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finals > Trauma > Flashcards

Trauma Flashcards

1
Q

How does neurogenic shock work

A

Spinal chord transection either decreases sympathetic or increases parasympathetic tone leading to increased peripheral dilation

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2
Q

Examination findings of neurogenic shock

A

Low BP
Warm peripheries

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3
Q

What causes a low BP in trauma patients

A

Most commonly haemorrhage
Can be;
- tension pneumothorax
- spinal chord injury
- cardiac tamponade
- cardiac contusion

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4
Q

What is used to treat neurogenic shock

A

Vasopressors

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5
Q

What defines SIRS

A

Systemic inflammatory response
- temp 36-38
- HR >90
- RR >20
- WCC>12,000 or <4,000

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6
Q

What defines severe sepsis

A

Sepsis with organ failure

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7
Q

What defines septic shock

A

Sepsis with refractory hypotension

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8
Q

What is parkland formula

A

4ml x %body surface area x weight (kg)
50% given in first 8 hours
50% given in next 16 hours

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9
Q

What fluid is given in burns patients

A

Crystalloid- hartmanns

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10
Q

What drugs impair all wounds from healing

A

NSAIDs
Steroids
Immunosuppressive drugs

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11
Q

What can cause drop in sats on insertion of intubation tube

A

Oesophageal placement

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12
Q

What are indications for head CT within 1 hour

A

GCS <13 on assessment
GCS<15 at 2 hours post injury
Post traumatic seizure
Focal neurology
More than 1 vomiting episode
Any indication of skull fracture
- battle sign
- CSF leak
- panda eyes

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13
Q

What are indications for head CT within 8 hours

A

65 or older
History of coagulation disorder
On anticoagulants
Dangerous mechanism
30 minutes of retorgrade amnesia

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14
Q

What counts as dangerous mechanism for CT within 8 hours

A

Pedestrian struck by car
5 stairs fallen down
Fall over 1m

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15
Q

What do if patient onanticoagulant hits head

A

CT within 8 hours

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16
Q

Who does autonomic dysreflexia occur in

A

Those with spinal injury above T6

17
Q

Presentation of autonomic dysreflexia

A

Sweating and flushing above the level of lesion
Severe HTN

18
Q

What is management of autonomic dysreflexia

A

Manage HTN
Relieve cause- ie urinary retention or faecal impaction

19
Q

How assess if endotracheal tube is in the oesophagus

A

End tidal CO2

20
Q

When is ICP monitorning necessary

A

GCS 3-8

21
Q

What is management if raised ICP from a bleed

A

Take to surgery
In meantime give IV mannitol

22
Q

What vein does a central line go into

A

Subclavian

23
Q

Patient with long term endotracheal tube starts choking after feeds and coughing sputum

A

Tracheo oesophageal fistula

24
Q

What is the best investigation for diffuse axonal injury

A

MRI brain

25
Q

What are panda eyes

A

Bruising around the eyes

26
Q

Signs of basilar skull fracture

A

Battles sign
Panda eyes
CSF leakage from the ears and nose

27
Q

If cant get IV access in an arrest call what do

A

Call trained individual who can get intraosseous access

28
Q

What is difference between membranous and bulbar urethral injury

A

MB in terms of proximal to distal

29
Q

What causes membranous vs bulbar urethral injury

A

Membranous- Pelvic fracture
Bulbar- straddle injuries

30
Q

Signs of urethral injury

A
  • urinary retention
  • perineal and penile haematoma
  • blood at the meatus
  • prostate displaced upwards
31
Q

How are urethral injuries investigated

A

Ascending urethrogram

32
Q

What is immediate management of urethral injury

A

Suprapubic catheter

33
Q

Investigation for bladder injury

A

IVU

34
Q

What is a laryngeal mask

A

Mask which goes into cover airway during anaesthesia which channels oxygen to lungs

35
Q

Problem of laryngeal mask

A

Poor control against reflux of gastric contents

36
Q

What is tracheostomy

A

Where hole made in neck to gain access to airway

37
Q

What is best IV induction agent if haemodynamically unstable

A

Ketamine as causes very little mycocardial depression

38
Q

Management of haemothorax plus indications for second line

A

Chest drain
Thoracotomy if drain over 1.5L or 200ml/hour over 2 hours

39
Q

Most common primary if bony mets ( man vs woman)

A

Woman= breasts
Men= prostate

finals (29 decks)

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