CORTEXT: trauma Flashcards
What are signs of airway obstruction?
noisy breathing; gurgling; stridor and agitation from hypoxia and hypercapnia
What is a definitive airway?
cuffed endotracheal tube
What GCS score implies a loss of airway control?
less than 8
What are the signs of a tension pneumothorax?
deviated trachea; repiratory distress; tachycardia; hypotension; sitended neck veins; no air entry on affected side
what is the management for a tension pneumothorax?
needle decomprssion-large bore needle in the 2nd intercostal space, midclavicaular line
chest drain
What are the signs of a haemothorax?
reduced air entry, dull to percussion
What is a flail chest?
segmental fractures of two or more ribs producing discontinuity of a segment of the thoracic cage and paradoxical movemtn of that segment with reduced expansion of the underlying lung
What is pulmonary contusion?
blood filling the alveoli with reduced ventilation
What are the all major trauma patients given IV initially?
2L of IV crystalloid
What is the minimum accepted urine output?
30ml/hr
What is an open book pelvi fracture?
the two hemi-pelvises are sprung apart
What is the treatment for an open book pelvic fracture?
reduced with a pevlic binder or emergency external fixator
What are the signs of intracranial hameorrhage?
pupil fixed, dilated
What is a trauma series of x-rays?
ateral C-spine; chest and pelvis
What clears a c-spine?
is patient is conscious; co-operative, not confused and no signs of injury- tenderness; pain on neck movement and no peripheral neuro deficit
Why are nasogastric tubes usually passed?
to prevent aspiration in the event of gastric dilation which can occur in major trauma
What is the secondary survey of major trauma?
a head-to-toe exam to detect otehr injuries
What is polytrauma?
where more than one major long bone is injured or where a mjor fracture is associated with significant chest or abdo trauma
What is SIRS?
systemic inflammatory response syndrome- an amplifaction of inflam casacades in response to trauma resulting in pyrexia, tachycardia, tachypnoea and leukocytosis
What may cause ARDS?
hypoperfusion, SIRS, aspiration of fat embolism
What happens in ARDS?
there is inflam of the lung parenchyma leading to inflam exudates forming in alveoli and impairment of gas exchange
What is the treatment for ARDS?
positive pressure ventilation
When does primary bone healing occur?
when there is minimal fracture gap- less than 1mm–hairline fractures or when fractures are fixed with compression screws and plates
What happens during primary bone healing?
the bone simplay bridges the gap with new bone from osteoblasts