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Paramedic Conditions > Paramedic - Major Trauma > Flashcards

Paramedic - Major Trauma Flashcards

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1
Q

What are the different methods used to control external cat Hem

A

1) direct pressure - hands, haemostatic gauze,
2) indirect pressure - tourniquet, blast bandage

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2
Q

Why should times be taken when tourniquet are applied

A

Over 2 hour increase risk of ischemia post isolation point. Rabdomutlsis compartment syndrome, nerve damage, tissue death

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3
Q

What does the first c stand for I’m drccabc

A

Cat hem

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4
Q

What is the 1st collum in the trauma triage tool (WMAS) - vital signs

A

Respiratory rate - 10-29 (outside problem)
Bp: under 90mmgh - (problem )
GCS : mother score less than 4

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5
Q

What is the second column in trauma triage tool (WMAS) - anatomy (full body)

A

Any depressed or open skull fracture
Any chest injury with hypoxia
Any torso penetration trauma
Any spinal injury with paralysis
Major pelvic injury
2+ long bone injury
Any amputation /open fracture / or mess above ankle and wrist

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6
Q

Where do major trauma patient go

A

MTC - major trauma centre

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7
Q

What is silver trauma safety net: + what is the age range for this to be in place

A

Patient must be over 65 with
-Bp of under 110 post injury
-Any femur or open fractures
-Hugh mechanism of injury

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8
Q

What should check when attending any child - safeguarding
Any injury with a vulnerable person take caution ( elderly or children).

A

Does the history, match the presentation match what I know about a&p

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9
Q

What does DRCCABC stand for

A

Danger
Response
Cat hem
C spine
Airway
Breathing
Circulation

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10
Q

In a CAR RTC - frontal impact. What types of injuries are more likely.
Quick stop - delegation

A

Up and over
Chest - hit steering wheel
Abdominal - hitting steering wheel

Down and under
Knee hit under steering
Face plant into steering wheels

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11
Q

In a car RTC - rear impact what is the likely injuries.

A

Neck - quick flextion and extension.
Whip lash

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12
Q

I’m a car RTC with Lateral impact.
What are the suspected Injuries

A

Injuries to impact side - arm, pelvis
Rational of neck

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13
Q

I’m a car RTC with rotational collision what are the suspect injuries

A

Combination of frontal and lateral
Person closest to impact = worse injuryies

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14
Q

In a car RTC with roller over
What are suspect injuries

A

All types. With person not wearing seatbelt - will be in the front out out of the car.

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15
Q

in a RTC - car vs predestrian, what are the suspected injuryies

A

hip and leg - from inual impact
torso - from hitting windscreen
head- from hitting ground

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16
Q

in a RTC - pedestrian vs car - adult vs child, where do you suspect they will have injuries ( posterior/ anterior and why

A

child - anterior = they look at th vechile and freeze
adult - posterior - they tend to run away

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17
Q

what are the managment principle of DR CCABCde

A

c– Control of exsanguinating haemorrhage
ca– Airway and cervical spine control
B– Breathing with high-flow oxygen
C– Circulation with haemorrhage control
D– Disability with prevention of secondary injury
E– Exposure with temperature control

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18
Q

what are the main point for cat hem to occur

A

injury site
junctional areas - axilla, neck groin, perituim

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19
Q

when dealing with petrating chest injury what is the preferable bandage to apply

A

Russel chest seal - valve - air out not in = less chance of tension pneumothorax

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20
Q

how to apply a cat hem torniquet

A

Identify site needs bleed stop
2/3 cm above
Clip on and tighten
Twist to further close and secure

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21
Q

how di you apply a kendrick traction splint

A

Measure bar against good leg
Place blue strap against the groin
Get the ankle strap lengthen the orange strap
Fix the ankle strap on the ankle
Place the bar peg bit on the orange bit
Get the knee strap on
Place traction via the red strap
Fix the leg in place via the traffic light system
Recheck leg - pulse and cap refill

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22
Q

how do you apply a pelvic binder

A

Make sure patient is trauma naked
Open the binder
Place black side under patients knees
Slide it up so the middle of the minder is against the greater trochontor
Cut the binder
Get the straps on
Apply equal strength and secure the binder

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23
Q

what is the algorium used for the management of traumatic cardiac arrest

A

HOTT
H- Hypovolemia = stop cat hem, 2L saline rapid, binder and straight legs, TXA
O- Oxygenation = 15L bvm
T- Tension pneumothorax - bilateral needle
T- cardiac tamponade - merit

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24
Q

how does a paramedic manage the “A” in DRCCABCDE

A

P- patient

V - voice

B- bone ( teeth / jaw

L - liquid ( vomit/ Blood - where from ( tongue gums vomit)

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25
Q

how does a paramedic manage the “B” in DRCCABCDE

A

through 12 flaps

Tracheal Deviatio n
Wounds
Surgical Emphysema
Laryngeal Fracture
Distended Neck Veins
evaluate - IPPA

PLACE PATIENT ON 15L OF O2 any raise in RR or in dropped RR with profound trauma - peri arrest

DO NOT Rely on spo2 - lack volume ( remaining blood full saturated)

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26
Q

what is the mnemonic to remember the cavities in the body for internal haemorrhaging

A

blood on the floor and 4 more -check:
chest
abdomen
pelvis
long bones

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27
Q

how does a paramedic manage the “c” in DRCCABCDE

A

-check pulses - rate, quality (strong ect)
-Check skin - colour ( 02 / perfusion)
-check capillary refill
-blood on the floor and 4 more- check chest abdomen pelvis long bones

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28
Q

how does a paramedic manage the “D” in DRCCABCDE

A

GCS
pupils

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29
Q

how does a paramedic manage the “E” in DRCCABCDE

A

coldness - trauma naked (prevent hypoxia

30
Q

what is COMA in trauma

A

clothing
oxygenation
montering
access (IV/IO)

31
Q

how long can the heart and brain last without oxygen before coming ischemic

A

4-6 minutes

32
Q

how long can the abdomen and last without oxygen before coming ischemic

A

45 minutes

33
Q

how long can the peripheries last without oxygen before coming ischemic

A

4-6 hours

34
Q

what is hydorstatic pressure

A

pressure generated by the heart - 2 mcuh water leaves blood, 2 less no blood movement

35
Q

how can you work out pulse pressure

A

systolic - diastolic = pulse pressure ( 120-80=40)

36
Q

what is MAP and what is it a measure of

A

Mean arterial pressure - measures end organ prefusion- normal map is 70-100mmgh

37
Q

what is the normal valves of MAP

A

70- 100mmgh

38
Q

what is shock

A

hypoperfusion of organs leading to change in rr - problem with cardiac ouput and o2 supply therfore kidney failure = death

39
Q

what is the key in preventing worsening of shock

A

02 and glucose

40
Q

how does shock cause decrease in cardiac output

A

lack of blood flow to pumonary veins and vena cava - less fill = less strech = less force of contraction = less stroke volume

41
Q

what is oncotic pressure

A

the pull of water from the outside into the blood via the solutes in it

42
Q

why is having to much water ( oedema ) in the intercial space a bad thing

A

creates a barrier stopping oxygen getting to the cell - facilitating anaerobic respiration

43
Q

When the body is experiencing shock ( hypovolemic) what pathway is activated - what are the action on of this

A

Sympathetic pathway
Increase RR and HR due to adrenline
Vasoconstriction of peripheral circulation - started anaerobic respiration periphery

44
Q

What is a sign of irreversible shock also known as the switch from compensation to decomposition

A

Drop in blood pressure - volume loss to great

45
Q

How many stages of hemorrhagic shock are. There

A

4

46
Q

What is classified as 1st stage hemorrhagic shock

A

Upto 750ml - no signs

47
Q

What is classified as 2st stage hemorrhagic shock

A

Upto 1500ml of blood - tachycardia + tachponea + decreased pulse pressure
= Fluids

48
Q

What is classified as 3st stage hemorrhagic shock

A

Upto 2000ml of loss
Tachycardia - 130++++
Tachypnea - 30++++

49
Q

What is classified as 4th stage hemorrhagic shock

A

Loss of 2000ml +++
HR - high 130 +++
Rr - 35+++
BP below 90mmgh systolic
Confused

50
Q

What is distributive shock

A

Problem with pipes
Pipes bigger than blood supply - vasodilation

51
Q

What are the sign of neurogenic shock

A

Low BP but NO TACHYCARDIA
Vasodilation past injury site - warm, perfused ect
Widening pulse pressure
Should be treated same as hypovolemic pt

52
Q

What are the clinical signs of hypovolemia

A

Weak pulse
Sweaty cold cyanotic skin
Delayed CRT
Loc or.confusion

53
Q

What is cardiogenic shock

A

Problem with the pump
Electrical mechanical - causing lack of blood flow

Cool clammy cyonosed skin
Delayed cap refill

54
Q

What is a tension penumothorax

A

Air enter into the pluerix space
Causes pressure on lung - reducing inflation = lack O2 for RBC - shock

55
Q

What is valvular disruption

A

Sudden force direct on heart - causes defect with heart valves
- causes acute heart failure - odema
New heart murmur

56
Q

What is cardiac tamponade

A

When blood or fluids fill the pericardial sack - compressing and rigidity to the heart muscle - eventually stopping movement = cardiac arrest

57
Q

What are the signs of life threatening conditions ( Phbts w

A

Pulses - absent radial or peripheral
Tachycardia -120+
Breathing - quick
Hypothermia - cold
Skin - cyanosis or pale
Thirst

58
Q

If the patient RR is above 30 what should the clinician do

A

BVM

59
Q

What is the guidelines for fluid resuscitation - peripheral or blunt

A

To maintain a palpable radial pulse or BP of 90mmgh in penetration or blunt

60
Q

What is the guidelines for penetrative trunk injury

A

Maintain a central pulse or a BP of 60mmgh - in all other injury’s a BP of 90mmgh or radial pulse

61
Q

What is permissive hypotension

A

When you give fluids increase BP but not to normal non trauma values

62
Q

Why is promissive hypotension a thing

A

As fluid = increased hydodtatic pressure - blowes clots
Can slow down bleed internally by not diluting clotting factors left

63
Q

What is the fluid resuscitation guidelines on burns coving over 25% BSA

A

Give 1L over 1 hour

64
Q

What is a drug given to patients who have severe bleeding within 3 hours and what is the pathophycology of the drug

A

TXA
stop the breakdown of clots to plasmin and stabilisers the clots

65
Q

Why is preventing hypothermia important in trauma patients

A

Under 36 degree it affects the clothing process

66
Q

What is the trauma triad

A
67
Q

What are signs of larageal obstruction ( cartilage breakage

A

Horse or changed voice
Stidor

68
Q

How can a person be hyperventilating but still be a dropping sats rate

A

Due to shallow breaking - tidal volumes 500ml + 150 dead space - reduced tidal volume = shit

69
Q

Why is over infusion of saline bad or why is permissive hypotension good

A

As it prevent water leakage in-between the intrsuiual space - barrier for O2

70
Q

Your arrive to patient who is gurgling or snoring - what the cause and what’s the difference

A

Obstruction - giggling= fluid, snoring - tongue to debree

71
Q

What is the effect of hypoventilation

A

co2 build up = blood acidic increase and anaerobic respiratorn

72
Q

What is the effect of hyperventilation

A

Vasoconstriction - causes worsening tbi

Paramedic Conditions (13 decks)

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