Trauma Flashcards
HOw do we assess for concussion
SCAT 5 or CHild SCAT
DOn’t do baseline testing
What do you use for peds head trauma
PCARN or Chalice
CT if: GCS<15 2 hours post injury Suspected fracture Worsening headache Irritability Signso f basal skull fracture Large scalp hematoma Dangerous mechanism >4 episodes of comiting
Describe the primary survery
Put on PPE Airway Breathing Circulation Hemorrhage (thorax, abdomen, pelvis, external) Basic neuro exam (PEARL, GCS, 4 limbs) Exposure
Types of shock
Septic Hypovolemic Obstructive Cardiogenic AnaphylactiK
How to hydrate burn victims
Modified brookes
2mLxBSABxweight
Give first half in first 8 hours and then second half over the next 24 hours
Burn treatment
Modified brookes for fluid
Run under cool water (this will reduce depth, need for surgery and skin grafting etc)
When to refer a burn
> 10%
3rd degree (deep thickness)
Electrical, chemical, or inhalation burns
Face, hand, foot, genitals, perineum, joint
Special needs (peds, social, comorbidities, fractures)
How to treat Frostbite (list 5 things you would do)
Rapid rewarming in water bath COnsider thrombolysis Sterile wound care Tetanus Pain control Consult surgery
Trauma imaging to get
FAST scan Chest CR C spine CR Pelvis CR Chest Abdo pelvis CT
Always stabilize before CT
GCS
Eyes 1-No response 2-Response to pressure 3-Response to sound 4-Spontaneous
Verbal 1-No response 2-Sounds 3-Words 4-Sentences but confused 5-A+O
Motor 1-No resonse 2-Extension 3-Flexion 4-Withdraws from pain 5-Localizing to pain 6-Obeys
What is a major change that has happened in regards to giving blood
Give earlier (after 1 L fluids) and give more (massive transfusion protocols) Also giving Tranexamic acid
What has changed in regards to pneumothroax
Using smaller chest tubes
Assessing if it needs a chest tube at all (observe for 4 hours)
Deedle decompression now at 4/5 intercostal space laterally
How to reverse
- Warfarin
- Dabigatran
- Apixaban
- Vitamin K 4 factor prothrombin complex concentrate
- Idarucizumab or 4 factor prothrombin complex concentrate
- 4 faactor prothrombin complex concentrate or activated PCC
Always stop the anticoagulant and compress the bleed
List five things specifically to do for a pregnant lady trauma
Chest tube 1-2 spaces higher NG tube LLD position No vaginal exam until previa rulted out Tatanus okay to give Rhogam if Rh negative
Import ant history to take in Trauma
AMPLE Allergies Medication Past history Last meal Events leading to the incident
