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Surgery I > Lec 21: Principles of Trauma Management > Flashcards

Lec 21: Principles of Trauma Management Flashcards

1
Q

what type of exam do we perform when an animal becomes ill or injured with life threatening results?

A

initial focused examination

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2
Q

what is the purpose of performing an initial focused examination?

A

to determine the type and extent of any life threatening injuries or medical problems.

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3
Q

primary survey consists of:

  • rapid assessment for ____ _______ problems
  • target _____ _______ by priorty
  • should be completed in ___ or less
A

life threatening ; critical organs ; 2 minutes

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4
Q

in our initial assessment, we need to pay attention to:

  1. level of _____, attitude, _____.
  2. unusual _____.
  3. unusual body or limb ______.
  4. positions that suggest bone ______, joint _______.
  5. ____ injuries.
  6. unusual ___ sounds or sounds suggesting _____ obstruction.
  7. obvious ___, wounds or other gross _________.
A
  1. consciousness ; behavior
  2. activity
  3. postures
  4. fracture ; dislocation
  5. traumatic
  6. breathing ; airway
  7. blood ; abnormalities
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5
Q

initial assessment pneumonic ABC (the old method) stands for…

A

A - airway
B - breathing
C - circulation

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6
Q

what comes after the old method of A B C?

A

neurologic, wounds

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7
Q

what causes cell death?

A

necrosis due to toxins, radiation, heat, trauma, lack of oxygen due to the interruption of blood flow

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8
Q

what is one thing that airway, breathing, and circulation have in common?

A

RED BLOOD CELLS

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9
Q

the airway provides a _____ for O2 to reach RBC’s in the lungs

A

pathway

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10
Q

breathing allows for ____ of O2 to red blood cells

A

transport

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11
Q

circulation allows for transportation of O2 in the red blood cells to the ______.

A

tissues

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12
Q

if there are not enough RBC’s to transport O2 to keep the cells alive, then airway, breathing, and circulation are _______.

A

IRRELEVANT

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13
Q

how are RBC’s lost in trauma?

A

hemorrhage

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14
Q

what two types of hemorrhage can a patient have in a trauma situation?

A

compressible or non-compressible

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15
Q

the NEW way to approach trauma:

A

M2ARCH2E

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16
Q

M in M2ARCH2E stands for:

member, two things!

A

massive hemorrhage & muzzle

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17
Q

A in M2ARCH2E stands for:

A

airway

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18
Q

R in M2ARCH2E stands for:

A

respiration

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19
Q

C in M2ARCH2E stands for:

A

circulation

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20
Q

H in M2ARCH2E stands for:

(remember 2 things!)

A

head injury & hypothermia

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21
Q

E in M2ARCH2E stands for:

A

evacuate / pain management /abx

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22
Q

why would we need to evacuate?

A

transport to referral hospital

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23
Q

ensure a ____ environment for you, your team, and your patient.

A

safe

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24
Q

with major wounds that cause instantaneous death, your ___ will have little to no effect.

A

actions

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25
Q

we should always slow down take a few seconds, and….

A

see what the patient is doing

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26
Q

ALL animals should be properly restrained and potentially ______.

A

muzzled.

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27
Q

what should you do first in the event of massive hemorrhage?

A

STOP THE BLEEDING - pressure pressure pressure!

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28
Q

arterial blood will be ____ in color, and squirting.

A

bright red

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29
Q

venous blood will be ____ in color and oozing.

A

dark red

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30
Q

should we use a tourniquet in the event of massive hemorrhage?

A

they are rarely used in practice. most of the time more beneficial to just put pressure on the bleed.

31
Q

besides applying pressure, what else could you use in the event of massive hemorrhage?

A

hemostatic bandages!

32
Q

how should we assess our patient’s airway?

A

listen for abnormal sounds, deformities of the face/neck/chest, examine and clear the oral cavity

33
Q

what safe preventative measures should we make sure to have in place when examining a patient’s airway?

A

restrain the jaw even if the patient is unconscious

34
Q

what type of repositioning will we possibly have to do in order to get the best look our patient’s airway?

A

straighten the head and neck

35
Q

clear the airway of any ____.

A

objects, blood etc

36
Q

palpate the ______ and _____ in the front/center part of the neck

A

throat area ; trachea

37
Q

look for masses, wounds or swelling that may cause ___ _____.

A

airway obstruction

38
Q

what technique should you use to clear airway obstructions caused by toys, bones, food, sticks etc?

A

the 2 finger sweep technique

39
Q

visually observe the patient, if unconscious….

A

possible needs an airway, observe and position airway placement → TRACHEOTOMY

40
Q

step 1 for a tracheotomy

  1. make a _____ incision through the _____ ligament between the ___ and ___ tracheal cartilages.
A

transverse ; annular ; third and fourth/fifth

41
Q

what should we be careful of when making our tracheotomy incision?

A

to not extend the incision around more than half of the circumference of the trachea.

42
Q

step 2 for a tracheotomy

  1. facilitate ___ placement by depressing the ____ cartilages with a hemostat.
A

tube ; proximal

43
Q

step 3 of a tracheotomy

  1. elevate the ____ cartilages with an _____ suture. Insert a tracheostomy tube that does __ completely fill the lumen.
A

distal ; encircling ; NOT

44
Q

after placing the trache, appose the _____ muscles, subcutaneous tissue, and skin cranial and caudal to the tube

A

sternohyoid

45
Q

after apposing the tissue, secure the tube by tying it with _____ or ____ around the neck

A

gauze ; umbilical tape

46
Q

how do we examine respiration?

A

look at how the animal is breathing, observe the chest and abdomen. inspect and palpate

47
Q

open pneumothorax is also called a

A

sucking chest wound

48
Q

how should we stabilize a patient with an open pneumothorax?

A

cover wound (can use a variety of different products)

49
Q

how do we relieve a tension pneumothorax?

A

needle decompression

50
Q

what land marks should we be aware of when relieving a tension pneumothorax via needle decompression?

A
  • want to place our needle somewhere between the 7th and 10th intercostal space
    • place the needle CRANIALLY to avoid a large artery that runs caudally
51
Q

the same landmarks used for needle decompression of a pneumothorax can also be used for…

A

thoracocentesis

52
Q

for a thoracocentesis, we want to replace the needle with an…

A

over the needle catheter

53
Q

deep, labored breathing is indicative of

A

lung trauma or other lung problems such as pulmonary contusions

54
Q

shallow, rapid breathing suggests…

A

air, blood or other fluid in spaces of the lungs that shouldn’t be there

55
Q

if the dog is not breathing, what is this called?

A

respiratory arrest

56
Q

irregular breathing may indicate…

A

a brain injury

57
Q

when evaluating respiration and breathing, we should always take a peak at the ___.

A

gums

58
Q

blue gums indicate _____.

A

a serious problem.

59
Q

when evaluating circulation in an animal that presents with hemorrhage, we should ____ bandages to ensure control of massive bleeding.

A

recheck (every time the patient moves!)

60
Q

after getting massive bleeding under control, we can move on to addressing _____ if necessary.

A

smaller wounds

61
Q

when evaluating circulation, initiate ___ and ___ devices if needed.

A

intravenous and intraosseous

62
Q

when evaluating circulation and we find a fracture, we should _____ the joint above and below the fracture, and place a ____ _____ immediately above and below the site of injury.

A

joint ; secure splint

63
Q

when evaluating circulation, we need to pay close attention to the ___, and consider the ___ and character (strong/weak, regular/irregular).

A

pulse ; rate

64
Q

determine the animal’s ___ when evaluating circulation. Normal is less than 2 seconds. Abnormal is ___ than two seconds.

A

CRT ; greater than

65
Q

rapid heart rate/pulse with prolonged CRT suggests….

A

shock, major trauma, or serious medical problem

66
Q

dogs can become _____ very quickly. space blankets should be utilized but be sure to maintain access to applied treatments and be able to assess the patient.

A

hypothermic

67
Q

when evaluating for a head injury, asses the level of ______.

A

consciousness

68
Q

you can assess the level of consciousness by: giving ____ commands, looking at the gait, visual observation of the ___, unresponsive

A

verbal ; head

69
Q

an important part to evalulate when looking for evidence of a head injury is _____.

A

anisicoria (pupils different sizes)

70
Q

preplan and practice ____ procedures.

A

evacuation

71
Q

pre plan ____ coverage.

A

veterinary

72
Q

abx should be _____ quickly once the need is identified.

A

administered

73
Q

after getting through M2ARCH2E - what else should you do?

A

asses the dog’s body for wounds, fractures, evidence of trauma elsewhere.

  • examine spinal column, abdominal region, flank, limbs for signs of trauma *

Surgery I (10 decks)

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