Trauma

Question 1

The primary survey of a trauma patient is focused upon____________?

Answer 1

Airway Protection; protection of the cervical spine

Question 2

Using the Glascow Scale, a patient that opens their eyes to voice but does not make sounds or movements has a score of______?

Answer 2

5

Question 3

The secondary survey of a trauma patient includes______________?

Answer 3

Head to toe exam; Complete history

Question 4

What mnemonic would you use to collect your history from a trauma patient?

Answer 4

AMPLE (Allergies, Medications, Past medical history, Last meal or other intakes, and Events leading to presentation)

Question 5

What is the cause of most chest trauma?

Answer 5

MVC

Question 6

What are potentially serious complications that may occur in a patient with a rib fracture?

Answer 6

Damage to the underlying structures including the subclavian artery and/or vein; lacerated liver, lacerated spleen, pneumothorax

Question 7

A patient with several rib fractures remains in severe pain after treatment with Toradol and escalation of opioids to the highest recommended doses. What is your next course of action for pain management?

Answer 7

Consult Pain Services. An intercostal nerve block may be needed.

Question 8

What chest wall injury is most likely to cause injury to underlying structures?

Answer 8

Flail chest

Question 9

A patient presents post-motor vehicle crash with severe chest trauma. A CXR confirms pneumothorax. The placement of a chest tube confirms a massive hemothorax. What is the appropriate fluid(s) for resuscitation of this patient?

Answer 9

Lactated Ringers. Autotransfusion may be considered after thoracostomy

Question 10

A patient with a rupture of the aorta is awaiting surgical repair by cardiothoracic surgery. NAME 3 interventions you would use to maintain hemodynamic stability prior to surgery.

Answer 10

Fluid resuscitation with crystalloids, transfusion with PRBC, Maintaining SBP less than 100-110 mmHg with vasodilators (i.e., Cardene, nipride) if necessary

Question 11

A lacerated liver can occur as a result of blunt abdominal trauma (BAT). What diagnostic tests/labs are done to assist in this diagnosis?

Answer 11

FAST USG, peritoneal lavage, abdominal CT. Lab work may show a decreased H&H, elevated PT, elevated pancreatic and liver enzymes

Question 12

What are 3 potential choices of single empiric antibiotic coverage for a patient with BAT?

Answer 12

Imipenem-Cilastin OR Meropenem OR Pipercillin-tazobactam

Question 13

A positive Kehr’s sign in a patient with BAT in an indication of ________________?

Answer 13

Ruptured Spleen

Question 14

What are 3 potential complications of a pelvic fracture?

Answer 14

Venous hemorrhage, visceral injury, GU injury, nerve injury. Thoracic aortic rupture is a possibility more from the injury that caused the pelvic fracture

Question 15

An eye trauma that is caused by a penetrating sharp object is_________

Answer 15

Open globe laceration