E1: Trauma Flashcards
What is the most common cause of preventable mortality?
Hemorrhage
What accounts of half of trauma deaths?
CNS injury
According to the SALT mass casualty algorithm, who should be assessed first and who should be assessed last?
- if they can walk, assess third
- if they can wave and give purposeful movement, assess second
- if they are still and have an obvious threat to life, assess first
What are the life saving interventions who can give during mass casualties?
- Control major hemorrhage
- open and position airway (if child, give two rescue breaths)
- Chest decompression
What are the ABCDEs of a primary evaluation of a trauma patient?
A: airway assessment and protection B: breathing- maintain adequate oxygen C: circulation -control hemorrhage D: disability: Neuro eval E: Exposure- undress pt and search for all possible injuries
How can you assess airway on a conscious patient?
-Asking simple questions like “ what’s your name?”
What should you do for airway management of an unconscious patient?
- Protect the airway immediately
- C-spine protection
How can you maintain airway patency?
- suction of secretions
- chin lift/jaw thrust
- nasopharyngeal airway
- definitive airway
What are the options for oxygen support?
- oxygen
- NRBM
- Bag valve mask
- definitive airway
What are the options to establish a definitive airway?
- Endotracheal intubation
- Surgical crichothyroidotomy
How is a cricothyroidotomy performed?
- Attempt ET intubation first
- incision through cricothyroid membrane and insert a small tube
- later convert to orotracheal tube or tracheostomy
What are the immediate threats to lift when assessing breathing and ventilation?
- Tension PTX
- Massive hemothorax
- Cardiac tamponade
If you suspect tension PTX, what should you do?
- Presumptively treat if they have hypotension, dyspnea, ipsilateral decreased breath sounds
- Use needle compression at the 4th or 5th intercostal space at the mid axillary line
- tube thoracotomy immediately following decompression
If you have an unstable trauma patient, what should you anticipate in regards to their breathing and ventilation?
Anticipate hemothorax or pneumothorax and do a tube thoracostomy
What is the treatment of shock?
1) 1 L of crystalloid NS or LR
2) 1-2 units of O neg PRBCs
3) Start massive transfusion protocol (1:1:1 ration of PRBC: FFP: platelets
What GCS level should you intubate?
GCS ≤8
What constitutes hypothermia?
< 35 C
How is hypothermia treated?
- Warm blankets
- warm IV fluids
- external warming devices
- Warm room
What is the lethal triad and acute coagulopathy of trauma/shock?
Hypothermia
Coagulopathy
Acidosis
How is hypothermia of the lethal triad treated?
Remove wet clothing and warm patient
How is the coagulopathy of the lethal triad treated?
Permissive hypotension and give blood products >crystalloids
How is the acidosis of the lethal triad treated?
Stop the bleeding, treat shock
What is the secondary surgery of a trauma patient?
- After primary survey is complete
- head to toe exam
- detailed hx
- thorough PE
- Additional studies, though dont do any tests you cant do anything about
Nexus criteria states that radiography is unnecessary if patient satisfies what 5 criteria?
1) No midline spinal tenderness
2) No focal neuro deficits
3) normal alertness
4) no intoxication
5) No painful distracting injury
