General Trauma Flashcards
what does the primary survey consist of?
ABCDE
when do you know if airway is clear?
they can speak
what does Glasgow coma scale of 8 or less imply?
loss of airway control
what should all trauma patient receive?
high flow oxygen (15L/min) with tight fitting mask
how do you assess circulation and perfusion?
pulse rate and blood pressure
what is the minimum accepted urine output?
30ml/hr
how many people are needed for a log roll?
4
what is the secondary examination?
head to toe examination to detect other injuries. a more thorough history of the injury can be done at this stage
what is polytrauma?
where more than one major long bone is injured
what is SIRS?
systemic inflammatory response syndrome
when does SIRS occur?
when there is an amplification in the inflammatory cascade in response to trauma
with pyrexia,tachycardia, tachypnoea and leukocytosis
what is ARDS?
acute respiratory distress syndrome
what is MODS?
multiple organ dysfunction syndrome
what is a fracture?
a break in a bone
name the 2 types of fracture?
partial
complete
what can cause fractures?
direct trauma
indirect trauma
name the 4 steps in fracture healing?
- inflammation
- soft callus
- hard callus
- remodelling
what is a transverse fracture?
occur with a pure bending force where the cortex on one side fails in compression and the cortex on the other side fails in tension
what causes an oblique fracture?
occurs with a shearing force (fall from a height)
can be fixed with an interfragmnetary screw
what causes a spiral fracture?
due to torsional forces
can be fixed with an interfragmentary screw
what is a fracture with 3 or more fragments?
comminuted fractures
what is a segmental fracture?
a fracture which is in 2 separate pieces
how do you describe a fracture at the end of a long bone?
intra-articular
or
extra-articluar
what does the position of a fracture depend on?
the displacement and angulation
what is displacement?
the direction of translation of the distal fragment
what is angulation?
the direction which the distal fragment points toward and the degree of its deformity
(medial/lateral or anterior/posterior)
clinical signs of a fracture?
localised bony tenderness
swelling
deformity
crepitus
what do you look at for the assessment of a fracture?
is it open or closed?
check neurovascular status- check pulses, cap refill, temp, colour, sensation, motor power)
compartment syndrome
status of skin and soft tissue envelope
what investigations would you do for a fracture?
x ray tomogram-moving xray for complex bones CT MRI-occult fractures Technetium bone scans
what is the initial management of a long bone fracture?
splintage or immobilization
name some early complications of farctures?
compartment syndrome
vascular injury
nerve compression injury
skin necrosis
what is the main late systemic complication of fractures?
PE
signs/symptoms of fracture rehealing
resolution of pain and function
absence of point tenderness
no local oedema
resolution of movement at fracture site
signs of non-union
ongoing pain
ongoing oedema
movement at fracture site
what is one of the slowest healing bones in the body?
tibia
what can result from delayed union/
infection
what is the initial management of an open fracture (in A&E)?
IV broad spectrum antibiotics
sterile/ antiseptic soaked dressing applied to wound
what is mainstay of treatment for soft tissue injury?
RICE
rest, ice, compression, elevation to reduce initial swelling followed by early movement to prevent stiffness
acute onset severe pain red hot tender joint severe pain on movement
septic arthritis
most common bug for septic arthritis in adults?
S.aureus
what bug causes septic arthritis in the IV drug abusers, the elderly and seriosuly ill?
e.coli
what bug causes septic arthritis in children?
H. influenzae
investigation for septic arthritis?
aseptic aspiration
treatment for septic arthritis?
surgical wash out
what is the min score on glasgow coma scale?
3
what nerve is in danger after a colles fracture
median nerve
what nerve is in danger with anterior dislocation of shouker
axillary nerve
what nerve is in danger after humeral shaft fracture
radial nerve
what nerve is in danger after supracondylar fracture of elbow
median nerve
what nerve is in danger with posterior dislocation of hip
sciatic nerve
what nerve is in danger after bumper injury to the knee
common peroneal nerve
