Exam 2: Lecture 19: Principles of Trauma Surgery Flashcards
why do we need to perform an initial focused examination on patients with trauma
to determine the type and extent of any life-threatening injuries or medical problems
what is the purpose of the primary survey
critical to identify life-threatening problems, rapid assessment for problem in 2 mins or less
what are the 7 things we look for during an initial assessment
- level of consciousness, attitude, or behavior
- unusual activity
- unusual body/limb postures
- positions that suggest bone fractures, joint dislocations
- traumatic injuries
- unusual breathing sounds or sounds suggesting airway obstruction
- look for any obvious blood, wounds, or other gross abnormalities
what was the ABC initial assessment (old method)
A - airway
B - breathing
C - circulation
N - neurologic
W - wounds
what can cause cell death
apoptosis - natural process of old cells dying and being replaced by new ones
necrosis - something that kills the cells via radiation, toxins, heat, trauma, lack of O2 due to interruption of bloodflow
what do A B and C have in common
airway - provide a pathway for O2 to reach RBCs in the lungs
breathing - to transport O2 to RBCs
circulation - to transport O2 in the RBCs to tissues
why is it super important to have enough RBCs
if there are not sufficient RBCs to transport enough O2 to keep cells alive, then airway, breathing, and circulation are irrelevant
what are the 2 types of hemorrhage
compressible and noncompressible
what is M2ARCH2E
- massive hemorrhage & muzzle
- airway
- respiration
- circulation
- head injury and hypothermia
- evacuate/pain management/Abx
what are the 3 things to remember for initial care
- ensure area is safe for you, your team, and patient
- with major wounds that cause instantaneous death your initial actions will have little effect
- take a few seconds and see what the patient is doing
what is the most important thing for massive hemorrhage
stop significant bleeding!!
what color is arterial blood
bright red, squirting
what color is venous blood
dark red, oozing or flowing
what are the 2 types of tourniquets
C-A-T and SOF-T
what is a C-A-T tourniquet
combat application tourniquet
what is a SOF-T tourniquet
special operations forces tourniquet
what are the 3 types of hemostatic bandages
combat gauze, chitogauze, and hemcon
what do we check the airway for
abnormal sounds, deformity of face/neck/chest, labored breathing, noisy breathing, wounds, masses, or swellings
how do we examine the airway
open the mouth and examine the inside as far back into the throat area as possible (look for masses, FB, swelling, deformities)
T/F: you should clear the airway with a 2 finger sweep if possible
true! Remove vomit, clots, FBs
what do we visually observe the airway for
barking, panting, lack of sounds, unconsciousness, bleeding oral cavity, burns, and external evidence of blockage or facial damage
what do we do if the airway needs protection
do a tracheotomy !!
what is a tube tracheotomy
when you put a tube directly into the trachea
what is this
a tube tracheotomy
how do you to a tube tracheotomy
appose the sternohyoid muscles, SQ tissue, and skin cranial and caudal to the tube and secure it by tying with gauze or umbilical tape around the neck
what do we do for an open pneumothorax or “sucking chest wound”
cover the wound!!
what do we do for tension pneumothorax
needle decompression or thoracocentesis
what are the landmarks for a needle decompression for a tension pneumothorax
7th to 10th intercostal space
what is being shown in this picture
landmarks for needle decompression
what type of issue does deep, labored breathing suggest
lung trauma or problems such as pulmonary contusion
what type of issue does shallow, rapid breathing suggest
air, blood, or some other fluid in spaces of the lungs that dont normally contain air, blood, or fluids
what type of issue does irregular breathing suggest
brain injury
T/F: If the dog is not breathing, it is in respiratory arrest and is an emergent condition
true
what do blue gums indicate
a serious problem with breathing
what are the 3 main things to look at for circulation
recheck bandages to ensure control of massive bleeding, address smaller wounds if necessary, and initiate IVs and IO devices if needed
what should we look for when checking the pulse
rate and character (is it strong or weak, is it rhythmic?)
what are the normal mucus membrane colors
pink
what are the abnormal mucus membrane colors
pale (grey or white), blue, yellow, or brick red
what is a normal CRT
less than or equal to 2 seconds
what is an abnormal CRT
> 2 seconds
what does CRT show us
an indication of blood flow to tissues
T/F: rapid HR or pulse with prolonged CRT suggests shock, major trauma, or a serious medical problem
true!!
T/F: Dogs do not become hypothermic quickly
false, they do!
what are 2 examples of warming type things
space blankets or rescue blankets
what 4 things should we remember for evacuation and antibiotics
- preplan and practice evacuation procedures
- pre-coordinate veterinary coverage
- practice using many platforms
- antibiotics should be administered quickly once needed
what should the brief exam of the rest of the dog contain
assess the dogs body for wounds, fractures, evidence of trauma elsewhere
also notice the spinal column, abdominal region, flank, and limbs for sign of trauma
what is the summary of trauma management
- visually assess
- M2ARCH2E
- rest of dog
