Trauma 101 Flashcards
(imaging) in patients with penetrating injuries to the thorax or abdomen; ALWAYS
CXR
Imaging for hemodynamically unstable patients
FAST exam
Imaging for hemodynamically stable patient
`CT scan
Any penetrating wound below the nipple requires a(n)
______
exploratory laparotomy
High-energy trauma + widened mediastinum on CXR →
Next best step in management?
CT Angiography for aortic injury
Blunt trauma + subcutaneous emphysema →
Next best step in management?
Bronchoscopy for tracheal injury
Signs of peritonitis (abdominal tenderness, rebound, guarding, rigidity) → Next best step in management?
exploratory laparotomy
Pt with Blood at the urinary meatus → Next best step in management?
Retrograde URETHRO-gram
might be bladder injury, but need to r/o urethral injury first
Pt presents with no blood at the urinary meatus, but has hematuria in the Foley catheter → Next best step in management?
Retrograde CYSTO-gram to r/o bladder injury
Pt presents with hematuria in Foley catheter.
Retrograde urethrogram and cystogram have been normal → Next best step in management?
CT scan to r/o kidney injury
why not retrograde pyelography?
Pts pupils are fixed (non-reactive to light) and dilated.
What 2 things can result in this finding?
Brain bleeds & herniation
Pt presents with narrowing Pulse Pressure (SBP–DBP) list one possible cause
Hemorrhage
→ cause SBP to drop & DBP to rise
→ this helps maintain MAP >65 for adequate perfusion
MAP = CO x TPR → DBP + 1/3 (PP)
Pt needs fluid resuscitation. What IVs are used?
2 large bore (16 gauge) peripheral IVs
Patient needs transfusion for massive hemorrhage what is given to the patient?
Whole blood
1:1:1 of pRBC, Plasma, Platelets
Most common injuries in trauma (5)
[SPLUGeD in trauma]
Splenic injury/rupture Pancreatic injury (handlebar injury) Liver injury/rupture Genital trauma Urinary trauma Duodenal rupture/ hematoma (kids mostly–Handlebar injury)
Handlebar injury should raise concerns for what 3 injuries?
Pancreatic injury
Splenic
Duodenal
Patient with Ecchymoses over the right chest &
pain in the right shoulder
should raise concerns for what injury?
Liver hematoma