TRAUMA

Question 1

what is included in the primary survey?

Answer 1

Catastrophic haemorrhage control
A: airway and c spine precautions
B: breathing and adequate ventilation
C: circulation and haemorrhage control
D: disability (neurology and pupils)
E: exposure (keep warm)

Question 2

what is included in the secondary survey?

Answer 2

A secondary survey requires a set of vitals, history and head-to-toe assessment, inspect the back/investigations, jot it down and debriefing

A: Allergies
M: medications
P: past medical history
L: last meal
E: events surrounding injury

Question 3

identify some life-threatening traumatic injuries

Answer 3

• tension pneumothorax
• massive haemothorax
• flail chest
• open pneumothorax
• internal and external bleeding

Question 4

what is a tension pneumothorax?

Answer 4

• Air accumulated between the lung and chest wall.
• Considered a one-way valve system that prevents air from escaping the pleural space. As a result, there is a buildup of tension that pushes the heart, trachea and lungs to one side of the thoracic cavity.

Question 5

how might patients with a tension pneumothorax present?

Answer 5

• SOB
• Dyspnea
• Chest pain
• Chest tightness
• poor SpO2
• asymmetrical chest movement
• respiratory distress

Question 6

how is a tension pneumothorax diagnosed?

Answer 6

• chest x-ray which will display tracheal deviation and a partially or fully collapsed lung. In severe causes, cardiac tamponade is present.
• structures should appear black

Question 7

what is involved in the management of a tension pneumothorax?

Answer 7

• immediate needle decompression w. 12g needle
  finger thoracostomy
  chest drain

Question 8

what is a massive haemothorax?

Answer 8

a collection of blood between the lung and chest wall.

• MH can be caused by severe chest trauma such as a penetrating force (stabbing) or major surgeries.

Question 9

how might an individual with a massive haemothorax present?

Answer 9

• respiratory distress
• decreased air entry
• asymmetrical chest

Question 10

what might be included in the management of a massive haemothorax?

Answer 10

• promote oxygenation
• insertion of drain
• blood transfusion

Question 11

what is a flail chest?

Answer 11

2 or more rib fractures in 2 or more places on the same rib = free-moving ribs

→ refers to the fracture of 3 or more rib segments. A rib fracture is painful and can break off from the rib cage and become a free-flowing rib segment that moves with every inspiration and expiration

Question 12

how might an individual with a flail chest present?

Answer 12

• possible pneumothorax
• pulmonary bruising
• pain
• difficultly breathing

Question 13

how do we manage a flail chest?

Answer 13

• ensure adequate oxygenation + ventilation
• analgesia

Question 14

what is an open pneumothorax?

Answer 14

A collection of air between the chest wall and lungs as a result of an open chest wound

Question 15

how might a patient with an open pneumothorax present?

Answer 15

• pain
• tachy
• hemopneumothorax
• signs of shock
• chest wall defect

Question 16

how do we manage an open pneumothorax?

Answer 16

• promote ventilation and oxygenation
• cover wound
• insert chest drain
  analgesia

Question 17

where might traumatic internal/external bleeding occur

Answer 17

• chest
• abdomen
• pelvis
• retroperitoneum
• limbs

Question 18

how do we manage internal/external bleeding?

Answer 18

• recognise it
• locate it
• identify cause
• manage cause

Question 19

what is the nursing role in the acute treatment of a trauma patient?

Answer 19

• Stabilisation of airway
• Frequent GCS
• Relevant tests ordered
• A-G
• Spinal precautions
• Head to toe examination

Question 20

what is the nursing role in the long-term care of a trauma patient?

Answer 20

• Referral to mental health services
• Physio
• Analgesia
• Social worker referral

Question 21

why do we need to document in trauma cases?

Answer 21

• Meticulous record keeping
• Requires structured documentation of assessment and management
• Forensic evidence