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SURG LE3 > Principles in trauma, BLS, Preparedness > Flashcards

Principles in trauma, BLS, Preparedness Flashcards

1
Q

What are the 2 classifications of trauma?

A
  • blunt trauma = motor vehicle accidents, fall, assault
  • penetrating trauma = stab wounds, hacking, gunshot, shotgun, impalement
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2
Q

What is the goal of initial management of trauma px?

A
  • identify & treat IMMEDIATELTY life-threatening injuries
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3
Q

What is are important information for the hx of the patient?

A
  • allergies
  • medications
  • pas medical hx
  • last meal
  • events &environment surrounding injury
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4
Q

what do you do during evaluation & diagnosis?

A
  • Primary survey & resuscitation
  • secondary survey & diagnostics
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5
Q

what are the steps in primary survey & resuscitation?

A
  • airway - make sure it is patent & protected
  • breathing = assess RR, O2 sat, chest wall trauma & expansion, breath sounds
  • circulation = life-threatening injuries
  • disability
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6
Q

what are interventions for breathing difficulties?

A
  • closed tube thoracostomy
  • open thoracotomy
  • neck exploration
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7
Q

what are the possible sources of bleeding?

A
  • external
  • chest
  • abdomen
  • retroperitoneum
  • pelvis
  • extremities
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8
Q

what do u assess if the px’s bleeding?

A
  • pulse (peripheral pulses)
  • skin color
  • capillary refill
  • blood pressure
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9
Q

what are the normal PR in radial pulse, femoral pulse, & carotid pulse?

A
  • radial pulse = SBP is 80mmHg
  • femoral pulse = SBP is 70mmHg
  • carotid pulse = SBP is 60mmHg
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10
Q

what are interventions in bleeding px?

A

pressure
packing
surgery

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11
Q

in assessing for disability, what should u do?

A
  • pupils
  • GCS score
  • Anal sphincter tone
  • bulbocavernous reflex
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12
Q

in assessing for disability, what should u do?

A
  • pupils
  • GCS score
  • Anal sphincter tone
  • bulbocavernous reflex
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13
Q

what are the indications of diff GCS scores?

A

GCS 13-15**= mild head injury
**GCS 9-12= moderate head injury
GCS <8 = severe head injury

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14
Q

what are secondary survey & diagnosis done?

A
  • x-ray
  • CT scan
  • ultrasound
  • diagnostic peritoneal lavage
  • local wound exploration
  • diagnostic laparoscopy
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15
Q

what are secondary survey & diagnosis done?

A
  • x-ray
  • CT scan
  • ultrasound
  • diagnostic peritoneal lavage
  • local wound exploration
  • diagnostic laparoscopy
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16
Q

what is the guidelines with Creatinine determnation & CT scan?

A

get creatinine determination first bcos contrast medium can push a px with marginal kidney function to AKI

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17
Q

what are C/Is of CT scan?

A
  • clear indication for surgery
  • hemodynamically unstable px
  • agitate px
  • allergy to contrast
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18
Q

what is the aim of ultrasound in trauma?

A

to detect present of free fluid

advantages:
* non-invasive
* repeatable, intial eval
* no radiation
* low cost

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18
Q

what is done in focus assessment with sonography (FAST)in trauma?

A
  • check 4 windows: R subcostal, Subxiphoid, L subcostal, Suprapubic
  • look at subhepatic space, pericardial window, left upper quadrant, pelvis
19
Q

what is done in Extended focus assessment with sonography in trauma (EFAST)?

A
  • pleural cavities, visualize any fluid in the chest
  • if there is hemothorax & pneumothorax -> chest tube must be inserted
20
Q

When do u do a diagnostic peritoneal lavage?

A
  • if utlrasound cannot be done
  • unexplained shock or hypotension
  • altered sensorium
  • gen anesthesia for extra-abdominal procedures
  • spinal cord injury
21
Q

what are C/Is of Diagnostic Peritoneal Lavage?

A
  • clear indication of surgery
  • relative: pregnancy, obesity, previous abdominal surgery
22
Q

what are the results of a positive peritoneal lavage?

A
  • aspiration of atleast 10mL gross blood
  • bloody lavage effluent
  • RBC >100,000mL3
  • WBC >500mL3
  • amyalse >19IU/dL
  • bile, bacteria, food fibers
23
Q

what technique involves more than simple visualization w/ scope & requires multiple ports and manipulation of the tissues?

A

diagnostic laparaoscopy

24
Q

what are the different liver injury scale?

A
  • **Grade I **= Hematoma, Laceration: Sucapsular <10^ SA, <1cm deep capsular tear
  • Grade II = Hematoma, laceration; 10-15% SA subcapsular, <10cm diam; 1-3cm deep, <10cm long capsular tear
  • **Grade III **= Hematoma, Laceration: >50% SA, >10cm, laceration is 3cm deep
  • Grade IV = Laceration = parenchymal disruption of 25-75% or >3% segments
  • Grade V = >75% lacteration, Vascular: juxtahepatic venous injuries
  • **Grade VI **= hepatic avulsion
25
Q

what are the different liver injury scale?

A
  • **Grade I **= Hematoma, Laceration: Sucapsular <10^ SA, <1cm deep capsular tear
  • Grade II = Hematoma, laceration; 10-15% SA subcapsular, <10cm diam; 1-3cm deep, <10cm long capsular tear
  • **Grade III **= Hematoma, Laceration: >50% SA, >10cm, laceration is 3cm deep
  • Grade IV = Laceration = parenchymal disruption of 25-75% or >3% segments
  • Grade V = >75% lacteration, Vascular: juxtahepatic venous injuries
  • **Grade VI **= hepatic avulsion
26
Q

what are the tx of liver injuries?

A
  • expectant/observatoin
  • drainage
  • hepatorrhapy
  • debridement/reseection
  • packing
  • angiography/embolization
27
Q

what is the step of BLS where injured organs are repaired or removed?

A

defintiive care

28
Q

on what criteria do we sort in triage?

A
  • urgency
  • probability of survival
  • availability & capability of the resources
29
Q

what are the diff priorities in the triage?

A
  • 1st priority = immediately life-threatening injuries
  • 2nd priority = major system injuries require treatment wihin 1 hr
  • 3rd priority = walking wounded
  • 4th priority = not expected to survive, near dead
30
Q

what is lethal triad needed to do damage control?

A

hypothermia
acidosis
coagulopathy

31
Q

what are common scenarios where damage control is done?

A
  • stable px with >2 of triad
  • hypotensive px w/ >1 of triad
  • mass casualty incident
  • anticipated need for massive transfusion
  • shortage of blood product supply
  • complex multisystem injuries
32
Q

what are the phases of damange control?

A
  • Phase 1 = ER assessment, decide to do damage control
  • Phase 2= damage control surgery, surgical control of hemorrhage & contaminatio
  • Phase 3 = ICU resuscitation, correction of hypthermia and coagulopathy in ICU
  • Phase 4 = repoeration with def surgical managenet of intra-abdominal injuries
33
Q

what are the diff types of hazards

A

natural
technological
biological societal

34
Q

what are the diff disasters in the NDRP?

A
  • I = hydro-meterological hazards
  • II = seismic hazards: earthquakes, landslides
  • III = tsunami
  • IV = volcano
  • V = pandemic/epidemic
  • others = fiore, transpo, pollution, civil disturbance, etc
35
Q

what is the risk formula?

A

risk = [(hazard x vulnerability)/capacity]

36
Q

what is an actual threat to public safety and or public health?

A

emergency

37
Q

what are the different factors that can determine the type and severity of consequences?

A
  • community
  • capacity
  • vulnerability
38
Q

what is the RA of National disaster irsk reduction management?

A

RA 10121

39
Q

what is the cycle of disaster?

A
  • prep for disaster
  • disaster occurrence
  • disaster response
  • recovery from disaster
  • mitigation against the impact of future disasters
  • risk reduction agsint the future disasters
  • prevention of future disasters
  • preparation for next disaster
40
Q

what is the part of disaster management cycle where it eliminates or reduces the probability of disaster occurrence

A

prevention

41
Q

what is the part of disaster management cycle where activties are reduced to either chance of hazard taking place or turning into a disaster?

A

mitigation
- building codes
- zoning and land use management
- regulations and safety codews
- preventive health care
- public education

42
Q

what is the management system used in responding to an incident?

A

incident command system (ICS)

only 1 person is in-charge

43
Q

what are the 2 types of ICS?

A

single commant = 1 agency
unified command = several agencies

q

44
Q

what are the different color tags?

A
  • red = immediate care, 1st for evacuation, life-threatening
  • yellow = needs care, not life-threatening, urgent condition
  • green = 3rd, minor injuries, delayed conditions
  • blue = 3/4th, near dead, after red & yellow condition
  • black & white = dead

SURG LE3 (4 decks)

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