Initial Assessment & Management

Question 1

Preparation phases?

Answer 1

1. Prehospital
2. Hospital Phase

Question 2

Triage - multiple casualties vs mass casualties?

Answer 2

1. Multiple casualties - does not exceed facility capabilities/ the most severe is attended to first
2. Mass casualties - exceeds the facilities capabilities/ the ones more likely to survive are attended to first

Question 3

Primary Survey Components?

Answer 3

A - airway maintenance + cervical spine restriction
B - breathing & ventilation
C - circulation + haemorrhage control
D - disability
E - exposure

Question 4

10 second Ax?

Answer 4

Introduce yourself
What is your name? What happened?

Question 5

Airway assessment?

Answer 5

• Patent? Maintainable? Intubate
• C-spine

Consider
- Foreign bodies
- Fractures mandible/facial/laryngeal
- Blood secretions
- GCS <8 = definitive airway

Question 6

Deterioration?

Answer 6

Ax again from beginning

Question 7

Breathing & ventilation Ax?

Answer 7

“RACES”
- Rate
- Air entry - Auscultation/ Expansion
- Colour
- Effort
- Saturation

Question 8

Circulation: What is volume replacement for ?

Answer 8

Maintain end organ perfusion

Question 9

Circulation Ax?

Answer 9

“RACES”
- HR
- AVPU
- Colour
- Extremities/ End Organ Perfusion/ Urine output
- SBP

Question 10

Haemorrhage types?

Answer 10

1. External
2. Internal: chest/ abdomen/ retroperitoneum/ pelvis & long bones

Question 11

Disability Ax?

Answer 11

4x P’s
1. Pupils - size & reaction
2. Posturing/ lateralising signs
3. AVPU
4. ICP - HR/BP/RR/Pupils

Question 12

Exposure Ax?

Answer 12

RST
- Rash
- Swelling
- Turn/trauma/temperature

Question 13

Adjuncts to Primary Survery ?

Answer 13

1. ECG
2. EFAST
3. ABG
4. Xrays
5. Urine catheter
6. NGT

Question 14

Secondary Survey?

Answer 14

History - AMPLE
Head to toe examination

Question 15

Types of trauma?

Answer 15

Blunt
Penetrating
Thermal

Question 16

End Goal Options?

Answer 16

Definitive car
Transfer
Discharge

Question 17

Injuries high risk for compartment syndrome?

Answer 17

Crush injuries
Circumferential burns
Prolonged ischaemia
Long bon. fractures

Question 18

Normal Urin Output values?

Answer 18

Adult 0.5ml/kg/hr
Paeds >1 year 1ml/kg/hr

Question 19

Indications for CO2 monitoring?

Question 20

EMS Handover?

Answer 20

MIST
Mechanism of injury
Injuries
(Vitals) Signs & Symptoms
Treatment received

Question 21

Correct sequence of events?

Answer 21

1. preparation
2. Triage
3. Primary survey + resus
4. Adjuncts to primary
5. ?Transfer
6. Secondary survey
7. Adjuncts to secondary
8. Revaluation
9. Definitive care or transfer