misc trauma cards Flashcards
what are the elements of the trauma triad
hypothermia, acidosis and coagupathy
why hypothermia is bad in trauma
A drop in body temperature reduces the effectiveness of clotting factors and platelets, making it harder to stop bleeding.
why dose acidosis occur in trauma patients
Poor oxygen delivery due to blood loss causes the body to produce lactic acid, leading to a low blood pH, which damages cells and impairs clotting.
what causes coagulopthy in trauma patient
Disrupted blood clotting due to dilution of clotting factors, hypothermia, and acidosis leads to uncontrolled bleeding, fueling the cycle.
when should tourniquet be utilised
when external pressure is insufficient to control life-threatening bleeding.
when should fluids be used in trauma
if the patient has signs of hypovolemia
things to remember when applying a tourniquet
Remove clothing from the limb if possible.
Apply as distally as possible.
Do not apply over a joint.
Tighten until bleeding clearly stops. The tourniquet must be tight enough to stop arterial flow.
Leave the wound exposed so that it can be observed for bleeding.
Record the time of application.
outline a potential complication of a tourniquet that is applied to a forearm or lower leg
the presence of two bones may limit the pressure that can be applied to vessels. If bleeding continues despite the tourniquet being tightened maximally, place the tourniquet on the upper arm or thigh.
indicator for TXA in trauma
TXA is indicated if there are signs of clinically significant bleeding or signs of hypovolaemia
what causes Cervical spinal cord neuropraxia (spinal shock)
It is due to bruising and/or stretching of the cervical spinal cord and is often associated with hyperflexion or hyperextension of the neck
what is spinal cord neuropraxia
temporary loss of motor and/or sensory function followed by recovery over a few minutes to a few hours.
criteria to clear c spine
A normal level of alertness, and
No complaint of pain in the midline of the cervical spine, and
No tenderness to palpation at the posterior midline of the cervical spine, and
No signs or symptoms of spinal cord injury, and
No pain or other factors that might distract the patient from the pain of a cervical spine injury.
Tension pneumothorax occurs when
the volume of air within the pleural space progressively increases with each inspiration, but is unable to escape during expiration because the pleural tear acts as a one-way valve. With each breath the pressure within the pleural space increases until it is higher than the venous pressure within the superior and inferior vena cava, resulting in a progressive fall in venous return to the right heart and cardiac arrest if not treated.
presentation of tension pneumothorax
Progressively worsening shock. This is an important defining feature. If the patient does not have progressively worsening shock they do not have tension pneumothorax.
Progressively worsening dyspnoea.
Distended jugular veins. This occurs as a result of impaired venous return to the right heart. Very rarely, distended jugular veins may not be present if the patient has both tension pneumothorax and severe hypovolaemic shock.
Tracheal deviation away from the affected side. This is an extremely late sign as it requires very high pressure within the thorax and is rarely seen.
how to manage amputated parts
Wash the amputated part(s) using clean running water or 0.9% sodium chloride if severely contaminated, but this is not a priority and significant time should not be taken to accomplish this.
Wrap in a clean damp towel or dressing.
Place into a clean (preferably sealed) plastic bag and place this into a second plastic bag.
Place a mixture of water and ice (icy slush) in the second (outer) plastic bag. It is acceptable to use cold packs and water if ice is not available.
Do not allow the part(s) to come into direct contact with ice, or into prolonged direct contact with fluid.
what to examine for in eye injury
The appearance of the eye and surrounding tissues.
Pupil size, shape and equality.
Pupil reactivity to light, including the consensual light reflex.
Eye movement, vertically and horizontally.
An approximate assessment of the vision in each eye.
