Initial assessment and management Flashcards

1
Q

Multiple casualty vs mass casualty

A

Multiple:

  • number of pt and severity of pt do not exceed the capability of the facilities
  • those with life-threatening problems prioritised

Mass:

  • Does exceed
  • those with the greatest chance of survival and requiring least expenditure of time and equipment prioritised
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2
Q

What GCS level requires a definitive airway

A

Less or equal to 8

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3
Q

Manual cervical immobilisation

A
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4
Q

Airway assessment

A

Look for foreign bodies/blood/secretions

Identify facial/mandibular/tracheal/laryngeal fractures

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5
Q

Airway management

A

Head tilt/chin lift or Jaw thrust

Oropharyngeal or nasopharyngeal airway

LMA

Definitive ET intubation

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6
Q

Things to assess in breathing

A

Look:

  • Jugular venous distention

Feel:

  • Position of trachea
  • Chest expansion
  • Percussion

Auscultation

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7
Q

Oxygen in ATLS

A

Every injured patient must get O2

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8
Q

Management of massive external bleeding

A

Apply direct pressure

If doesnt work consider tourniquet

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9
Q

Fluid temperture for resus

A

All needs to be warmed to 37-40 degrees either through a machine or via storage in warm environment

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10
Q

Medicine for control of bleeding

A

Tranxaemic acid bolus within 3 hours followed by by 8 hour infusion

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11
Q

Primary survey

A

Quick A-E to r/o

airway obstruction

Pneumo/haemothorax

Bleeding

Reduced GCS

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12
Q

When to do secondary survey

A

After primary is completed or if can be done without interfering with primary survey

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13
Q

What is involved in the secondary survey?

A

Head to toe evaluation including AMPLE history and physical examination

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14
Q

AMPLE hx

A

Allergies

Meds

Past illness

Last meal

Events/environments related to the injury

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15
Q

Blunt vs penetrating trauma examples

A

Blunt: car collisions, falls

Penetrating: gunshot, stabbing

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16
Q

Sequence of secondary survey

A

Head, maxillofacial, cervical spine and neck, chest, abdomen and pelvis, perineum/rectum/vagina, MSK system and neurological system

17
Q

Assessment of head in secondary survery

A

Assess scalp, head for lacerations/ contusions/evidence of fractures

Examine eyes for size, haemorrahge and AFRO

18
Q

Examination of maxillofacial structures

A

Palpation of bony structures

Assessment of occlusion, intra-oral examination and assessment of soft tissue

19
Q

How to insert NG tube in presence of base of skull injury

A

Insert it orally

20
Q

Where to auscultate for pneumothorax

A

High anterior side

21
Q

Where to auscultate for haemothorax

A

Posterior base

22
Q

Handover from ambulance service

A
MIST
Mechanism (and time) of injury

Injuries found and suspected

Symptoms and signs

Treatment initiated