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Paramedic > Trauma > Flashcards

Trauma Flashcards

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1
Q

Order of spider straps

A
  1. Shoulders
  2. Feet
  3. Above Knee
  4. Pelvis
  5. Armpits
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2
Q

When two holes in chest, how is oclusive dressing applied?

A

Vented seal is higher than non-vented

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3
Q

Who gets cel-x (special wound packing)

A

Hypothermia and blood thinners
i.e., cold and old

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4
Q

Muscle injury from overstretching or overexertion

A

Strain

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5
Q

Obstructive shock

A

Due to something that is limiting function - tamponade, tension pneumo, pulmonary embolism

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6
Q

Distributive shock

A

w/o loss of fluids but with floppy wide blood vessels: neurogenic, septic, anaphylactic - shock

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7
Q

Cardiogenic shock

A

Due to damage to heart - problematic rhythms, MCI, trauma to heart (contusion)

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8
Q

Hypovolemic shock

A

Due to the loss of fluid - hemorrhage, loss of plasma, loss of body fluids

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9
Q

Trauma triad

A

Hypothermia, coagulopathy, acidosis

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10
Q

Coagulopathy happens…

A

Below 95 degrees, above 1.5 INR

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11
Q

End tidal above ?? means the kidneys are perfused

A

20

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12
Q

MAP formula and hypoperfusion MAP #

A

MAP is DBP + 1/3 PP
Hypoperfusion MAP<60

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13
Q

Drugs NR considers for unconscious patient w\o known reason

A

Thiamine, D50 and Naloxone

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14
Q

Open fracture and shortness of breath

A

Lead to pulmonary embolism
Especially tib-fib, FAT embolism that can reach lungs. s/s shortness of breath

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15
Q

Compartment syndrome following supracondylar fracture. Distal humorous, close to the elbow; common, especially PED

A

Volkmann contracture

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16
Q

Blast injuries impact

A
  1. Primary - blast wave itself
  2. Secondary - missiles propelled
  3. Tertiary - impact w/another object
  4. Quaternary - collateral: burns, crush injuries, toxic inhalation
  5. Quinary - long term damage
    Related injury - arterial air embolism from alveolar disruption
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17
Q

Bleeding that is life threatening

A

Exsanguination

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18
Q

Another term for swelling (edema)

A

Erythema

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19
Q

Term for a bruise w/ black and blue marks

A

Ecchymosis (e cha mosis)

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20
Q

Collection of blood under the skin. Blue discoloration

A

Hematoma

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21
Q

The four phases of shock

A
  1. Initial - hypoxia, anaerobic cell respiration. Tachypnea
  2. Compensatory - (MAP above 60 means cells are still perfused)
  3. Progressive/uncompensated - MAP below 60. Organs are compromised.
  4. Refractory - Vital organs have failed, imminent death.
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22
Q

The fracture is at an angle to the shaft

A

Oblique fracture

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23
Q

The fracture is perpendicular to shaft

A

Transverse fracture

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24
Q

Growth plate in bone - fracture there can cause growth problems

A

Epiphyseal plate

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25
Q

Shifting of the joint without a full dislocation. Unlike dislocations, allows for normal, albeit painful motion.

A

Subluxation (sab lak say shen)

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26
Q

Falling on locked knees. Can result in tearing of the ligaments of the pelvis, symphysis pubis, and sacrum.

A

Vertical shear injury

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27
Q

Alveolar collapse, prevents ventilation

A

Atelectasis (a te LEK ta ses)

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28
Q

Air under the skin (“snap, crackle, pop”) suggest lung or airway injury

A

Subcutaneous emphysema

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29
Q

Mid section of the thoracic cavity; contains the heart and main blood vessels. Inflammation of

A

Mediastinum and mediastinitis

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30
Q

Flail chest is

A

TWO or more consecutive ribs must also be fractured in TWO or more places

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31
Q

Rib fractures concerns

A
  • Aortic injury
  • Tracheobronchial injury
  • Pneumothorax (look for subcutaneous emphysema)
    9-11 be suspicious of abdominal injuries
32
Q

Can be auscultated when lung collapses (pneumothorax)

A

Hyperresonance

33
Q

s/s of pulsus paradoxes

A

Drop of 10 mmHg during inspiration; we can feel radial pulse on expiration but not inspiration

34
Q

Common between tension pneumo and simple pneumo

A

Shortness of breath, absent/diminished sounds on impacted side

35
Q

Difference between tension pneumo and simple pneumo

A

Tachycardia and hypotension due to intrathoracic pressure causing decreased venous return to the heart.

36
Q

Signs of tension pneumothorax

A

Absence of breath sounds on affected side, unequal chest rises, pulsus paradoxes, tachycardia and progression to vfib, JVD, narrow pulse pressure and tracheal deviation

37
Q

Space between the visceral and parietal pleura of the lungs

A

Pleural cavity. One for each lung. Lubricated. Each space can hold up to 3000ml (exsanguination)

38
Q

Massive hemothorax defined

A

More than 1500ml of blood in the pleural space (about 25% of adult blood volume).

39
Q

When air leaks into the mediastinum

A

Pneumomediastinum (aka mediastinal emphysema)

40
Q

s/s = Frequent PVCs in trauma patient. Shortness of breath, chest pain, cardiac dysrhythmias

A

Myocardial contusion

41
Q

Beck’s triad (pericardial tamponade)

A
  1. Hypotension (bcs pressure limits preload)
  2. Muffled heart sounds (Fluid makes it harder to hear)
  3. Jugular venous distension (backup of blood in superior vena cava or heart)
    Also, tachycardia and narrowing pulse pressure.
42
Q

Treatment for pericardial tamponade - Prehospital and in hospital

A

Prehospital attempt to increase preload through fluids. In hospital - pericardiocentesis

43
Q

Common between cardiac tamponade in tension pneumo

A

Right ventricle and vena cava compressed on inspiration - preload leading to lower BP

44
Q

Different between cardiac tamponade in tension pneumo

A

w/TP no lung sound on one side; air hunger

45
Q

Common to pulmonary contusion and pulmonary embolus

A

V/Q mismatch. i.e., ventilation normal but low pso2 & high end tidal

46
Q

Aortic dissection, disruption , rupture s/s

A

Tearing pain behind sternum or in scapula; sign of shock; hematoma can lead to hoarseness or difficulty swallowing; harsh murmur as blood passes the injury site; Blood flow may be interrupted to extremities leading to pulse difference between left/right, upper/lower
Treatment: supportive, fluids

47
Q

Concussion impact on memory

A

Transient retrograde amnesia (retrograde means before the event)

48
Q

TBI Hematoma shapes

A

Subdural - crescent / banana shape (narrow)
Epidural lemon/round shape and bigger. More severe, only 1-2% of TBI

49
Q

ETCO2 and head injury
“Targeted Ventilatory Management”

A
  • Maintain 35-40 if NO signs of herniation.
  • If herniation, 30-35.
  • Never allow the ETCO2 to drop below 25 mmHg (increased mortality)
50
Q

Signs of ICP

A

GCS drop of 2 or more, from 9
Pupillary changes
Cushing triad
Hyperpyrexia

51
Q

Exceptionally high body temp due to ICP or infection

A

Hyperpyrexia

52
Q

Cushing triad, (ICP sign)

A
  1. Widening pulse pressure;
  2. Bradycardia;
  3. Chaine Stokes/abnormal breathing
53
Q

Medications that decrease cerebral edema and ICP

A

Mannitol (Osmitrol), furosemide (Lasix)

54
Q

Epidural hematoma s/s

A

Often lose consciousness initially; regain consciousness for a while; and then fall unconscious when ICP at critical levels.

55
Q

Head injury w/rapid onset of s/s: significant headache, mimic meningitis, Cushing reflex.

A

Subarachnoid hemorrhage

56
Q

Injury separating facial bones from skull

A

Le Fort III

57
Q

This injury disconnects the axons in the spinal cord to the brain.

A

Diffuse axonal injury

58
Q

Results from hyperextension of the cervical spine. Loss of function in upper extremities.

A

Central cord syndrome

59
Q

Fracture with s/s of battle sign, raccoon eyes, a positive halo test.

A

Basal skull fracture

60
Q

Lesion in the spinal cord causing weakness or paralysis on one side and a loss of sensation on the opposite side.

A

Brown-Sequard syndrome (BSS)

61
Q

Flexion injury with s/s motor and sensory loss inferior to the injury.

A

Anterior cord syndrome

62
Q

Extension injury leading to decreased sensation to light touch and proprioception.

A

Posterior cord syndrome

63
Q

Body’s ability to sense its position, movement, and orientation in space.

A

Proprioception, aka kinesthesia

64
Q

Double vision

A

Diplopia

65
Q

Neurological, ability to move both eyes in the same direction.

A

Conjugate gaze

66
Q

4 Layers of skin

A
  1. Epidermis - part of it is dead cells that continuously shed
  2. Dermis - nerve, vessels, sweat, hair
  3. Subcutaneous tissue - insulates, protects and stores fat
  4. Deep fascia - thick, dense
    Below them tendons connect muscles to the skeleton
67
Q

Surgical procedure to treat full-thickness circumferential burns.

A

Escharotomy (es ke RA tami)

68
Q

Most significant systemic response to burns

A

Hypovolemic shock due to (a) Fluid loss through damaged skin, (b) Volume shifts of fluids across body.

69
Q

Injury to skeletal muscle and involves leakage of large quantities of toxic intracellular contents into plasma (potassium).

A

Rhabdomyolysis (rabdo ma YA la sis)

70
Q

Emergency procedure to decompress compartment syndrome

A

Fasciotomy

71
Q

Collected blood in abdominal cavity

A

Hemoperitoneum

72
Q

Referred pain to left shoulder

A

Kehr sign

73
Q

Hypothermia temp

A

Body temperature has decreased to 35°C (95°F) or less

74
Q

Fragile bones

A

Osteoporosis

75
Q

s/s Blood clots, Bruising, mottling of the skin, Drop in blood pressure, Bleeding from many sites in the body

A

Disseminated intravascular coagulation, or DIC

Paramedic (11 decks)

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