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Clinical Care Year 3 > Trauma > Flashcards

Trauma Flashcards

1
Q

What is a primary brain injury

A

Happens in the moment of incident when excessive energy is transferred to the head

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2
Q

What are the can diffuse head injury be split into

A

Axonal

Concussion

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3
Q

What is a diffuse Axonal injury

A

Axons are sheared, torn, stretched away from cell body

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4
Q

What is diffuse concussion injury

A

Brain jarred towards and then away from site of injury can self resolve

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5
Q

What can focal brain injuries be split in to

A

Contusion
Intercranial haemorrhage

They are focused on specific area of brain

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6
Q

Type of intercranial haemorrhage

A 
Epidural 
Extradural 
Subdural 
Subarachnoid 
Intracerebral
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7
Q

Secondary brain injury is

A

When the brain tissue does not have adequate perfusion

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8
Q

Head injuries bad signs

A

Low blood pressure
Hypoxia

Asymmetry pupils

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9
Q

Monroe Kellie doctrine is

A

Skull is rigid container any increase in component causes an increased icp and can cause herniation

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10
Q

Work out CPP

A

CPP = MAP -ICP

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11
Q

What will happen if ICP rises

A

The CPP will decrease unless the blood pressure increases

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12
Q

What does cpp need to be

A

60 or above

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13
Q

Management of head injury

A

If isolated head injury give fluids to maintain blood pressure at 110

If not isolated then maintain blood pressure at 90

Give TXA on route
Give O2
Assist ventilation if needed

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14
Q

What is normal capnography

A

35-45 mmHg

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15
Q

Head injury considerations

A

PHEA

RSI

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16
Q

What is pupil asymmetry a sign of

A

Herniation

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17
Q

Early signs of increasing ICP h

A 
Vomiting 
Headache 
Dizziness 
Amnesia 
Visual disturbances 
Altered LOC 
Seizures
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18
Q

Late signs of increased ICP

A

Cushing triad
Hypertension with widening pulse pressure
Bradycardia
Irregular respiration e.g cheynes stokes

Pupils changes
Coma
Posturing

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19
Q

What is normal ICP

A

5-15 mom Hg

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20
Q

Work out MAP

A

DBP+ 1/3 of pulse pressure

21
Q

What’s in Cushing triad

A

Hypertension (widening pulse pressure)
Irregular respiration
Bradycardia

22
Q

Isolated head injury give fluids when…

A

Systolic below 110

23
Q

Head injury and limb injury give fluids when…

A

Below 90 systolic

24
Q

Head injury and torso injury give fluids when

A

Below 60 systolic

25
Q

TXA dose
Give when
Don’t give

A

1g over 10 minutes
Obvious bleeding, gcs less than 12 in head injury.

Don’t give if bleeding started 3 hours ago, bleeding has stopped

26
Q

With a child when should you intervene with breathing

A

If it’s 1/2 normal resp rate or 3 times normal resp rate

27
Q

What nerve is control pupils

A

Oculomotor

28
Q

What does cheynes stokes breathing mean

A

It is bodies way of correcting ph level and decreasing co2

29
Q

What does central neurological breathing mean

A

Decreased stimulation of brain stem by sustained hyperventilation to decrease CO2

30
Q

What does biots breathing mean

A

Represent damage to brain stem

31
Q

What position can reduce ICP

A

30 degree head up position

32
Q

Order of spinal nerves

A 
Cervical - 8 
Thoracic - 12 
Lumbar - 5 
Sacral - 5
Coccygeal - 1

32

33
Q

Below shoulders paralysis is

A

C4

34
Q

Below waist paralysis is

A

T12

35
Q

Hauswalds biomechanics

A

Injury is done at time of impact rather than any movement after. An alert patient will develop a position of comfort

36
Q

How many ribs are there

A

12
10 attached to sternum
2 floating

37
Q

Where are rib fractures most common

A

4-8

38
Q

What can malposition of needle decompression result in

A

Cardiac tamponade
Ineffective
Too small to drain area

39
Q

Becks triad is for and what is it

A

Cardiac tamponade

Distant or muffled heart sound
JVD
Hypotension

40
Q

How much blood can u lose in a pelvic injury

A

1-2L

41
Q

Where should I apply cat tourniquet

A

On single bone
Above knee
Above elbow

42
Q

When should u use celox ?

A

Pack wound where u can see it

Do not use on head

43
Q

What does HOTT stand for and is used for

A

Hypovolaemia
Oxygenation
Tamponade
Tension pneumothorax

Traumatic cardiac arrest

44
Q

What would unilateral dilated pupil mean

A

Compression of the oculomotor nerve

45
Q

Bilateral dilated pupils mean

A

Midbrain injury

Cocaine

46
Q

Irregular pupils indicated

A

Orbital trauma

47
Q

Conjugate gaze deviation is and indicates

A

Sustained shift in horizontal gaze to one side.

Indicates lesion in Frontal lobe, brain stem, basal ganglia

48
Q

Small pin point pupils

A

Pontine injury (injury to pons)
Heroin

Clinical Care Year 3 (18 decks)

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