Emergency Medicine Flashcards
What is the linear algorithm for the management of acute trauma?
AcBCDE
1° survey
2° survey
Stabilize the patient at each step before moving on.
Indications for intubation
Impending airway compromise
A Glasgow Coma Scale (GCS) score of ≤ 8
Decreased mental status
Apnea
Severe closed-head injuries
Causes of impending cardiopulmonary death in emergencies
Tension pneumothorax
Cardiac tamponade
Open pneumothorax
Massive hemothorax
Airway obstruction.
List the Glasgow Coma Scale. What are the minimum and maximum scores obtainable
E= Eye Opening
- Spontaneous
- Responds to voice
- Responds to pain
- No response
V= Verbal Response
- Oriented
- Confused speech
- Inappropriate speech
- Incomprehensibe speech
- No response
M= Motor Response
- Obeys command
- Localizes pain
- Withdraws to pain
- Abnormal flexion
- Abnormal extension
- No response
Minimum score is 3 and maximum score is 15
What is a “trauma series”?
AP chest
AP abdomen/pelvis
AP/lateral/odontoid C-spine x-rays.
Criteria for clinical clearance of the C-spine
- The patient is alert and not intoxicated
- No posterior midline C-spine tenderness
- No neurologic deficit
- No painful distracting injuries
Signs of basillar skull fracture
Battle’s sign
Racoon’s eys
What is Cushing’s triad? What does indicate?
Widening pulse pressure
Bradycardia
Irregular breathing
Cushing’s triad indicates ICP, as from a closed-head injury.
What are the components of Beck’s triad?
What other features may be seen with Beck’s triad?
JVD
muffled heart tones
hypotension
It indicates cardiac tamponade
Sometimes pulsus paradoxus is also noted
Pericardiocentesis brings back unclotted blood.
List some contraindications to insertion of Folley’s catheter in trauma patients
Blood at the urethral meatus
A severe pelvic fracture
Abnormal position of the prostate
