Intoduction to Trauma

Question 1

What is the epidaemiology of traumatic death?

Answer 1

4th leading cause of death in western countries

Leading cause of death in 1st 4 decades of life

An average of 36 life years are lost per trauma death

Question 2

What is the definition of the golden hour

Answer 2

A time period lasting from a few minutes to several hours following traumatic injury during which there is the highest likelihood that prompt medical treatment will prevent death

Question 3

What information do paramedics need about an injury to transfer to the hospital?

Answer 3

Mechanism
Speeds
Scene
Seat-belted
Ejection
Pedestrian
Falls

Question 4

What is BATLS?

Answer 4

Battlefield Advanced Trauma Life Support

(C)ABC -> Catastrophic bleeding, airway, breathing, circulation

Question 5

What is DCR (Damage control Resuscitation)?

Answer 5

A systemic approach to major trauma combining the CABC paradigm with a series of clinical techniques from point of wounding to definitive treatment in order to minimise blood loss, maximise tissue oxygenation and optimise outcome

Question 6

What is the step up treatment of catastrophic bleeding?

Answer 6

Press on it
Elevate it
Tourniquet it

Question 7

The A of ABCDE/ CABCDE means airway with cervical spine control.

When should you assume C spine injury?

How do you immobilise the C spine?

Answer 7

Assume C Spine Injury:

• Significant mechanism
• Injury above clavicles
• Decreased conscious level

C Spine immobilisation:

• Manual in line immobilisation
• Hard collar, Head huggers, tape

Question 8

What 3 things should you consider during airway assessment?

Answer 8

Patent or signs of obstruction
Injury
Airway at future risk

Question 9

Give 6 ways to manage an airway

Answer 9

Oxygen - 15L O2
Suction
Simple airway maneuvers
Airway Adjuncts
Definitive Airway
Surgical Airway

Question 10

How do you assess someones breathing?

Answer 10

EXPOSE CHEST

• Work of breathing
• Tracheal position
• Palpate
• Percuss
• Auscultate

Question 11

Give 6 life threatening conditions affecting breathing

what pneumonics are there?

Answer 11

ATOM FC

• Airway Obstruction
• Tension Pneumothorax
• Open Pneumothorax
• Massive Haemothorax
• Flail Chest
• Cardiac Tamponade

Question 12

How do you assess someones circulation?

Answer 12

HR
Pulse Pressure
BP
Cold 
Clammy
Capilary Refil
Agitation and confusion

Up to 30% blood volume first

Question 13

How do you manage someones circulation?

Answer 13

IV access

• Ideally 2 large bore cannulae in the antecubital fossae
• Alternatively IO

Bloods including XM/GS

IV fluids…

• What?
• How much?

Question 14

What are common sources of haemorrhage?

5 Marks

Answer 14

On floor or at scene
Chest
Abdomen
Pelvis
Long Bones

Question 15

How do you assess disability?

Answer 15

Neurological function
AVPU or GCS
Pupillary reflexes
Move fingers and toes

Question 16

How do you manage exposure and environment?

Answer 16

Expose fully (but maintain dignity)

Cover to prevent heat loss
Temperature (core if necessary)

Question 17

What does DEFG mean

Answer 17

DONT
EVER
FORGET
GLUCOSE

Question 18

What bedside tests can you perform on trauma patients?

6 marks

Answer 18

BM
Urine dipstick
Urine volumes
ABG
ECG
USS

Question 19

What ultrasound investigations can you carry out on trauma patients?

(3 marks)

Answer 19

FAST (extended)
HART scan
IVC assessment

Question 20

What laboratory and specialist investigations can you carry out in a trauma patient?

(4 marks)

Answer 20

Laboratory
-Bloods

Specialist

• X-rays
• CT
• Angiography

Question 21

What is involved in an AMPLE history?

Answer 21

Allergies
Medication
PMH
Last Ate
Events/Environment

Question 22

What is Transexamic acid?

What is it used for

Answer 22

Tranexamic acid (TXA) is an antifibrinolytic medication used to treat or prevent excessive blood loss from trauma, surgery, and in various medical conditions including hemophilia and heavy menstrual bleeding. It comes in oral and intravenous forms.