Trauama

Question 1

theophylline OD symptoms?

Answer 1

seizure, hypotension, Cardiotachy

Question 2

Do digital rectal before foley b/c what?

Answer 2

High riding prostate could mean urethral damage, SO NO FOLEY in that case

also check for meatus blood

Question 3

Pelvic fracture tx

Femur fracture tx?

Answer 3

Wrap around pelvis with bedsheets to stabilize

Femur fracture: close reduction with tractio

Question 4

GCS categories?

Answer 4

Eye: spontaneous voice pain none

Verbal response: oriented, confused, inapprop words, incomp sounds, none

Motor: obey command, localize 5, withdraw pain, decorticate, decerebrate, none

Question 5

GCS bad with what?

Answer 5

8 or less. Minor is 12 or more

Question 6

Drug if suspect bleed in head after trauma?

Answer 6

Mannitol!

Question 7

Spinal injury? What drug do you give?

Answer 7

IV STEROIDS! High dose

Question 8

GCS less than 8 need what?

Answer 8

INTUBATE to protect airway

Question 9

Zones of neck? Structures in them?

Answer 9

Zone 1: Clavicle to cricoid
Great vessels, lung apices, nerves

Zone 2: Cricoid to mandible: carotid and vertebral arteries, and jugular

Zone 3: mandble to base of skulle: salivary and partoids, andother obvious stuff

Question 10

What you do if neck injury in zone 1?

Zone 2?

Zone three?

Answer 10

Zone 1: 4 vessel CT angio and triple endoscopy

Zone 2: Surgical exploration: MUST EASIER TO LOOK

Zone 3: CT angio gram

Question 11

Flail chest?

Answer 11

Multiple rib fractures: watch for cardiac contusion

Question 12

Loss of aortic knob?

Answer 12

CXR finding with ruptured thoracic aorta (along with widened mediastinum as the biggie

Question 13

Abdominal trauma penetrating?

Blunt?

Answer 13

EXPLORATORY

Blunt is treat concervatively unless acute abdomen

Acute abdomen even if blunt need OR

Question 14

Abdominal trauma needs NG tube why?

Answer 14

To assess for blood in stomach

Question 15

Blunt trauma and stable Vitals is done what?

Answer 15

NG and Foley and CT of abdomen and pelvis

Question 16

Blunt trauma and unstable?

Answer 16

FAST exam
If blood: emergency laparotomy

If no blood in pelvis: angiography and embolization.

Question 17

Blunt trauma and unstable and no signs of bleeding?

Answer 17

LOOK FOR OTHER SIGNS of hypotension. Which is why not straight to surgery!

Question 18

What if retroperitoneal hematoma? What do you do?

Answer 18

If penetrating, do surgical exploration

If blunt trauma and no blood in abdomen, FOLLOW Hemoglobin

IF hemodynamically unstable or falling hemoglobin, angiography and embolization

Question 19

GU trauma?

Answer 19

Cystoscopy and surgical repair

Question 20

Pelvic fracture treatment?

Answer 20

IV fluids, FAST for blood
If blood, do emergent lap
No blood but unstable? Do angiography and embolization

Use blanket around pelvis to stabilize and assess for urethral injury with retrograde cyst

If exztraperitoneal bladder rupture, use FOLEY FOR 10-14 days

Question 21

Tx for extraperitoneal bladder rupture?

Answer 21

Foley for 14 days after cystourethrogram done to make sure it is safe

Question 22

Inconclusive FAST?

Answer 22

DPL is done

Question 23

Shoulder dislocation, check what?

Answer 23

Axillary nerve sensation over deltoid

Question 24

Trauma and preggers c section for who?

Answer 24

fetus over 24 weeks and in distress

Mom with CV compromise

REMEMBER RHOGAM for RH- mom with bleeding