Extra Flashcards
First Law of Motion
body in motioh stays in motion…
Second Law of MOtion
accecleration = M x A
THird Law of MOtion
for every action, there is an equal and opposite reaction
START triage
when you have a color, STOP that’s the color
- ambulate = walking wounded
- no respirations after head tilt = expectant
- breathing but unconsciuos
first step of START
ambulate = walking wounded = green
second step of START
breathing spontaneously?
- if not, head tilt/CL = expectant
- breathing but unconscuosu = red
START = breathing but unconsciuos
RED = immediate
START RR limits
RR above or below 30
above 30 = immediate = red
START perfusion
capillary refill or no radial pulse = immediate = red
red catagory of START
immediate
yellow catagory of START
delayed
steps for START
- can you walk?
- can you breathe on your own?
- RR
- perfusion (cap refill/radial pulse)
- AMS
5 things that qualify you for red catagory of START
can't ambulate breathing but unconscious RR over 30 perfusion (poor cap refill/pulse) AMS/can't follow direfctions
step 1 of SALT
walk?
wave/purposeful movement
still/obvious threat to life
trauma diamond of death
coagulopathy
hypothermia
acidossi
blood loss in class I shock
under 750ml
blood loss in class III shock
1500-2000
blood loss by b. volume in different classes
I = under 15%
II = 15-30%
III- 40-40%
IV = over 40%
what changes in the hemorrhage/hypovolemic shock chart
b. loss HR BP RR urine output CNS
CNS s/s of shock
anxious, confused, lethartic
CNS in late state hemorrhage
anxiuos to confused to leahagic
RR in hypovolemic shock
class II = 20 -30 III = 30-40
what two values are similar in the hypovolemic/hemorrhage classes
RR & % blood loss are similar
urine output across the hemorrhage severity chart
class II = 20-30 CLass III = 5-15 Class IV = negligible
hangman’s fracture
C2
C2 fracture
hangman’s fracture
T12 fracture
chance fracture
Chance Fracture
T12
Jefferson’s Fracture
C1
C1 fracture
Jefferson’s Fracture
burst fracture
severly compressed vertebral body injuury
falls heights
15-20ft or 3z standing height
signs present in spleen injury
ballance = dullness in LUQ and shifting dullness in right flank
Kehr’s
dullness to perfussion in LUQ
Ballance sign
REBOA
resuscitative endovascular Bllloon occlusion of the aorta
how does REBOA work
Resuscitative ENdovascular Balloon Occlusion of the Aorta
*internal tournique to occlude bllood flow from the aorta until pt goes to OR
Coopernail’s sign
blood in labia/scrotum
blood in labia/scrotum
Coopernail’s sing
high riding prostate
urethra rupture
indication of Coopernail’s fracture
suspect pelvic trauma
intervention if high riding prostate
retrograde pyelogram
suspect pelvic trauma
COopernail’s Fracture = blod in labia/scrotum
cause of spontaneous pneumo
bleb rupture
when is open pneumo a problem
defect must be over 2/3 the diameter of hte trachea
pathophysiology of t. pneumo
mediastinal shift
when do you expect pneumoT if on a m. ventilator
sudden PIP/pPLAT increase
needle D sites
5th ICS mid axillary = over 6th rib
2nd ICS mid clavicular =over 3rd rib
over rib to avoid nerves/blood
treat sucking chest wound
open pneumo needs oclcusive dressing
site for chest tube
5-6th ICS mix axillary
massive hemothorax
1/3 pt blood volume/over 1500ml
paradoxical chest wall movement
flail chest
scaphoid abdomen
diaphragmic hernia
Kussmaul’s sign
rise in venous pressure on inspiration
cardiac tamponade
rise in venous pressure on inspiration in spontaneously breathing
Kussmaul sign
paradoxical pusle
cardiac tamponade
s/s of cardiac tamponade
pulsus paradoxys
tachyardia
Becks’s triad
Kussmau;’s sign
paradoxical pulse
in cardaicl tamponade
Beck’s triad
muffled heart tones
narrow pulse pressure
JVD
treatment of cardiac tamponade
pericardiocentesis
EKG of cardiac tamponade
electrical alternans
*hearts gets closer to and further away as it moves aroudn inside the sac of fludi
Hamman’s crunch
crunching raspy sound syncrhonous w/heart beat
trachehobroncihia disrupton
s/s of tracheobronchial disruption
Hamman’s crunch
Sc emphsyema
where does the tracheobronchial disruption occur
within 1.5 of carina
SC emphysema & Hamman’s crunch
tracehobronchial disruption
builds up in rhabod
myoglobin
EKG of rhabdo
peaked T
prolonted QT
labs of rhabdo
elevated myoglobin
Ca/Na go into the cell so lowhigh K
blood in anterior chamber of eye
hyphema
hyphema
blood in the anterior chamber ofthe eye
landmarks for femoral line insertion
lateral to medial = NAVEL nerve artery ein lymph node
why does blood cause hypocalcemia
citric acid as anticaogulant
T&C for plt
not needed
T&C for FFP
must be compatible
PRBC with RBC suspended
FFP
use for FFP
coagulation
reversal of warfarin
reverse warfarin
FFP
reverse warfarin
FFP
requires ABO compatibility but not Rh matching
FFP
accepttance of FFP
requiers ABO compatibility but not Rh matching
most common rx for trauma related DIC
Cryo
created from FFP
cryo
what is cryoprecipitate
contains factors and created from FFP
treat hemophilia
cryo
treat von willebrand
cryo
use for cryoprecipitate
hemophilia
DIC in trauma
on willebrand
s/s of hemolytic reaction to blood
palpitations, abd/back pain, syncope, sense of doom
ther s/sstopping blood transfusion if febrile reaction
tylenol.
can continue if no o
TACO
transfusion associated circulatory overload
TRALI
transfusion related acute lung injury
treat TACO
circulatory overload so stop, give LAsix
treatment for TRALI
reaction to leukocyte antibodies
up to 6hrs post transfusion
causes acute pulmonary edema
acute pulmonary edema in blood transfusions
TRALI