TARMS Flashcards
When is NPA contraindicated?
Basal skull fracture
What is a sign of basal skull fracture?
Bruising around the eyes
What is primary traumatic brain injury?
What happens at the event
e.g. skull fracture, concussion, intracranial haematoma
What is secondary traumatic brain injury?
Inflammatory response to the primary injury
What is CPP?
What is the issue in traumatic head injury?
CPP = MAP-ICP
Blood supply to the brain is dependent on the difference between BP & ICP
In head injury, ICP is rising & BP reducing - difference between the two is reducing (brain is less likely to be perfused)
What happens in brain injury with a decompensated state
Coning
What does ATOM FC stand for?
Causes of thoracic trauma Airway obstruction Tension pneumothorax Open pneumothorax Massive haemothorax Flail chest Cardiac tamponade
What are the signs of a tension pneumothorax?
Severe respiratory distress
Unilateral hyperexpansion with reduced movement
Hyperresonance with reduced air entry
Tracheal deviation (late sign)
How is tension pneumothorax managed?
Cannula into 2nd IC space, mid-clavicular line
Followed by a chest drain into the 5th IC space, mid-axillary
How is an open pneumothorax managed?
Flutter valve (opens on expiration)
What causes massive haemothorax?
Significant injury to major vessels in the chest
What is the definition of a massive haemothorax?
> 1.5L blood in the chest
How is massive haemothorax managed?
Chest drain + fluids
What is flail chest?
Mobile segment of the chest wall (e.g. 2 or more ribs broken in 2 or more places)
Why is tidal volume reduced in flail chest?
Can’t take deep breaths in
How is cardiac tamponade managed?
Thoracotomy
Systolic BP can stay normal until what % reduction in circulating volume?
30-40% reduction
What is an early sign of hypovolaemia?
Increased resp rate
before HR!!
What are the 5 common sites of a large haemorrhage?
'On the floor + 4 more' External Femur Chest Abdo Pelvis
What is a fast scan?
Abdo USS
Can detect >500ml
What is the aim of a pelvic binder?
Haemostatic (NOT bone control)
How do you manage long bone fracture?
Splint them!!
How do you replace blood in haemorrhage?
With blood!
Blood, FFP + platelets
If someone on warfarin is haemorrhaging what do you give them?
TXA + octuplex
Why is it particularly bad if someone on a DOAC is haemorrhaging?
Very difficult ot reverse
