Trauma

Question 1

common causes of trauma

Answer 1

non-penetrating or blunt trauma –> physical trauma to a body part by impact, injury or physical attack. include RTA and falls

penetrating trauma –> include gunshot wounds and stab wounds

thermal trauma –> burn-related

Question 2

purpose of triage

Answer 2

• identify patient requiring immediate care
• categorise and prioritise injuries to direct patient for treatment
• facilitate patient flow and avoid congestion
• provide initial assessment and history documentation

Question 3

triage levels

Answer 3

P0: death on arrival
P1: critically ill
P2: major emergency
P3: minor emergency

Question 4

role of trauma team

Answer 4

• identify and treat life threatening injuries
• resuscitate patient and stabilise vital signs
• determine nature and extent of other injuries
• prepare and transport patient to a place of definitive care

Question 5

describe advanced trauma life support (ATLS)

Answer 5

• forms the framework used in the assessment and treatment of patients who suffer traumatic injuries, and to look for possible diagnosis
• works on team approach using horizontal organisation
• consists of primary and secondary surveys
• allows the whole interprofessional team to treat patients under one standardised method
• minimises mortality and mobidity
• only for physicians

Question 6

what does the ATLS primary survey check for

Answer 6

A - airway with spinal control
B - breathing
C - circulation
D - disability

FAST to look for intraperitoneal fluid

Xray

Question 7

what does ATLS secondary survey check for

Answer 7

• Reassess ABCD
• physical examination of entire body
• spine check (log roll to assess alignment)
• rectal examination
• decide on further imaging

Question 8

role of radiographer in trauma

Answer 8

• produce diagnostic images in speedy manner
• communicate with a large team of multidisciplinary healthcare professionals, patient and maybe relatives
• suggest alternative or additional imaging
• radiation protection

Question 9

what x-rays are done first during trauma

Answer 9

• AP chest –> general assessment of lungs and ribs

- AP pelvis –> only during high energy trauma/impact –> to check for bleeding

Question 10

importance of orthogonal imaging

Answer 10

cases can appear normal in one projection, abnormal in the next.

plain radiographic imaging in acute setting often comprise of 2 or more angles of the same region.

orthogonal projections are necessary to convey the 2D nature of the anatomy in question

Question 11

factors affecting choice of imaging

Answer 11

patient condition - pt may be unable to tolerate CT or MRI based on current medical status

• tissue or area of body one wishes to image
• radiation exposure - pregnancy may prelude a CT if other imaging is available
• availability of imaging modalities
• patient implants ie pacemaker

Question 12

explain reduction

Answer 12

• can be via ‘closed’ or ‘opened’ method
• typically done to restore a fracture or dislocation to the correct alignment
• commonly referred to as manipulation and reduction
• performed under a short-acting anaesthetic, sedative or nerve blocking
• maintained by application of casts (for closed method), traction, plates, screwed or other implants
• accuracy is verified by clinical tests and x-rays