Trauama Flashcards
theophylline OD symptoms?
seizure, hypotension, Cardiotachy
Do digital rectal before foley b/c what?
High riding prostate could mean urethral damage, SO NO FOLEY in that case
also check for meatus blood
Pelvic fracture tx
Femur fracture tx?
Wrap around pelvis with bedsheets to stabilize
Femur fracture: close reduction with tractio
GCS categories?
Eye: spontaneous voice pain none
Verbal response: oriented, confused, inapprop words, incomp sounds, none
Motor: obey command, localize 5, withdraw pain, decorticate, decerebrate, none
GCS bad with what?
8 or less. Minor is 12 or more
Drug if suspect bleed in head after trauma?
Mannitol!
Spinal injury? What drug do you give?
IV STEROIDS! High dose
GCS less than 8 need what?
INTUBATE to protect airway
Zones of neck? Structures in them?
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
What you do if neck injury in zone 1?
Zone 2?
Zone three?
Zone 1: 4 vessel CT angio and triple endoscopy
Zone 2: Surgical exploration: MUST EASIER TO LOOK
Zone 3: CT angio gram
Flail chest?
Multiple rib fractures: watch for cardiac contusion
Loss of aortic knob?
CXR finding with ruptured thoracic aorta (along with widened mediastinum as the biggie
Abdominal trauma penetrating?
Blunt?
EXPLORATORY
Blunt is treat concervatively unless acute abdomen
Acute abdomen even if blunt need OR
Abdominal trauma needs NG tube why?
To assess for blood in stomach
Blunt trauma and stable Vitals is done what?
NG and Foley and CT of abdomen and pelvis
Blunt trauma and unstable?
FAST exam
If blood: emergency laparotomy
If no blood in pelvis: angiography and embolization.
Blunt trauma and unstable and no signs of bleeding?
LOOK FOR OTHER SIGNS of hypotension. Which is why not straight to surgery!
What if retroperitoneal hematoma? What do you do?
If penetrating, do surgical exploration
If blunt trauma and no blood in abdomen, FOLLOW Hemoglobin
IF hemodynamically unstable or falling hemoglobin, angiography and embolization
GU trauma?
Cystoscopy and surgical repair
Pelvic fracture treatment?
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
Tx for extraperitoneal bladder rupture?
Foley for 14 days after cystourethrogram done to make sure it is safe
Inconclusive FAST?
DPL is done
Shoulder dislocation, check what?
Axillary nerve sensation over deltoid
Trauma and preggers c section for who?
fetus over 24 weeks and in distress
Mom with CV compromise
REMEMBER RHOGAM for RH- mom with bleeding
