Trauma Flashcards

1
Q

What is the most common cause of death and disability in those under 40?

A

Head injury

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2
Q

Who are at most high risk of head injury?

A
Young men
Elderly
Alcoholics
PWIDs
Low income individuals
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3
Q

What are the most common causes of head injury?

A

Falls
RTAs
Sport

Alcohol is involved in 50% of cases.

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4
Q

Aside from the first hour following injury, when does the 2nd peak of deaths occur following head injury?

A

7 hours after injury.

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5
Q

What are the 3 categories in the GCS?

A

Eye opening
Motor
Verbal

Try to consider each as an individual component.

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6
Q

What does a GCS of 14-15 indicate?

A

Mild LOC.

Can have slight confusion.

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7
Q

What does a GCS of 9-13 indicate?

A

A moderate injury.

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8
Q

What does a GCS of 3-8 indicate?

A

A severe injury.

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9
Q

What does the ‘panda eyes’ sign suggest?

A

Basilar skull fracture.

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10
Q

What does the ‘battle’ sign suggest?

A

Haematoma across the mastoid.

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11
Q

What does leakage of blood/CSF from the ear indicate?

A

Basilar skull fracture.

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12
Q

Do extradural haematomas cross suture lines?

A

No, as the dura mater is bound tightly to bones.

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13
Q

How do extradural haematomas present?

A

Presents with LOC. May have had initial recovery following by a lucid episode.

They are lens-shaped lesions.

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14
Q

Can haematomas within the skull be left untreated?

A

No, as it will keep expanding.

Surgery is necessary to address haematomas.

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15
Q

What shape do subdural haematomas take?

A

Crescent-shaped.

They are not limited by suture lines.

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16
Q

How does an acute subdural haematoma appear on CT?

A

A hyperdense crescent-shaped lesion.

Not limited by suture lines.

17
Q

How does a chronic subdural haematoma appear?

A

Will also be crescent-shaped, however will be less dense than an cute presentation.

Can be ‘flushed out’.

18
Q

Which surgical procedure is used to treat an acute subdural haematoma?

A

Craniotomy

19
Q

What is an intracerebral haematoma?

A

Bleeding that occurs within the brain tissue itself.

20
Q

What are coup and contra-coup injuries?

A

When the brain strikes an object, rebounds and hits the skull on the other side.

21
Q

Which appears more dense on a CT, acute subdural haematoma or chronic subdural haematoma?

A

Acute subdural haematoma.

22
Q

How does an axonal injury present?

A

History of shearing forces
Reduced consciousness
No signs on CT scan (present on MRI but not regularly performed)

23
Q

What are the 5 forms of brain herniation?

A
Sub-falcine
Tentorial
Uncal
Tonsillar
Transcalvarial
24
Q

What is brainstem death?

A

When a person cannot survive without a life support machine. This is in the absence of drugs, hypothermia and metabolic disturbances.

25
Q

How is raised ICP treated?

A
Sedation
Maximise venous drainage from the brain
CO2 control
Osmotic diuretics
CSF release