Kahoot Quiz Review Flashcards
A patient has gurgling respirations with bleeding into throat and from the mouth. What should you do first?
Suction
Dermatomes are?
An area of the skin supplied by nerves from a single spinal root.
Spinal nerves help to relay information from other parts of your body to your central nervous system. As such, each dermatome transmits sensory details from a particular area of skin back to your brain.
Dermatomes can be helpful in evaluating and diagnosing conditions affecting the spine or nerve roots.
Trauma Triad of Death is made up of?
Hypothermia, Acidosis & Coagulopathy
What is kinematics?
The process of predicting injury patterns.
A 13 year old has fallen 15 feet. He has a deformed right thigh and is lethargic to respond. What should you do first?
Manually stabilise C spine
A 45 year old hit in the chest. He complains of pain with inspiration. Vitals are normal with RR of 24. You should suspect?
Rib fractures
What type of impact to an unrestrained occupant commonly results in multiple system injury?
Rotational
Your patient’s trachea deviates away from the injury. What should you suspect?
Tension pneumothorax
When the vascular container enlarges without proportional increase in the fluid volume, the shock is known as?
Distributive Shock
What is the first sign of shock that usually appears in patients?
Altered mental status
In a compound extremity fracture involving the loss of distal pulses, what is your first priority in providing care?
Haemorrhage control.
After legs being trapped in a car by compression for 60 minutes you should suspect?
Crush syndrome
Which of the following mechanisms of injury would likely result in the coup-contrecoup trauma?
Frontal impact MVA
Which of the following describes bruising or discoloration behind the ears as a result of a fractured skull?
Battle’s Sign
Explain the injuries you may see with an up and over vs down and under pathway in a MVA.
Windshield impact:
- brain, soft tissue and cervical spine injuries
Steering Wheel impact:
- Chest compression
- Rib fractures - Paradoxical breathing
- Tension pneumothorax
Dashboard impact:
- face, brain c spine, pelvis, hips, knees and feet injuries
Explain the triad of death
- Severe blood loss
- blood clotting problems (coagulopathy)
- increased lactic acid in the blood
- Acidic blood (acidosis)
- Decreased heart performance
- Decreased body temperature (hypothermia)
- Decreased coagulation
What is your assessment for an unconscious MVA?
- ABCD
- Secure airway & C spine
- Assessment & management of respiratory status, including application of high flow oxygen.
- Assessment of circulation, including vital signs and external signs of blood loss.
- IV access for fluid administration to maintain BP of 90mmHh in 250ml bolus + ketamine.
- Assess GCS
- Complete head to toe
What would be your treatment plan for a MVA patient?
Spinal immobilisation: head held in pouring rain, clothing removed from around neck and cervical
collar applied.
• Oxygen applied 8 L/min via Hudson or NRB.
• Intravenous (IV) access 16G. NaCl in 250ml bolus to achieve permissive hypotension.
• Cardiac monitoring.
• Pain relief – Fentanyl initially then Ketamine per DTP.
• Extrication using spine board.
• Patient’s wet clothing removed.
• Pelvic binder.
• Leg splints.
Major Trauma should be considered in any one of the following criteria:
Mechanism
- MBA > 30 km/h with injuries.
- MVA > 60 km/h with injuries.
- Ejection from vehicle
- Penetrating injury to head, neck, torso or proximal extremities.
- Fall > 3m
- Fatality on scene whereby the patient was in the same vehicle.
- Pedestrian or cyclist with speed impact > 25km/h
Anatomical Criteria • Flail chest • Pelvic Fractures • Amputation / crush Injury proximal to hand and foot. • 2 or more long bone fractures • Suspected Spinal Injury • Polytrauma • Open or depressed skull fracture
Explain the physiological basis for the vital-sign findings of a patient in shock
The physiological basis for this set of vital signs is hypovolaemic shock.
HR: The increased heart rate is
compensation for decreased circulating volume and reduced haemoglobin;
BP: the low blood pressure reflects
significant loss of circulating volume;
RR: the increased respiratory rate is compensation for reduced
haemoglobin;
Skin: and the pale, cool periphery results from vasoconstriction to divert available blood to vital
organs.
The body has 2 main compensatory mechanisms in place to regulate blood pressure when hypotension is present, what are they?
- The sympathetic nervous system
- Angiotensin aldosterone system
Outline the role of permissive hypotension in haemorrhagic shock.
the principle of gaining hemorrhage control before restoration of euvolemia and normal blood pressure.
What may cause a decrease in oxygen stats in a MVA patient.
- Blunt trauma
- Rib fractures
- Pain & guarding
- Reduced tidal volume & alveolar ventilation = hypoxaemia
- treat with analgesia
may also be tension pneumothorax and flail chest resulting in paradoxical breathing.
What are the primary categorisations of head injury?
Mild = CSG 13-15 Moderate = GCS 9-12 Severe = <8
What is the difference between primary and secondary traumatic brain injury?
Primary:
- skull fractures
- cerebral contusions
- cerebral lacerations
- intercranial haemorrhage
Secondary:
- Ischemia
- Hypoxia
- Cerebral swelling
- Infection
What are the primary treatment goals for the TBI patient?
Minimise minimising factors that contribute to
- raised intracranial pressure,
- cerebral oedema and
- cerebral ischaemia.
This is achieved by:
• Avoidance of hypoxia
• Maintenance of normocapnia – hypercapnia = cerebral vasodilation = increase cerebral blood flow = increased cerebral edema;
hypocapnia = inadequate cerebral blood flow leading to ischaemia.
- Maintenance of normotension
- Maintenance of normoglycaemia
- Maintenance of normothermia - fever can increase cerebral metabolism and increase oxygen demand.
- Avoidance of seizures
The thoracic cavity contains three major anatomical systems are?
the airway, lungs, and the cardiovascular
system.
What inflammatory response will be triggered by the burn?
Cardiovascular:
- Altered vascular permeability results in leaky capillaries with the
- Large volumes of fluid are lost through evaporation and third space losses.
- Result: systemic hypotension + reduced organ perfusion.
Respiratory:
- Inflammatory-induced bronchoconstriction.
- ARDS
- Result: impaired tissue oxygenation.
Metabolic:
- Basal metabolic rate (BMR) increases up-to three times.
- Result: hyper-metabolism, breakdown in muscle protein.
Immunological:
- Release of stress hormones (cortisol, catecholamines, glucagon) result in the suppression of both cellular and humeral immunity.
- Loss of normal gut barrier function can permit bacterial translocation resulting in sepsis.
- Result: immunosuppression, increased susceptibility to infection.
What is the rule of 9s in burns patients?
Everywhere is worth 9%, except genitals = 1%
Children:
Legs = 14%
Face = 18%
