ED Care 2

Question 1

Describe level 1 trauma

Answer 1

Regional resource facility

• highest
• serve dense pop areas
• collaborative care for all aspect of injury

Question 2

Describe level 2 trauma

Answer 2

• community hospitals

- can provide care for vast majority

Question 3

Describe level 3 trauma

Answer 3

Stabilize pt with major injuries

Question 4

Describe level 4 injuries

Answer 4

Rural or remote areas

*lowest

Question 5

What is the mechanism of injury

Answer 5

Describes the manner in which the traumatic injury occurred

Question 6

What are the most common producing mechanisms

Answer 6

Blunt trauma

Penetrating trauma

Question 7

Describe blunt trauma

Answer 7

• Results from impact forces (ie/ car accidents, fall, assault w/ fists, kicks or baseball bat)
• trauma to bones blood vessels and soft tissue

Question 8

What is blast effect

Answer 8

From exploding bomb

Type of blunt trauma

Question 9

Describe acceleration deceleration forces

Answer 9

Energy transmuted from blunt forces involved produce injury

*occurs in blunt trauma

Question 10

What are penetrating traumas

Answer 10

Caused by injury from sharp objects and projectiles

(Is/ knife, ice pick, bullet wounds

Question 11

When do you not follow ABCDE

Answer 11

Follow primary survey unless clear presence of massive uncontrolled bleeding
*priorities shift to CAB d/t external hemorrhage

Question 12

When are tourniquets used

Answer 12

Used to manage severe bleeding when direct pressure fails

Question 13

Hemostatic dressings

Answer 13

Impregnated with substances that speed up clotting

Question 14

What to do if external hemorrhage

Answer 14

Firm direct pressure on bleeding site with thick dry dressing

Question 15

Before the cuff is used how do you know the systolic BP

Answer 15

• radial pulse: BP 80
• femoral pulse: BP 70
• carotid pulse: BP 60

Question 16

Describe primary survey

Answer 16

ABCDE

• the initial assessment of the trauma pt
• organized system to rapidly identify and effectively manage immediate threats to life

Question 17

What occurs simultaneously with each element of primary survey

Answer 17

Resuscitation efforts

Question 18

What is A in primary survey

Answer 18

Airway and cervjcal spine

• establish patent airway
• manual align neck into neutral in like positions (jaw thrust maneuver)
• supplemental O2 (nonrebreather mask)
• pt with GSC < 8 requires endotracheal tube and mechanical vent

Question 19

What is B in primary survey

Answer 19

Breathing

• determine whether bent efforts are effective or not (if pt breathing or not)
• listen to breath sounds, chest expansion, resp effort, chest wall trauma
• • ensure effective ventilation

Question 20

What is c in primary survey

Answer 20

Circulation

• adequacy of HR, BP, and overall perfusion
• restore effective circulation with hemorrhage control, cardiopulmonary resuscitation, IV access with fluid and blood administration, drug therapy

Question 21

How should fluid and blood he given

Answer 21

Warmed before administered to prevent hypothermia

Question 22

What is d of ABCDE

Answer 22

Disability

• rapid baseline assessment of neuro status and LOC
• ACPU (alert, responsive to voice, responsive to pain, unresponsive)
• Glasgow Coma Scale

Question 23

Describe Glasgow coma scale

Answer 23

Scores eye opening, verbal response, monitor response
Lowest is 3 (unresponsive)
Normal is 15

Question 24

What is e in primary survey

Answer 24

Exposure

• remove all clothing
• prevent hypothermia with blankets l, heating device, warm solutions
• may need evidence collection for rape, elder abuse, domestic violence, home use, suicide, drug overdose, assault

Question 25

What is hypothermia

Answer 25

< 95 F or 36 C

Question 26

What is the expected sequence or ED

Answer 26

Treatment, stabilization, discharge home or admission for hospitalization

Question 27

Older adults that come to the ED…

Answer 27

Often admitted to the hospital for comorbidities

Question 28

What is a secondary survey

Answer 28

• more comprehensive head to toe

- identify other injuries and medical issues that need to be managed that may affect course of treatment