Lecture 19: Principles of Trauma Management (Exam 2) Flashcards
What is done to determine the type & extent of any life threatening injuries or medical problems
Initial focused exam
Describe a primary survey
- Rapid assessment for life threatening problems
- Target critical organs by priority
- 2 min or less
What should be noted in an initial assessment
- Level of consciousness, attitude, & behavior
- Unusual activity
- Unusual body or limb postures
- Positions that suggest bone fractures or joint dislocations
- Traumatic injuries
- Unusual breathing sounds or sounds suggesting airway obstruction
- Look for any obvious blood, wounds, or other gross abnorms
What are the ABCs of an initial assessment
- Airway
- Breathing
- Circulation
- Neurologic
- Wounds
Define apoptosis
The natural process of old cells dying & being replaced by new ones
What can causes necrosis
- Toxins
- Radiation
- Heat
- Trauma
- Lack of oxygen due the interruption of blood flow
What do A, B, & C have in common
- Airway - to provide a pathway for O2 to reach red blood cells in the lungs
- Breathing - to transport O2 to RBCs
- Circulation - to transport the O2 in the RBCs to the tissue
What if there are not sufficient RBCs to transport enough oxygen to keep the cells alive
Airway, breathing, & circulation are irrelevant
How are critically needed RBCs lost in trauma
Hemorrhage (compressible or non compressible)
What does M2ARCH2E stand for
- Massive hemorrhage
- Muzzle
- Airway
- Respiration
- Circulation
- Head injury
- Hypothermia
- Evacuate/ pain management/ Abx
What is done in the initial care
- Ensure the area is safe (move px to a safe area if necessary)
- Major wounds that cause instantaneous death initial actions will have little effect
- Take a few seconds & see what the px is doing
What safety precautions should be taken
- All animals should be properly restrained & possibly muzzled
- Certain procedures & situations will dictate otherwise
- Human health & safety should always take precedence
Where is blood coming from if it is bright red & squirting out
Arteries
Where is blood coming from if it is dark red & oozing/flowing out
Veins
What is a CAT
Combat application tourniquet
What is SOFT
Special Operations Forces Tourniquet
List some hemostatic bandages
- Combat gauze
- Chitogauze
- Hemcon
What is done during airway assessment
- Check for patent airway (abnorm sounds, deformity of face/neck/chest)
- Restrain the jaw even if unconscious (exam & clear oral cavity)
- Reposition jaw, tongue, head/neck if needed
- Clear airway of objects, blood, etc
- Listen for labored & noisy breathing
- Feel the throat area & trachea in the front center part of the neck
When opening the mouth what should be looked for
- Look inside as far back into the throat area as possible
- Masses
- Foreign objects
- Swelling
- Deformities that may cause airway obstruction
How can an airway obstruction be cleared
- 2-finger sweep tech
- Sweep vomit, blood clots, foreign objects from the mouth
- External extraction tech
What should be looked for when visibly observing the airway
- Barking, panting, lack of sounds
- Unconscious - possibly needs airway, observe, & position airway placement
- Bleeding oral cavity, burns, & external evidence of blockage or facial damage (needs airway protection)
What airway tech generally do not work in canines
Nasal trumpets
What should be done instead of a CRIC
A tracheotomy
Explain how to do a tracheotomy
- Make a transverse incision through the annular ligament btw/ the third & fourth or fourth & fifth tracheal cartilages (Do not extend the incision around more than half the circumference of the trachea)
- Facilitate tube placement by depressing the proximal cartilages w/ a hemostat
- Elevate the distal cartilages w/ an encircling suture. Insert a tracheostomy tube that doesn’t completely fill the lumen
What should noted about a tube tracheotomy
- Appose the sternohyoid muscles, subQ tissue, & skin cranial & caudal to the tube
- Secure the tube by tying it w/ gauze or umbilical tape around the neck
What should be done in the B of the ABCs
- Observe the chest & abdomen
- Remove the vest if they are wearing one
- Inspect & palpate (fur hinders observation)
Describe an open pneumothorax
- Sucking chest wound
- Cover the wound
Describe a tension pneumothorax
- Needle decompression
- Thoracocentesis
What can deep labored breathing suggests
Lung trauma or probs like a pulmonary contusion
What can shallow rapid breathing suggest
Air, blood, or some other fluid in spaces of the lungs that don’t norm contain air, blood, or fluids
What does it mean if the dog is not breathing
Respiratory arrest
What can irregular breathing indicate
Brain injury
What do blue gums indicate
Serious problems
What is done during the circulation assessment
- Recheck bandages to ensure control of massive bleeding
- Address smaller wounds if necessary
- Initiate IVs & IO devices if needed
- fractures
- Pulse (rate & character)
- Mucous membrane colors
- CRT
What should be done if fractures are present
- Immobilize the joint above & below
- Secure splint immediately above & below site of injury
What is the normal CRT
< 2 secs
What does rapid heart rate or pulse w/ prolonged capillary refill time suggest
Shock, major trauma, or a serious medical prob
What does absence of pulse or hear rate indicates
Significant prob w/ the heart
What should be done for hypothermia/head injuries
- Can become hypothermic quickly
- Space blankets or rescue blankets (be sure to maintain access to applied tx & be able to assess)
- Assess level of consciousness (verbal commands, gate or how he stands, visual observation of head, unresponsive)
- Observe equality btw/ pupils
What should be done during a brief exam of the rest of the dog
- Assess the dog’s body for wounds, fractures, &/or evidence of trauma elsewhere
- Notice the spinal column, abdominal region, flank, & limbs for signs of trauma
