Review: Section 7 Trauma Flashcards
What is the rule of nines?
The rule of nines divides the body into sections, each of which is approximately 9% of the total surface area. (pg 825)
How is the rule of nines for infants and children different from adults?
The head of an infant is relatively smaller than that of an adult and the legs are relatively smaller. (pg 825)
What body parts are the same in infants, children & adults?
The arms and front and back torso. (pg 825)
What percent of body surface area is the head of an infant (front and back)?
18% (pg 825)
What percent of body surface area is the head of an child (front and back)?
12% (pg 825)
What percent of body surface area is each leg of an infant (front and back)?
13.5% (pg 825)
What percent of body surface area is each leg of a child (front and back)?
16.5% (pg 825)
What is the rule of palm?
The size of a patient’s palm is roughly equal to 1% of the patient’s total body surface area. This can be used to estimate burn area. (pg 825)
Define sprain.
A joint injury involving damage to supporting ligaments, and sometimes partial or temporary dislocation of bone ends. (pg 1005, 1010)
Define strain.
Stretching or tearing of a muscle; also called a muscle pull. (pg 1006, 1011)
Define dislocation.
Disruption of a joint in which ligaments are damaged and the bone ends are completely displaced. (pg 1005, 1010)
Define fracture.
A break in the continuity of a bone. (pg 1005, 1007)
Number one priority in patient care.
The airway. Do what you need to do to maintain it.
Can splinting be placed on too tight?
Yes, it can result in compression of nerves, tissues and blood vessels. Also in reduction of distal circulation. (pg 1031)
How would you know that splinting is placed on too tight?
Check for reduction in PMS (pulse, motor and sensory)
What should you do if you notice that the splint is on too tight?
Loosen and rewrap the splint.
What are the signs of decompensated shock?
Falling blood pressure, Labored or Irregular breathing, Ashen, mottled or cyanotic skin, Thready or absent peripheral pulses, Dull eyes, dilated pupils, Poor urinary output. (pg 389)
What is the difference between a concussion and a contusion?
A concussion is a mild traumatic brain injury. A contusion is far more serious than a concussion because it involves physical injury to the brain tissue, which may sustain long-lasting and even permanent damage. (pg 896-897)
What is a priaprism?
Priapism (prolonged erection of the penis) is indicative of spinal cord injury in a trauma patient.
What are the three layers of the meninges?
The Dura Mater, the Arachnoid Mater, and the Pia Mater.
Find it, _____ ____, and move on.
Fix it
Why are circumferential burns bad?
Circumferential burns of the chest can compromise breathing. Circumferential burns of an extremity can lead to neurovascular compromise and irreversible damage if not appropriately treated.
What are the signs of Cushing’s Triad?
Hypertension, Bradycardia, and Irregular respirations as seen in traumatic brain injury.
In what situation is it appropriate to skip the C-Spine evaluation?
Never.
What should be applied to a penetrating wound on the neck to prevent air from entering a vein or artery?
Occlusive dressing
Describe a first-degree burn.
A superficial burn which involves only the top layer of skin, the epidermis. The skin turns red, but does not blister or actually burn through. The burn site is painful. A sunburn is a good example.
Describe a second-degree burn.
A partial thickness burn which involves the epidermis and some portion of the dermis. These burns do not destroy the entire thickness of the skin nor is the subcutaneous tissue injured. Typically, the skin is moist, mottled, and white to red. Blisters are present. Partial-thickness burns cause intense pain.
Describe a third-degree burn.
A full-thickness burn which extends though all skin layers and may involve subcutaneous layers, muscle, bone, or internal organs. The burned area is dry and leathery and may appear white, dark brown, or even charred. Some full-thickness burns feel hard to the touch. Clotted blood vessels or subcutaneous tissue may be visible under the burned skin. If the nerve endings have been destroyed, a severely burned area may have no feeling. However, the surrounding, less severely burned areas may be extremely painful.
What are the priorities in a trauma patient?
Obvious life threats, ABCs.
What does electrocution to do the heart?
Electrical current can cross the chest and cause cardiac arrest or arrhythmias.
What is the correlation between trauma and pregnancy?
As pregnancy progresses, the uterus enlarges substantially and rises out of the pelvis, becoming vulnerable to both penetrating and blunt injuries. These injuring can be particularly severe because the uterus has a rich blood supply during pregnancy. Look for shock and labor contractions. Note the patient’s due date.
Why should lying a pregnant patient in a supine position be avoided and what is the appropriate position to lie the patient in?
The uterus will place pressure on the inferior vena cava, reducing blood returning to the heart. The patient should be placed on her left side.
What are the fatal complications of serious burns?
There are several serious complications that can result secondary to a burn injury, all of which can be life threatening? infection, hypothermia, hypovolemia, shock, airway constriction.
What are heat cramps?
Painful muscle spasms that occur after vigorous exercise. Heat cramps usually occur in the leg or abdominal muscles.
What is heat exhaustion?
Hypovolemia as the result of the loss of water and electrolytes from heavy sweating.
What is heat stroke?
Severe hyperthermia caused by exposure to excessive heat, marked by warm, dry skin; severely altered mental status, often irreversible coma.
How do you treat heat cramps?
Remove from environment, administer O2, rest, rehydrate, replace electrolytes, actively cool patient.
How do you treat heat exhaustion?
Remove from environment, administer O2, splash with cool water, trendelenburg’s position, fan patient, if alert encourage to sit up and slowly drink, transport if symptoms don’t resolve promptly.
How do you treat heat stroke?
Remove from environment, remove clothing, 100% O2, ice packs to neck, groin and armpits, cover with wet towels and fan, immediate transport.
Why should a patient with moderate or severe hypothermia be warmed slowly?
Rewarming the patient too quickly may cause a fatal cardiac arrhythmia that requires defibrillation. For this reason, passive rewarming (high indoor heat) is also best delivered at an appropriate facility.
How should you position a patient to prevent evisceration?
Have the patient flex his knees.
What considerations should be taken with a patient that has a brachial shunt?
Central venous catheters are often located in the chest, upper arm, or subclavicular area. Problems associated with these devices may include broken lines, infections around the lines, clotted lines, and bleeding around the line or from the tubing attached to the line. If bleeding occurs, you should apply direct pressure to the tubing and provide immediate transport to the hospital.
When backboarding, what should be done with void spaces?
Fill them with padding.
Which patients will have the most voids in backboarding?
Children
How do you treat a flailed chest?
Positive pressure ventilation with a bag-mask device.
