Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Specialties - Surgery > Surgery Trauma Lecture + Reading > Flashcards

Surgery Trauma Lecture + Reading Flashcards

1
Q

Which pts require a definitive airway?

A

GCS < 8
ALOC
Severe head injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Signs of tension pneumothorax?

A

Hypotension
Distended neck veins
Tracheal shift away from affected side
Hyperresonance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the treatment for tension pneumothroax?

A

Needle in 2nd ICS midclavicular

Converts tension to simple

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Treatment for open pneumothorax

A

Seal would with occlusive dressing on 3 sides - flutter valve

Then put in chest tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do you place a chest tube in?

A

Midaxillary line at the level of the nipple

Directed posteriorly and superiorly toward the apex of the thorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What venous access is necessary for a pt in shock?

A

At least 2 14-16 gauge IV lines in antecubital fossa

If this fails go IO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

After IV line is inserted, what is the first fluid that will be administered?

A

Crystalloid infusion

Adults - 2L LR or NS (if no response give 2 more L, unless you think they’re in hemorrhagic shock, then you would move to blood products)

Children - 20 mL/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Besides giving PRBC what must you considering giving to pts?

A

Fresh plasma or thawed fresh frozen plasma to avoid coagulopathy in massively transfused pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

TXA

A

Tranexamic acid
Clotting promoter
Antifibrinolytic (blocks breakdown of blood clots)
NOT qeffective if given <3h post injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the ratio of fresh frozen plasma to PRBC you should administer a pt?

A

1:5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When is an emergency room thoracotomy appropriate?

A

For pts with penetrating thoracic trauma in cardiac arrest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What 3 interventions can you do to decrease the ICP in an unconscious pt?

A

Mannitol
Hypertonic saline
Moderate hyperventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

FAST exam

A

Ultrasound

  • subxiphoid pericardial window
  • morison’s pouch - hepatorenal recess
  • perisplenic
  • Douglas pouch - suprapubic window
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What tests are you going to first order for an unconscious pt?

A

Blood EtOH
Urine toxicity
Glucose
Head CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which blood do you give to a women of child bearing age?

A

Rh negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the order of fluid administration when resuscitating a trauma?

A

1) give fluids (cystalloid)
2) blood products if bleeding
3) still hypotensive: give epi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What should you do for a pt with blunt trauma complaining of neck injury but had a negative CT?

A

Get an MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is a definitive airway?

A

Cuffed airway —ET tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What injuries impair ventilation in the short term?

A

Remember that a patent airway does not mean adequate ventilation

Tension pneumothorax
Flail chest with pulmonary contusion
Massive hemothorax
Open pneumothorax

20
Q

What is the ultimate treatment for pneumothorax?

A

Chest tube

21
Q

Flail chest

A

At least 2 fractured ribs with 2 fractures per rib (free segment)

22
Q

What is the predominant cause of preventable deaths?

A

Hemorrhage

23
Q

Once you have treated the tension pneumothorax, what is the next step?

A

Treated hypotension

24
Q

Where are the major areas of internal bleeding?

A 
Chest
Abdomen
Retroperitoneum
Pelvis
Long bones
25
Q

What is GCS used for?

A

Predictor of head injury severity and neurological recovery

26
Q

Trauma pts are assessed once all of their clothes have been removed, once the assessment is done, what should you do?

A

Cover pt with warm blankets and warm IV fluids to prevent hypothermia

27
Q

Which 3 conditions if present show a bad prognosis for shock pts?

A

Hypothermia
Coagulopathy
Acidosis

28
Q

Decorticate vs decerbate

A

Decorticate GCS 3
Arms to the core of the body

Decerebrate GCS 2
Upper motor neuron
Arms down at the side

29
Q

Massive transfusion is defined as

A

> 10 units of PRBCs within 24 hours of admission

30
Q

An injured pt who is ___ and ___ is in shock until proven otherwise

A

Cool and tachy

31
Q

Who do you not give LR to?

A

Pts with renal problems d/t potassium

32
Q

Cardiac tamponade is most commonly seen with what type of trauma?

A

Penetrating thoracic

33
Q

Do isolated intracranial injuries cause shock?

A

No

34
Q

Pts who have sustained a spinal injury often have ______ trauma

A

Abdominal

35
Q

What should be obtained within 3 hours of septic shock admin?

A

Obtain lactate level
Blood cultures (prior to ABX)
ABX broad-spectrum
30mL/kg of crystalloid solution

36
Q

What is the hgb level that requires RBC transfusion?

A

Below 7g/dl

Taget rage is 7-9 g/dL

37
Q

Ketamine

A

An induction agent used for RSI

Drawbacks: 
Increased secretions 
HTN
Tachycardia
Raised IOP
38
Q

What two types of drugs are given for RSI?

A 
Induction agent (sedative)
Nueromuscular blocking agent (paralytic)

ALWAYS sedate them first before giving paralytic

39
Q

What are the 3 neuromuscular blockers?

A

Suxamethonium
Rocuronium
Vecuronium

40
Q

What is the major difference between ketamine and etomidate?

A

Ketamine provides analgesic while etomidate does not —etomidate is typically pre-treated with fentanyl IV to aid in analgesic

41
Q

What are the benefits of etomidate over ketamine?

A

Etomidate is used for status epilepticus

There is an antagonist available

Both are used for hemodynamically unstable

42
Q

What are the adverse side effects to ketamine?

A

Increase secretions
Raised IOP
Caution with CV disease

43
Q

What are the adverse effects are etomidate?

A

Adrenal suppression

Myoclonus

44
Q

What 2 sedatives are used for hemodynamically stable patients?

A

Propofol

Midazolam

45
Q

What similarities do propofol and midazolam have in common?

A

Hemodynamically stable
Provide sedation and amnesia without analgesia

Adverse effects: hypotension

46
Q

Which induction agents are used for status epilepticus?

A

Etomidate
Propofol
Midazolam

47
Q

When is atropine used?

A

To prevent bradycardia upon induction

Commonly used in children

Clin Specialties - Surgery (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions