Multiply injured patient Flashcards

1
Q

Femoral fractures -> what splint

A

Thomas splint

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2
Q

Trauma network vs major trauma centers.

A

Trauma network = all spots, pre hosp services, small and larfe treana centers and rehab. Major trauma centre = multi-speciality care to seriously injured patients. Optimised for trauma care provision. If can be there in 10 mins fab, otherwise is the golden hour.

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3
Q

What is the method?

A

Dr(ccc, catastrophic haemorrhage,call for help,c-spine)ABCDE(g-glucose). Trauma team get pre-alert, and then ATMIST handover from paramedics (Age, time of injury, mechanism of injury, Injuries sustained, Signs and symptoms, treatment)

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4
Q

ATLS vs BATLS

A

ATLS = advanced life support
BATLS = for battlefield, includes checking for cat hem beforehand.

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5
Q

When do we assume c spine?

A

If mechanism would suggest. Lowering neuro response. Unconscious/reduced conscious level, neurological signs.

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6
Q

Primary vs secondary survey:

A

primary – abc -> immediate threats to life. Secondary = injuries and more detailed history.

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7
Q

What do we do on breathing?

A

RIPPAS. Note EEE -> Effort (RR, wheeze, accessory muscles), Efficacy (tracea, percussion, air entry), effect (stats, cyanosis)

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8
Q

What are the signs of flailed segment?

A

Ribs move inwards instead of outwards when you breath in -> rib snapped in 2 .

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9
Q

5 spots for blood loss:

A

pelvis, abdo, thorax, floor, long bones (femur)

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10
Q

Rti -> pelvis, need to use what?

A

Pelvic binder

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11
Q

What do we do for circulation

A

Get IV access, HR, pulse, BP, narrowed pulse pressure, urine output, confusion. Check haemoglobin, lactate, ultrasound/ct imaging to look for blood loss. If IV is difficult can give blood IO (into bones). Hypovolaemic patients give blood not crystoloid where you ca.

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12
Q

What is permissive hypotension?

A

Giving enough fluid to perfuse vital organs but not achieving normal bp as this can disturb developing clot

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13
Q

reach 6 or 4 units, add what in fluids ->

A

clotting factors and platelets

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14
Q

What is the lethal triad?

A

Acidosis, coagulopathy and hypothermia

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15
Q

– What do we do in D?

A

AVPU
– GCS
– Pupils
– Tone and reflexes
– Log roll

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16
Q

E?

A

Expose and environment -? Exposure will allow full examination -> remember to look out for hidden injuries posteriorly!

17
Q

What do we do in secondary survey and investigation?

A

That US/CT if not already done in C. And check everything else. Looking for other non lifethreatening things.