DAY ONE Flashcards
Pulsus paradoxus
If patient loses peripheral pulse during inspiration
Becks Triad
Three clinical signs of cardiac tamponade- distended neck veins, muffled heart sounds, pulsus paradoxus
Signs & Symptoms of compensated shock
Weakness/lightheaded ness, thirst, pallor, tachycardia, diaphoresis, tachypnea, decreased urinary output, weak peripheral pulses
Signs & Symptoms of Decompensated Shock
Hypotension, AMS, Cardiac Arrest
What level of CO2 can be an indication of circulatory collapse?
<35
Deadly Dozen
Airway obstruction, flail chest, open pneumothorax, massive hemothorax, tension pneumothorax, cardiac tamponade, myocardial contusion, aortic rupture, trachea/bronchial tree injury, diaphragmatic tears, pulmonary contusion, blast injuries
Airway obstruction treatment
Airway management
Flail chest treatment
Large- endotracheal intubation and assisted ventilations
Small- O2 and positive airway pressure
Open Pneumothorax treatment
Seal wound (3 sides) Load&Go, treat for shock
Massive hemothorax treatment
Load&Go, treat for shock
Tension pneumothorax treatment
NCD
Cardiac tamponade treatment
Open airway, Load&Go, O2, 12lead, treat for shock
Myocardial Contusion Treatment
Open airway, O2, Load&Go, treat for shock
Aortic Rupture treatment
Airway management, O2, Load&Go, IV access
Tracheal/Bronchial tree injury
Load&Go
Diaphragmatic Rupture treatment
Open airway, assisted ventilations, I2, Load&Go, treat for shock
Pulmonary Contusion treatment
O2, intubation/assisted ventilations, Load&Go, I’VE access
Blast injuries treatment,
Open airway, O2, Load&Go, manage other injuries, IV access
Neurogenic shock S&S
Hypotension, normal skin CTT, slow HR
Difference between tension and simple pneumothorax
Signs and symptoms of shock
What are the components of a brief neurological exam?
Pupils, GCS, & signs of cerebral herniation
When do you stop giving fluids to a hypovolemic patient?
80-90 mmHg
List reasons to intubation
Unconscious, anaphylaxis, facial trauma, burns
Do not stop assessment unless:
Scene becomes unsafe, airway obstruction, or cardiac arrest
Respiratory Rate
Adult 10-20
Children 15-30
Infant 25-50
Normal ETCO2
35-40 mmHg
Ventilation rates
10-12 per min non-intubated
8-10 per min intubated
What factors make a BVM difficult?
BOOTS
Beard, obesity, older, toothlessness, snores/strider
S&S of cerebral herniation
Decreased LOC, coma, pupil dilation, paralysis of arm & leg on opposite of injured side, high BP, bradycardia
How do you treat possible cranial herniation?
Hyperventilate
What are the five P’s of compartment syndrome
Pain, pallor, pulselessness, parathesia (numbness&tingling), paralysis
Define primary and secondary brain injuries
Primary- immediate damage to tissue by force
Secondary- hypoxia & decreased perfusion
Three types of intracranial hemorrhages
Acute epidural hematoma, acute subdural hematoma, intracerebral hemorrhage
What is coup & contra coup
Coup- damage to brain at area of original impact
Contra coup- damage to brain at opposite side (bouncing)
Four types of skull fractures
Linear non displaced, open, impalement, depressed
What is compartment syndrome
Swelling and bleeding that is contained within a closed space by the fascia
What is subcutaneous emphysema?
Air bubbles under skin, prevelent in divers
What should the BP be maintained at in a Head trauma patient?
110-120 mmHG
Cushing’s Triad for ICP
RR abnormal
HR decrease
BP increase
If you are hyperventilating a patient, what is the rate
Adult- 20 per minute
Children- 25 per min
Infant- 30 per min
What should the ETCO2 be kept at in a head trauma
30-35 mmHG
How much fluid do you give a patient with hypovolemia
20ml/kg
Enough to reach 80-90 mmHG
How does the percentage of fluid loss correlate with shock
0-30%- early shock
30-45%- late shock
When should a fracture be splinted at the scene?
If it is femoral or in the hips
What ate the criteria of a load and go patient?
AMS, abnormal breathing or circulations, penetrating wounds of torso, pelvic instability, bilateral femoral fractures, sig MOI or poor general health
