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Cam's Cards > Trauma 1 > Flashcards

Trauma 1 Flashcards

1
Q

2 main forces of trauma?

A

Blunt and penetrating trauma

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2
Q

A fall greater than ___ in an adult is a major trauma

A

20ft (2 stories)

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3
Q

A fall greater than ___ in a child is a major trauma.

A

10ft or 2-3x height of child

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4
Q

Other mechanism criteria to call major trauma? (6)

A

Death in same vehicle, patient ejection, vehicle rollover, intrusion of 12cm in occupant compartment or 18cm anywhere, auto-pedestrian/bicycle >20mph, MCA >20mph

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5
Q

Anatomic criteria for major trauma? (8)

A

Penetrating injury to head/neck/torso, 2 more more proximal long bone fx, amputation proximal to wrist or ankle, open or depressed skull fx, neuro deficits, pelvic fx, flail chest

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6
Q

Physiologic criteria for major trauma?

A

GCS <13, SBP <90, RR<9 or >30, HR>100

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7
Q

Primary survey of a trauma patient includes?

A 
Airway
Breathing
Circulation
Disability (neuro)
Environment
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8
Q

List some mandatory indications for airway management.

A 
Massive facial injuries
Head injury with GCS<8
Penetrating injury to cranial vault
Missile injury to neck
Blunt injury to neck with alteration of voice or expanding hematoma
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9
Q

Signs of tension pneumothorax?

A

JVD
Absent breath sounds unilaterally
Tracheal deviation

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10
Q

First step in management of tension pneumothorax?

A

Decompression

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11
Q

What type of dressing should be applied to a sucking chest wound?

A

Some type of 1 way valve, such as a asherman chest seal.

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12
Q

In the circulation assessment, how do you chest for blood volume status?

A

Color, pulses, cap refill, BP

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13
Q

At what stage of hemorrhage are blood products always needed?

A

Class III, moderate hemorrhage

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14
Q

Will you see any changes in HR, BP, or GCS in class 1 hemorrhage?

A

No

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15
Q

What changes in HR, BP, and GCS will be seen in class II/mild hemorrhage?

A

Increase HR, no change in GCS or BP

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16
Q

What changes in HR, BP, and GCS will be seen in class III/moderate hemorrhage?

A

Increased HR, Decreased BP, decreased GCS

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17
Q

What changes will be seen in class IV/severe hemorrhage?

A

Very increased HR, decreased BP, decreased GCS.

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18
Q

How long can a tourniquet stay on?

A

6 hours

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19
Q

Where do you want to place a tourniquet?

A

As close to the axilla/groin as possible.

20
Q

Stages of hypovolemic shock?

A

Initial
Compensatory
Progressive
Refractory

21
Q

What is the triangle of death in trauma?

A

Bleeding
Hypothermia
Coagulopathy

22
Q

In a hemorrhage, what fluids should be given to your patient?

A

ONLY 1 liter of crystalloids, then blood

23
Q

After __ units of blood, start massive transfusion protocols.

A

3

24
Q

What is checked in the disability assessment?

A

GCS

25
Q

Drops in GCS of __ are concerning. Drops of __ are VERY bad.

A
  1. 3.
26
Q

List the scores for the eye portion of the GCS.

A 
Eye opening:
Spontaneous - 4
To loud voice - 3
To pain -2
None - 1
27
Q

List the scores for the verbal portion of the GCS.

A 
Verbal response:
Oriented - 5
Confused/disoriented - 4
Inappropriate words - 3
Incomprehensible sounds - 2
None - 1
28
Q

List the scores for the motor portion of the GCS.

A 
Best motor response:
Obeys - 6
Localizes - 5
Withdraws - 4
Abnormal flexion posturing -3
Extension posturing - 2
None -1
29
Q

What is the decorticate response?

A

Flexion in response to pain.

30
Q

What is the decerebrate response?

A

Extension in response to pain

31
Q

What is a FAST exam?

A

Focused assessment with sonography for trauma.

32
Q

Where do you US in a FAST exam?

A

Peri-hepatic space
Peri-splenic space
Pericardium
Pelvis

33
Q

What is included in a secondary survey?

A 
H & P
head to toe exam
blood/urine analysis
X rays
Consider CT, vascular imaging or surgery
34
Q

FGH should also be done at some point during a trauma exam, what does it stand for?

A

Fetus- are they pregnant?
Glucose - check it
Hypertet - give them a tetanus shot

35
Q

Damage to a carotid artery causes what signs/symptoms?

A

Bruits
TIAs
Horner Syndrome (Ptosis, miosis, anhydrosis)

36
Q

Damage to a vertebral artery causes what signs/symptoms?

A 
Dizziness
Vertigo/ataxia
nystagmus
Dysarthria
Diplopia
37
Q

How should you diagnose a tension penumothorax?

A

Physical exam!!!

Do NOT need X ray

38
Q

What type of shock is caused by tension pneumothorax?

A

Obstructive shock

39
Q

Cardiac tamponade can be recognized by what triad?

A

Becks triad

JVD, muffled heart tones, and hypotension

40
Q

A patient with hypotension after a blunt chest force should make you consider?

A

Thoracic aorta injury

41
Q

X ray findings of a thoracic aorta injury?

A

Wide mediastinum on CXR

42
Q

What is considered a wide mediastinum?

A

Greater than 1.5x the width of the vertebrae

43
Q

What is the complication of a pulmonary contusion?

A

Pneumonia

44
Q

A fracture of what rib is the most concerning?

A

1st rib - indicates high force injury

45
Q

What patients qualify for a thoracotomy?

A

Patient with loss of vitals within 2-3 minutes of arrival to ER with active CPR and penetrating trauma.

Cam's Cards (103 decks)

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