Pfeiffer Flashcards
The two major causes of preventable death
hemorrhage (anticipate shock) and infections (contaminated prevention)
Spleen, liver, stomach are all intra or retro peritoneal?
intraperitoneal
kidneys and aorta are intra or retro peritoneal
retroperitoneal –> hidden hemorrhage
Major Regional injury to:
- thoracic region - liver and spleen
- true abdomen - intestines
- retroperitoneal
- liver and spleen - hemorrhage
- shock, peritonitis, infection
- severe hidden hemorrhage (major vessels)
More common abdominal trauma - blunt or penetrating?
blunt > penetrating (gunshots > stabbings)
Two major concerns regarding abdominal trauma
Hemorrhagic shock
SEPSIS (+/or peritonitis)
What is direct compression of the abdomen called?
Wha happens to solid organs (spleen/liver) v. hollow organs (intestine)?
BLUNT abdominal trauma
Solid organs fracture
Hollow organs blowout
What do deceleration forces result in in blunt abdominal trauma?
TEARING of organs and blood vessels
What organ(s) is/are most commonly injured in blunt abd trauma? Dangerous why?
-liver/spleen most commonly injured.
Dangerous bc often no/minimal external evidence, BLOOD LOSS and pain are concealed.
What is direct trauma to organ or vasculature of the abdomen called? Do not do what type of rescusitation for this?
PENETRATING abd injury
-caution vigorous fluid rescusitation
Splenic injury refers where?
Left posterior shoulder pain
Liver injury refers where?
right posterior shoulder pain
distension, tenderness, tenseness,
pelvic tenderness, bony crepitation all indicate what?
severe hemorrhage
always assess and treat for what, even if injury is not apparent?
shock - signs do not appear early
do what three things for eviscerations?
- DO NOT push viscera back into abdomen
- cover with moistened gauze(cloth)
- apply nonadherent material to prevent drying
What 3 steps for impaled object?
- DO NOT remove
- gently stabilize object
- avoid mvmt
5 strategies to ensure coorperaiton
- ID yourself and orient pt to surroundings
- tx with respect, avoid being judgemental
- acknowledge concerns and feelings
- let pts know what’s required of them
- ask closed ended questions for history
Note what upon initial survey/assessment of pt?
Mental status Pupils Speech Respiration Needle marks
Altered mental status is due to what three things until proven otherwise?
Head injury, shock, hypoglycemia.
Under the influence of what if there’s slurred speech
alcohol and sedatives
Under the influence of what if there’s significantly depressed respirations
opiates and sedatives
Under the influence of what if pupils:
constricted
dilated
fixed and dilated
- constricted - opiates, early barbituate use
- dilated - amphetatimes, cocaine, hallucinogens, marijuana
- fixed and dilated - high dose barbituates
Do what 3 things when interacting with an uncooperative pt?
be firm
set limits to behavior
consider physical restraints
Types of restrains (4)
Spinal immobilization
reeves sleeve
soft restrains
CHEMICAL (paralytic)
