Spinal injury and polytrauma (Garcia) Flashcards
1
Q
Differentiate from other acute events (5)
A
- Seizures
- Toxicities
- Saddle Thrombus
- IVDD
- Hansen type I & II
- Type III vs. ANNPE - Non-traumatic inj
- vasc events
- orthopedic dz
2
Q
Confirmed Traumatic event (4)
A
Assess major body systems
- Cardiovasc status
- Resp status
- Neuro - brain/spine
- orthopedic assess
3
Q
Bedside testing
A
- art blood gas-lactate; PCV/TS; Electrolytes
- AFAST/TFAST
- ECG
4
Q
In polytrauma first things first (4)
A
- Stabilize major body systems first
- Suspect spinal trauma based on primary survey
- Characterize trauma based on neuro exam and imaging
- Decided surgical vs non
Timing of surgery
-Degree of instability
-Concurrent injuries and trauma burden
-Ease of management of unstable spine-patient size
5
Q
Base prognosis off of
A
neuro exam, not rads
6
Q
Medical management an option for
A
Calm, small animals with minimal deficits and stable fractures
7
Q
Surgery best for (4)
A
- Two compartment or
- ventral compartment fractures
- Animals that won’t tolerate external coaptation
- Uncontrollable pain
8
Q
Patterns of injury for spinal trauma (3)
A
- High impact-HBC, Projectiles
- Falls from height
- Big dog little dog bite wounds
9
Q
Flexion w/axial loading
A
ventral fracture, facets ok
10
Q
Extension forces
A
Facets take the hit
11
Q
Compression fx
A
shortened vertebrae
12
Q
Non-ambulatory after trauma DDX (8)
A
- Hemorrhagic/hypovolemic shock
- Long bone fractures
- Pelvic fractures
- Exacerbation OA/DJD
- Brachial plexus injury, avulsion
- Spinal fx/lux
- Spinal contusion
- Traumatic IVDD
13
Q
Neurologic assessment before correcting shock
A
Is not accurate
14
Q
Standard IV fluid resuscitation (2)
A
- Isotonic crystalloids 20-30 ml/kg IV bolus, repeat PRN
2. Shock dose represents blood volume of patient
15
Q
Low volume IV fluid resuscitation (2)
A
- Hypertonic saline 2-4 ml/kg, repeated once
2. Sometimes combined with artificial colloids at 5-10 ml/kg
