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Surgery 1 (SAB) > Lecture 19: Principles of Trauma Management > Flashcards

Lecture 19: Principles of Trauma Management Flashcards

1
Q

What is done to determine the type & extent of any life threatening injuries or medical problems

A

Initial focused exam

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2
Q

Describe a primary survey

A
  • Rapid assessment for life threatening problems
  • Target critical organs by priority
  • 2 min or less
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3
Q

What should be noted in an initial assessment

A
  • 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
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4
Q

What are the ABCs of an initial assessment

A
  • Airway
  • Breathing
  • Circulation
  • Neurologic
  • Wounds
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5
Q

Define apoptosis

A

The natural process of old cells dying & being replaced by new ones

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6
Q

What can causes necrosis

A
  • Toxins
  • Radiation
  • Heat
  • Trauma
  • Lack of oxygen due the interruption of blood flow
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7
Q

What do A, B, & C have in common

A
  • 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
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8
Q

What if there are not sufficient RBCs to transport enough oxygen to keep the cells alive

A

Airway, breathing, & circulation are irrelevant

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9
Q

How are critically needed RBCs lost in trauma

A

Hemorrhage (compressible or non compressible)

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10
Q

What does M2ARCH2E stand for

A
  • Massive hemorrhage
  • Muzzle
  • Airway
  • Respiration
  • Circulation
  • Head injury
  • Hypothermia
  • Evacuate/ pain management/ Abx
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11
Q

What is done in the initial care

A
  • 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
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12
Q

What safety precautions should be taken

A
  • All animals should be properly restrained & possibly muzzled
  • Certain procedures & situations will dictate otherwise
  • Human health & safety should always take precedence
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13
Q

Where is blood coming from if it is bright red & squirting out

A

Arteries

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14
Q

Where is blood coming from if it is dark red & oozing/flowing out

A

Veins

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15
Q

What is a CAT

A

Combat application tourniquet

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16
Q

What is SOFT

A

Special Operations Forces Tourniquet

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17
Q

List some hemostatic bandages

A
  • Combat gauze
  • Chitogauze
  • Hemcon
18
Q

What is done during airway assessment

A
  • 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
19
Q

When opening the mouth what should be looked for

A
  • Look inside as far back into the throat area as possible
  • Masses
  • Foreign objects
  • Swelling
  • Deformities that may cause airway obstruction
20
Q

How can an airway obstruction be cleared

A
  • 2-finger sweep tech
  • Sweep vomit, blood clots, foreign objects from the mouth
  • External extraction tech
21
Q

What should be looked for when visibly observing the airway

A
  • 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)
22
Q

What airway tech generally do not work in canines

A

Nasal trumpets

23
Q

What should be done instead of a CRIC

A

A tracheotomy

24
Q

Explain how to do a tracheotomy

A
  1. 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)
  2. Facilitate tube placement by depressing the proximal cartilages w/ a hemostat
  3. Elevate the distal cartilages w/ an encircling suture. Insert a tracheostomy tube that doesn’t completely fill the lumen
25
Q

What should noted about a tube tracheotomy

A
  • 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
26
Q

What should be done in the B of the ABCs

A
  • Observe the chest & abdomen
  • Remove the vest if they are wearing one
  • Inspect & palpate (fur hinders observation)
27
Q

Describe an open pneumothorax

A
  • Sucking chest wound
  • Cover the wound
28
Q

Describe a tension pneumothorax

A
  • Needle decompression
  • Thoracocentesis
29
Q

What can deep labored breathing suggests

A

Lung trauma or probs like a pulmonary contusion

30
Q

What can shallow rapid breathing suggest

A

Air, blood, or some other fluid in spaces of the lungs that don’t norm contain air, blood, or fluids

31
Q

What does it mean if the dog is not breathing

A

Respiratory arrest

32
Q

What can irregular breathing indicate

A

Brain injury

33
Q

What do blue gums indicate

A

Serious problems

34
Q

What is done during the circulation assessment

A
  • 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
35
Q

What should be done if fractures are present

A
  • Immobilize the joint above & below
  • Secure splint immediately above & below site of injury
36
Q

What is the normal CRT

A

< 2 secs

37
Q

What does rapid heart rate or pulse w/ prolonged capillary refill time suggest

A

Shock, major trauma, or a serious medical prob

38
Q

What does absence of pulse or hear rate indicates

A

Significant prob w/ the heart

39
Q

What should be done for hypothermia/head injuries

A
  • 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
40
Q

What should be done during a brief exam of the rest of the dog

A
  • 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

Surgery 1 (SAB) (16 decks)

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