Initial Assessment Flashcards
3 vitals criteria for immediate trauma center transport
Dypnea/tachypnea, BP<90, GCS <13
motor cycle speed for transfer
20
fall height for adult transfer
20ft 6 m
What important vital may be misleading in adults over 55? What number may indicate shock
BP<110
what is primary survey?
Secondary?
ABCDE
Head to toe
1.5 L infusion of crystalloid for trauma patients is and independent indicator of increase in _____
mortality
Within what time should TXA be given? repeat when
3 hours; 8 hours
Blood at meatus, next move?
RUG
Good EMS hand over mnemonic
MIST
MC site of spinal fracture
C5
If tourniquet is up for one hour prior to operative availabilitiy, what can be attempted?
tourniquet release
What is an MSK adjunct in the TB?
splint
The most significant differnce between burns and other injuries is that the consequence of burn are directly related to ….
inflammatory response
4 unique early intubation considerations for burns
Severe burns for patient pending transfer
40-50s TBSA
Facial burns
mouth burns
Half life of CO association with oxygen? Treatment?
4 hours, high flow non rebreather to red to 40
Parkland formula Adults vs kids
2ml LR x kg x TBSA
3ml LR x kg x TBSA
Target burn uops adults v kids
30-50ml/h or 0.5ml/kg/h
1ml/kg/h
Electrical burn parkland
4ml
adult burn % v babies
Head 9 v 4.5
legs 7 v 9
rule of 9s for adults
Hand trick for burns
1% for a palm
what degree is a superficial burn? what kind of common burn does this equate to ?
first
sunburn
partial superficial v partial deep characteristics
moist, hyper sens
dry, less painful, DO NOT BLANCH
full thickness burn appearance
leathery
how to clean burn wound?
room temp saline
dry chemical on skin, first step?
brush off then lots of warm saline
what metabolic disorder is associated with electrical burn
rhabdo
4 non obvious transfer criteria for burns
TBSA >10%
face, perineum, genitals
3rd degree
electrical burns
what to do for frost bite
warm in 40 C or 104 F
Where do the main fluid losses occur for burns
Interstitial losses from inflammatory response
Where do the main fluid losses occur for burns
Interstitial losses from inflammatory response
urine goals for electric burns, why
100ml/h to combat rhabdo
important position for babies concerning airway patency
sniffing position
Childrens ETT size trick
nares or little finger
Always do this prior to attempting intubation for children
pre ox
equation for childrens sbp
90 + (2x age)
Severe ped blood loss percent
45
At what age to heart rate norms catch up to adults?
13
Infant normal HR? school age?
160
120
Normal UOP for infant v 13y
In between?
2 v .5
1-1.5
Peds hemorrhage resuscitation protocol
20 ml/kg crystalloid bolus
then 10-20 ml/kg blood
then 10-20 ml/kg ffp
MC life threatening injury in kids?
why?
Tension Ptx
very mobile mediastinal structures
ALARA?
As low as reasonably achievable
Fatal cancer rate in children who have CT scans
1 in 1000
Normal pCO2 in pregnancy?
normal low
acute blood loss effect on fetus initially
uterine blood supply constriction
effects of pregnancy on fibrinogen? wbc? plasma? crit?
up
up
up
down
pa co2 in preg? why?
25-30; progesterone sensitizes central co2 receptors leading to increase in TV
First line treatment for eclampsia seizures?
Mg
Pregnant patient positioning in TB?
left tilt
Main cause of traumatic fetal death
Maternal shock and death
