Exam II Lecture 8 Poly Trauma Dayton

Question 1

The trauma evaluation first begins when…

Answer 1

The evaluation begins when you first see the patient.

Checking neuro status, obvious injuries, stabilization/IV access or EMS/family story.

Question 2

What does the primary survey cover?

Answer 2

ABCDE
Airway
Breathing
Circulation
Dissability
Environmental contaminants.

Question 3

What should falls and MVA be packaged with?

Answer 3

Package these patients with a C collar and back board.

Question 4

A patient that is clammy with cold skin is showing signs of….

Answer 4

Shock!

No radial pulses is also a bad sign that the circulation to organs isnt sufficient.

Question 5

What should the minimum systolic pressure to the radial pulse be?

Answer 5

At least 70 mmHg

Question 6

What do you do if a patient isnt responding to IV?

Answer 6

Give them blood!

This is all to rule out shock after the administration of crystalloid fluid.

Question 7

Describe hemorrhagic shock

Answer 7

Diminished tissue perfusion secondary to blood loss.

Question 8

Class 1 shock

Answer 8

15% loss with normal vitals and slightly anxious.

Question 9

Class 2 shock

Answer 9

15-30% mild tachy normal BP (Pulse pressure drops) RR increases and pt is anxious

Question 10

Class 3 shock

Answer 10

30-40% pulse is >120 and the patient is hypotensive.

Less UOP but confused.

Question 11

Class 4 shock

Answer 11

> 40%

Pt is obtunded, extremely tachycardic, cool and hypotensive.

Question 12

What is the initial treatment for shock?

Answer 12

IV fluids
2 Liters in adults or
20mL/kg bolus for children.

If not responding to fluids use blood.

Question 13

Kidneys are not making urine.

Answer 13

If the blood volume is low kidneys will stop making urine

Question 14

Definitive treatment for hemorrhagic shock?

Answer 14

Surgery.

you need to stop the bleeding.

Question 15

Should Dopamine or Doputamine be used in patients experiencing shock?

Answer 15

NO
Just makes the heart pump even faster/harder.

you need the volume.

Question 16

At which Glascow Coma Scale level should the pt be intubated?

Answer 16

Intubate when the GCS is 8

Range is 3-15

Question 17

Always assume an alcoholic under trauma has….

Answer 17

Head injury.

Question 18

When should you get a head CT?

Answer 18

If loss of conciousness or neuro defecits

what about alcohol?

Question 19

5% of head trauma also has,…

Answer 19

Cervical spine injury

Question 20

What are the NEXUS five reasons to take the C-collar off?

Answer 20

No bony tenderness (bone only)
No distracting injury (Open fx etc)
No neuro deficits (push pull tracking)
No cognitive dysfunction
No intoxication

Question 21

What age range requires pregnancy test?

Answer 21

8-80

Question 22

What should you order if you cannot see C7 on X-ray?

Answer 22

Order a CT

Question 23

When do people typically die from trauma?

the three peaks

Answer 23

At scene from large vessel or head/neck.

Shortly after arriving to the ER

In the ICU from head, overwhelming infections or clots.