surgery Flashcards
place of triage
several times b4 and in the hospital
order of ttt in multiple and mass casulaties
- Multiple → treat the more severe first
- Mass → treat the better prognosis + less time and money first
diagnosis of spinal cord injury
should not precede resucitation
pulse oximetry measures
SpO2 (oxygen saturation level)
NOT
PaO2 (partial pressure of oxygen)
deep palpation in abdominal trauma
not recommended → ↑ hemorrhage
Grey-Turner sign indicates
retroperitoneal bleeding
(most commonly acute Hgeric pancreatitis)
Cullen sign indicates
peritoneal bleeding ( m/c → pancreatic hge)
kehr sign indicates
diaphragmatic irritation (splenic injury, free air, intra-abd. bleeding)
Ballance sign indicates
splenic injury
how much fluid can FAST scan detect
250 cc total
100 cc in Morison’s pouch
gold standard for identifying intraparenchymal injury
CT scan
tracheobronchial tree injury leads to
massive air leak
placement of more than one chest tube may be necessary
tension pneumothorax leads to which type of shock
obstructive shock
regarding open pneumothorax
mediastinum moves back and forth with respiration
opening on the chest wall > 2/3 tracheal diameter → air moves through the opening (least resistance)
1st line management of open pneumothorax
Cover the hole by semi-occlusive
dressing: closed on three sides (flap/ flutter valve effect)
then
chest tube
definitive ttt → surgical closure
amount of blood in massive hemothorax
> 1500 ml
200 cc/h for 4 hours
which type of shock occurs in hemothorax
hypovolemic
placement of chest tube in massive hemothorax / simple pneuothorax
5th IC space anterior to MAL
significance of Beck’s triad
Cardiac Tamponade
1. JVD
2. Hypotension
3. Muffled heart sounds
ECG changes in cardiac tamponade
- sinus tachycardia
- low voltage
- PEA
prognosis of traumatic aortic rupture
98-99% will die at the scene from free
rupture
1 ~ 2 % will have tamponade
m/c cause of simple pneumothorax
blunt trauma
regarding pulmonary contusion
Initial x-ray findings have NO correlation
with severity of contusion
epidural hematoma is most commonly due to tear of
middle meningeal artery
mostly located in Temporal/Tempoparietal regions
