I've fallen and I can't get up (& other trauma & burning desires) Flashcards
The trauma triad- diamond (an extra point)
- Hypothermia
- Acidosis
- Decreased coagulability
- Hypocalcemia
Your patient has sustained a CHI. Your (2) biggest concerns are:
Hypoxia
Hypotension
Beck’s Triad (name 3)- and is indicative of:
Narrowing pulse pressure
JVD
Muffled heart tones
Indicative of cardiac tamponade
Parkland’s formula
SO fluid infusion
4 ml x BSA % x kg / 2 = infuse over the first 8 hours
500 ml
Differentiate between simple and tension pneumothorax
Hemodynamic instability
What is:
HR / SBP (normal range 0.4-0.7 with > 1 consistent with circulatory shock requiring fluid and potentially blood products)
SI (shock index score)
An unrestrained patient in an MVC presents with a fractured pelvis and laceration above the R eye. GCS- 11 (4, 2, 5), pale, and diaphoretic. VS: HR- 143, BP- 60/40, RR- 30.
You suspect (what type of shock)?
Considering the CO equation, which component is primarily affected?
Hypovolemic/ Hemorrhagic
Preload
A lucid interval is indicative of a(n)?
Which is usually a result of?
Epidural hemorrhage
Rupture to the middle meningeal artery
Which information obtained by assessment ensures that the patient’s respiratory efforts are adequate?
A. The patient is able to talk.
B. The patient is alert and oriented.
C. The patient’s oxygen saturation is 97%.
D. The patient’s chest movements are uninhibited.
B. The patient is alert and oriented.
Draw the (3) Types of Le Forte Fractures
Le Fort I: Fracture of Maxilla with hard palate and inferior maxilla involvement
Le Fort II: Fracture with a Pyramid shape, nasal bone, and inferior maxilla involvement
Le Fort III: Separates entire midface from the Cranium
How should you manage this injury?
Immediately cover with an occlusive dressing.
Differentiate between a sprain and a strain.
Sprain- overstretching of a ligament
Strain- overstreching of a muscle/ tendon
A boxer reports vision concerns including flashing, light specks, and
“floaters.” You suspect:
Retinal detachment
Direct blow to the left chest during ventricular repolarization, specifically during the upstroke of the T-wave before its peak results in:
Commotio Cordis
Accumulation of air within the pleural cavity, causing decreased preload and intrathoracic pressure:
tension pneumothorax
A patient presents with unequal chest rise, and crepitus to the R lateral/ anterior chest wall upon palpation.
The patient is dyspneic, SpO2 90% with poor excursion.
CI-
You should:
Flail chest
Provide PPV
During assessment you note a scaphoid abdomen and auscultate bowel sounds in the patient’s chest.
CI-
You should:
Diaphragmatic rupture
Provide PPV
A homeless patient with a history of alcohol abuse has an AMS. Their friend’s state they were assaulted last week. You are most concerned about:
Caused by:
Subdural hemorrhage
-Elderly and alcoholics
-atrophied brain and tearing bridging veins
bleeding into the space below the dura mater, a membrane between the brain and the skull.
Accumulation of blood within the pleural cavity is:
Hemothorax
Fluid accumulation within the pericardial sac is:
cardiac tamponade
A patient fell 20 ft. You note a distended abdomen and the patient reports referred left shoulder pain.
This is called:
You suspect:
Kehr’s sign
Splenic injury
A patient reports extreme pain, and you note pallor, paresthesia, pulselessness, paralysis in an extremity after being hit during a game of football the previous day. You suspect:
Compartment syndrome
Damaged muscles release myoglobin, this is called
rhabdomyolysis
A patient experienced an amputated foot. You should:
-Rinse debris
-Wrap part in loose saline-moistened gauze
-Seal in bag
-Place in cool container/ slushy water
Do NOT place directly on ice
A patient has been crushed by a vehicle for an hour and has an extended extrication.
CI-
You should:
Crush injury
-Obtain IV NS prior to removal
-Sodium Bicarb 1 mEq/ kg
Which radiation particles passes through the body and solid materials?
Gamma
A patient presents with severely reddened and blistered skin after falling a sleep on the beach. This is a:
2nd degree or partial thickness burn
A patient presents with, bleeding from their ear, periorbital and retroaurical ecchymosis. You suspect:
Basilar skull fracture
A SCI that occurs most commonly in those who suffer a hyperextension injury. The patient presents with more significant strength impairments in the upper extremities compared to the lower extremities.
Central cord syndrome
A patient reports ipsilateral sensory loss of all sensations, pressure, vibration, position and contralateral loss of pain and temperature.
Brown Sequard Syndrome
A patient involved in a knife fight presents with abdominal contents protruding from the abdomen.
CI-
You should:
Eviseration
Cover with a moist sterile dressing
Potential blood loss in femur
1000- 1500 ml
A 220 lb patient has blistered skin over their upper anterior chest wall and their entire right arm and hand.
Calculate: %BSA
Calculate: fluid you should infuse in 1 hour using Parklands Formula
18%
Anterior upper chest: 9%
Right arm: 9%
(100kg)(18%)(4) = 7200/ 24 hr
3,600 ml/ 8 hrs
450 ml/hr
A patient was climbing a mountain and experienced difficulty breathing and a dry cough. They are tachycardic and tachypneic with bilateral rales.
You suspect:
High Altitude Pulmonary Edema
A patient ascended too quickly while scuba diving when they panicked upon seeing a shark.
You suspect:
Caused by:
Which gas laws (2) are in effect:
Decompression sickness
Nitrogen within the blood is forced into the tissues of the body
Henry’s Law: the amount of a particular gas dissolved in solution is proportional to the partial pressure of that gas over the solution.
Boyle’s Law: gas expands (volume increases) as pressure diminishes.
A patient is experiencing nausea, vomiting, cramping and weakness after completing a triathlon.
You suspect:
You should:
Heat exhaustion
Move to a cool area
Remove clothing
Avoid shivering
O2, IV NS bolus
AMS and a lack of shivering are indicative of:
Severe hypothermia
Hyperventilation prior to breath holding while swimming may lead to:
Shallow water blackout
