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
