multiply injured patient

Question 1

leading cause of death for first 4 decades of life

Answer 1

trauma

Question 2

Thomas splint

Answer 2

introduced in WW1 and has decreased mortality rate in femoral fracture

Question 3

good quality trauma care - 5 steps

Answer 3

prevention 
pre-hospital care 
acute trauma care 
special definitive care 
rehab

Question 4

trauma network

Answer 4

all providers eg pre hospital services, smaller local trauma units and rehab services

Question 5

Major trauma centres

Answer 5

multi-speciality hospital care to seriously injured patients

Question 6

How is the team alerted of the patient?

Answer 6

trauma call pre-alert

Question 7

pre-alert team

Answer 7

ED, anaesthetics, radiology, surgery

Question 8

paramedic handover includes what?

Answer 8

time and mechanism of injury
suspected serious injuries
vital signs
interventions carried out

Question 9

primary survey

Answer 9

ABC

detects and treats immediate threats to life

Question 10

secondary survey

Answer 10

identification of all injuries and more detailed history

Question 11

ATLS

Answer 11

ABC approach

Question 12

ABCDE and a bit of info

Answer 12

Airway - C spine control
Breathing with O2
circ with haemorrhage control
Disability 
exposure and environment

Question 13

BATLS

Answer 13

CABC

catastrophic haemorrhage

Question 14

assessing airway

Answer 14

noises eg speech

visual eg swelling, vomit

Question 15

airway management

Answer 15

manoeuvres
suction
adjuncts
advanced procedures

Question 16

assume C spine injury when?

Answer 16

dangerous mechanism
reduced conscious level
injury above clavicles
neurological signs

Question 17

breathing

Answer 17

look - injuries, RR, effort
feel - palpate and percuss
listen
oxygen, analgesia, drain

Question 18

circulation - clinical assessment

Answer 18

HR, radial pulse, CRT, BP, urine output, confusion

Question 19

blood test and imaging - circulation

Answer 19

HB and lactate

USS and CT

Question 20

5 sites for blood loss

Answer 20

floor 
chest
abdomen 
pelvis 
long bones

Question 21

volume replacement - circulation

Answer 21

IV access or IO access

type and amount of fluid

Question 22

IO access

Answer 22

intraosseus

Question 23

monitoring volume replacement

Answer 23

vital signs
urine output
lactate

Question 24

lethal triad - circulation

Answer 24

acidosis
hypothermia
coagulopathy

Question 25

disability

Answer 25

AVPU 
GCS 
pupils 
tone and reflexes 
log roll

Question 26

DEFG

Answer 26

don’t ever forget glucose

Question 27

bedside tests

Answer 27

ECG, ABG, urine dipstick

Question 28

traditional primary and secondary survey

Answer 28

P = c-spine, chest, pelvis xrays
S = log roll, pelvis, orifices

Question 29

modern approach to primary and secondary survey

Answer 29

USS/CT

minimal handling