SESAP- Trauma

Question 1

Open fracture types

Answer 1

Type I: clean lacs <1cm
Type II: lacs >1cm, minimal soft tissue damage
Type III: lacs >10cm, exposed bone, or missing soft tissue
IIIa: adequate soft tissue coverage
IIIb: requires soft tissue transfer to achieve coverage
IIIc: asstd vascular injury requiring repair

Question 2

Abx for open fx

Answer 2

Type I & II: gram + coverage, dc 24hrs after wound closure
Type III: Gram + and - coverage, dc 72hrs after closure, add high dose PCN in presence of fecal or clostridial contamination

Question 3

Blunt aortic injury grades

Answer 3

Grade I: intimal tear <10mm, no external contour abnormality
Grade II: intimal tear >10mm
Grade III: pseudoaneurysm
Grade IV: evidence of rupture w contrast extrav or hemothorax

Question 4

Blunt aortic injury (BAI) treatment

Answer 4

Grade I: BP control w Bblocker and antiplt agents
Grade II: BBlocker, antiplt, repeat imaging in 7 days
Grade III and IV: intervention

Question 5

Blunt cerebrovascular injury/carotid injury (BCVI) stroke rate

Answer 5

20%; tx usually hep gtt as inpt w PTT 40-50 and aspirin as outpt

Question 6

Exposure for subclavian injuries

Answer 6

anterolateral thoracotomy and clavicular incision; endovascular repair has similar results

Question 7

tx to reduce hypermetabolic response in burn injury

Answer 7

propranolol, early excision of burn wound and grafting