Multisystem part 2

Question 1

Trauma First-Line Assessment

Answer 1

ABCDE

Airway: ensure a patent airway - consider intubation (stabilize the cervical spine if a spinal cord injury is suspected

Breathing: provide 100% oxygen and ventilation

Circulation: 2 large bore IVs with warm isotonic LR

Disability: perform a quick neuro exam - LOC, pupils, motor (GCS is part of the neuro exam, NOT all!)

Expose/Environmental: remove the patient’s clothes, provide warmth/cooling as needed

Question 2

Trauma Second-Line Assessment

Answer 2

FGHI

Full set of vital signs (ECG monitor, pulse oximeter, CO2 detector, urinary catheter, labs, etc)

Give comfort measures (pain management)

History

Inspect posterior: Turn the patient over

Question 3

A patient who is agitated (even a patient with a medical, rather than a surgical, diagnosis) should first receive an ____ before receiving anxiolytics.

Answer 3

analgesia (analgesia-first sedation)

Question 4

Maintaining light levels of sedation in adult ICU patients is associated with _____

Answer 4

improved clinical outcomes (ie a shorter duration of mechanical ventilation and a shorter ICU length of stay

Question 5

Levels of Sedation

Answer 5

Minimal (Light) Sedation: the patient responds normally to verbal commands

Moderate Sedation: the patient responds purposefully to verbal commands, either alone or accompanied by light tactile stimulation. The patient is able to maintain a patent airway.

Deep Sedation: the patient cannot be easily aroused but responds purposefully to repeated or painful stimulation. The patient may require assistance maintaining a patent airway.

General Anesthesia: this is a loss of consciousness during which patients are not arousable, even by painful stimuation