Fallen 2 flights case

Question 1

How do you assess for the correct size of a cervical collar?

Answer 1

You measure with your fingers the VERTICAL distance from the chin to the top of the trapezius. It is important that your hands are not running along the length of the neck but vertically - from the trapezius upwards.

Question 2

How do you adjust the size on a cervical collar according to your measurement?

Answer 2

You place your fingers so that they are measuring upwards from the bottom of the blue part of the collar and work out which pin/hole is required.
Then adjust the collar so that the red dot is seen through this hole.
See youtube video for more details.
In order to adjust the height the blue clips of the collar should be loosened and then clipped back into place when the correct size has been made.

Question 3

What are some tips when you are actually fitting the cervical collar to the patient?

Answer 3

MAKE SURE SOMEONE IS STABILISING THE HEAD THROUGHOUT!
Fold the Velcro part back on itself when passing under the neck
Inform the patient that this part of the fitting may not be too comfortable

Question 4

How do you apply a pelvic binder?

Answer 4

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Question 5

When can the major haemorrhage protocol be activated?

Answer 5

When it is estimated that the patient has lost > 500ml of blood

Question 6

Where is a cannula placed in order to relieve a tension pneumothorax?

Answer 6

2nd ICS Mid clavicular line

Question 7

Following relief of a tension pneumothorax a chest drain is inserted. Where is this put?

Answer 7

5th ICS mid axillary line

Question 8

Where do you listen for heart sounds?

Answer 8

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Question 9

Where do you place ECG leads?

Answer 9

4ICS - right and left sternal edges, 5th ICS MCL, inbetween 2 previous, 5th ICS mid axillary line

Question 10

Where do you listen/how do you attenuate a murmur?

Answer 10

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Question 11

What are the indications for a pelvic binder?

Answer 11

-

Question 12

What is the difference between a primary, secondary and tertiary survey?

Answer 12

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Question 13

What is it essential you do in the management of an open fracture?

Answer 13

Check distal neurovascular status

Question 14

What medications may be given to a patient with an open fracture?

Answer 14

Antibiotics - definitely

Tetanus - if soil/contaminated

Question 15

What bloods are commonly ordered in a trauma case? and WHY?

Answer 15

FBC
Crossmatch
Clotting
U&E
LFTs
Amylase

Question 16

What scans may be ordered in a trauma case?

Answer 16

Pelvic X-ray, Chest x-ray
FAST scan to look for any signs of any internal bleeding
Limb x-rays

Question 17

What is considered to be the lethal triad in major trauma?

Answer 17

Hypothermia, Acidosis and Coagulopathy