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COMAT - Surgery > Trauma > Flashcards

Trauma Flashcards

1
Q

A blunt cerebrovascular injury to the neck often occurs with deceleration. What vessels are often affected?

A

Internal Carotid arteries
Vertebral arteries

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2
Q

How will injury to the Internal Carotid/Vertebral arteries present?

A

Focal neurological deficit – like a stroke

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3
Q

What is Flail Chest?

A

> 3 consecutive rib levels with > 2 breaks in each

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4
Q

> 3 consecutive rib levels with > 2 breaks in each is called?

A

Flail chest

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5
Q

How will Flail Chest present?

A

Paradoxical motion
= As chest expands with inspiration, the portion of ribs affected will compress and vice versa with expiration they will expand

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6
Q

If Flail chest is present, what diagnostic studies should be obtained?

A

X-ray/CT and possibly CTA

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7
Q

What is the treatment for Flail Chest?

A

ORIF with pain management

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8
Q

What pain medication should be given for Flail Chest or severe rib fractures?

A

Anesthetics – opioids will decrease respiratory rate and do not want that

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9
Q

Hemothorax is blood in the pleural space often due to?

A

Rib fracture that lacerates intercostal arteries

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10
Q

How will a Hemothorax present?

A

Decreased lung sounds and DULLNESS to percussion

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11
Q

What will be seen on X-ray with Hemothorax?

A

Horizontal Meniscus

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12
Q

What are 2 treatment options for a Hemothorax?

A

Thoracostomy (chest tube)
Thoracotomy to stop bleed if severe

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13
Q

Pneumothorax is air in the pleural space. How will it present?

A

Decreased lung sounds and HYPERRESONANCE to percussion

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14
Q

What is the treatment for a Pneumothorax? Tension Pneumothorax?

A

Thoracostomy (chest tube)
– Needle thoracostomy for Tension Pneumothorax

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15
Q

What extra sign can be present with a Tension Pneumothorax that will not be present with a regular Pneumothorax?

A

Distended jugular veins due to compression of venous structures

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16
Q

A Pulmonary Contusion often occurs following chest trauma. How will it present?

A

Worsening hypoxia/dyspnea and tachypnea following the trauma

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17
Q

What lung sound may be heard with a Pulmonary Contusion?

18
Q

What will be seen on X-ray with a Pulmonary Contusion? CT?

A

X-ray = Patchy infiltrates
CT = Ground glass opacities

19
Q

Treatment for a Pulmonary Contusion?

A

Oxygen and maintain PEEP

20
Q

Blunt Cardiac Injury may present in what 2 ways?

A
  • Arrhythmias
  • Shock with low EF
21
Q

What workup should be done for a Blunt Cardiac Injury?

A

ECG
Troponins
Echo

22
Q

Treatment for Blunt Cardiac Injury?

A

Watch for arrhythmias and limit IVF

23
Q

Injury to the aorta often follows a deceleration injury. What will be seen on X-ray?

A

Widened Mediastinum

24
Q

What is the treatment for an aortic injury/dissection?

A

Lower BP with IV beta blocker
+/- stent/surgery

25
Q

Cardiac Tamponade is blood in the pericardial space. What are the main 3 signs?

A

Hypotension
Muffled/distant heart sounds
Distended jugular veins

26
Q

Cardiac Tamponade is blood in the pericardial space. What are the main 3 signs?

A

Hypotension
Muffled/distant heart sounds
Distended jugular veins

27
Q

What can be seen with the BP with Cardiac Tamponade?

A

Pulsus Paradoxus
= With inspiration, the SBP drops by more than 10

28
Q

What may be seen on EKG with Cardiac Tamponade?

A

Low voltage QRS complexes

29
Q

What may be seen on CXR with Cardiac Tamponade?

A

Enlarged cardiac silhouette

30
Q

What may be see on Echo with Cardiac Tamponade?

A

Right atrial/ventricular collapse

31
Q

Treatment for Cardiac Tamponade?

A
  • Pericardiocentesis
  • Pericardial Window
32
Q

If Cardiac Tamponade is suspected based on the symptoms, do you need to get a CXR?

A

NO – will not offer much help… just treat

33
Q

With burns, what 3 things is the patient at risk for?

A

Infection
Hypothermia
Hypovolemia

34
Q

With burns, what 3 things is the patient at risk for?

A

Infection
Hypothermia
Hypovolemia

35
Q

With burns, the capillaries will leak and will often result in?

36
Q

What 2 complications are common with burn patients?

A

ARDS
Compartment syndrome

37
Q

What fluids should be given to burn patients?

A

Lactated Ringers

38
Q

What must be placed to assess volume status in a burn patient?

A

Transurethral catheter

39
Q

List signs of an Inhalation injury?

A
  • Soot in nares/singed nose hairs
  • Carbonaceous sputum = grey/black
  • Erythema of oropharynx
40
Q

If a patient has signs of an Inhalation injury, what should be done? What are those signs?

A

Prophylactic INTUBATION
- soot in nares/singed nose hairs
- Carbonaceous sputum = grey/black
- Erythema of oropharynx

COMAT - Surgery (13 decks)

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