The Multiply Injured Patient Flashcards
1
Q
Why is trauma important?
A
- Leading cause of death for the first 4 decades of life
- For every death there are 2 survivors with significant disability
- Trauma deaths in Scotland higher than rest of the UK
2
Q
What advances have been made in trauma care?
A
- Advanced trauma life support
- Battlefield advanced trauma life support
- HEMS/MERT
3
Q
What is in place to help doctors improve their trauma skills?
A
- Standard operating procedures (SOPs)
- Checklists
- Simulation
- Study days
- Debrief
- Documentation
- Audit (STAG, TARN)
4
Q
When should trauma management start?
A
- From time of injury
- Golden hour/ platinum 10 minutes
5
Q
What should be established in pre-hospital care?
A
- Time of injury
- Mechanism of injury
- Speed/forces involved
- Ejection/pedestrian
- Likely serious injuries
- Vital signs
- Interventions carried out
6
Q
What preparation is required pre-arrival?
A
- A Trauma call pre-alerts the trauma team of a patient.
- Team is made up of ED, anaesthetics, radiology, ICU and surgical specialities.
- Equipment and drug set up takes place prior to arrival.
- An ABC approach for this helps.
7
Q
What is involved in a primary survey?
A
- ABC
- Detects and treats immediate threats to life
8
Q
What is involved in a secondary survey?
A
-Identification of all injuries and planned management
9
Q
What is the goal of damage control resuscitation?
A
- Minimise blood loss
- Maximise tissue oxygenation
10
Q
ATLS Primary Survey.
A
- Airway with C-spin control
- Breathing with O2
- Circulation with haemorrhage control
- Disability
- Exposure and environment
11
Q
BATLS Primary Survey
A
- Catastrophic haemorrhage control
- Airway with C-spin control
- Breathing with O2
- Circulation with haemorrhage control
- Disability
- Exposure and environment
12
Q
How is airway assessed?
A
Noises
- Speech
- Gurgling
- Stridor
Visual
- Swelling/deformity
- Vomit/blood/debris
13
Q
How can airway be managed?
A
- Manoeuvres
- Suction
- Adjuncts
- Advanced procedures
14
Q
When should a c-spine injury be assumed?
A
- Major trauma
- Reduced conscious level
- Dangerous mechanism
- Injury above clavicles
- Neurological signs
- If distracting injuries during clinical assessment
15
Q
How is breathing assessed?
A
Expose the chest
- Look for work of breathing/expansion and effort
- Feel (palpate and percussion)
- Auscultate
