress Ulcer onset

Answer 29

2-10d

Question 30

black, tarry stool

Answer 30

Melena

Chronic