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XIO > trauma > Flashcards

trauma Flashcards

1
Q

trauma

A

Injury caused by exposure to mechanical, thermal, electrical, or chemical energy.

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2
Q

TRAUMA INCIDENCE

A

Leading cause of death ages 1 to 44 y/o.
Males 2.5X’s more likely to have trauma
> 50% of trauma is related to alcohol use.

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3
Q

Three essential components of an injury are: (the pattern of a mechanic is force)

A

MECHANISM OF INJURY
FORCE OF INJURY
PATTERN OF INJURY

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4
Q

MECHANISM OF INJURY

A

What causes the injury?
Mechanical, Thermal, Chemical, Electrical?
MVC
Fall
Fire
Gunshot

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5
Q

FORCE OF INJURY

A

What is the force or amount of energy causing the injury?

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6
Q

EXAMPLE OF FORCE - don’t need to memorize this or calculate anything

A

150 pound person hits a brick wall traveling at 60 mph.

Newton’s 2nd Law of Motion
Body wt X mph = psi of impact.
150 lbs X 60 mph = 9000 pounds per square inch of force in a millisecond.

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7
Q

PATTERNS OF INJURY

A

Possible to anticipate a pattern of injury based on the mechanism and force of injury.

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8
Q

Example of Pattern of Injury:
PEDESTRIAN VS AUTO (PVA)

A

Car backs up and hits pedestrian

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9
Q

EXAMPLES OF INJURIES

A

MECHANISM
FORCE
PATTERN

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10
Q

Mechanism (the mechanics of what)

A

GSW (gun shot wound)
Foreign object
SW (stab wound)

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11
Q

Forces

A

Hand gun at close range
Knife Stab
Impaled with nail gun

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12
Q

Pattern of Injury

A

Trajectory?

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13
Q

DEGLOVING INJURY

A

Driver, Brake pedal injury.
Mech: Degloving injury from brake pedal MVC
Force: High speed MVC
Pattern: Foot with shearing injury from brake pedal

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14
Q

TRAUMA ASSESSMENT AND RESUSCITATION (the alphabet)

A

Rapid systematic approach to major trauma:
Primary Assessment (A – F)
Resuscitation
Secondary Assessment (G – H)

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15
Q

A = AIRWAY

A

INCLUDES: C-SPINE PRECAUTIONS for Traumas

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16
Q

AIRWAY PATENCY ?

A

Check head and neck position
Maintain airway with chin lift or jaw thrust
Consider airways, ET tubes, tracheotomy

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17
Q

OXYGENATION

A

Give 100% O2 non-rebreather mask
Check O2 sats, ABG’s

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18
Q

B = BREATHING -
ASSESS FOR 5 LIFE-THREATENING CHEST INJURIES (5 thoraxes)

A

Tension Pneumothorax
Open Pneumothorax
Massive Hemothorax
Flail chest
Pericardial Tamponade

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19
Q

TENSION PNEUMOTHORAX

A

Air enters pleural space and can’t escape.
Intrathoracic pressure ↑’s and the lung collapses.

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20
Q

open pneumothorax - where is the air?

A

Air enters pleural space and can escape
Sucking Chest Wound


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21
Q

open pneumothorax treatment

A

3 sided vented dressing to prevent Tension Pneumo
chest tube insertion w/ suction

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22
Q

open pneumothorax - do NOT

A

Do Not remove
objects impaled in chest w/o MD

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23
Q

MASSIVE HEMOTHORAX - what amount?

A

> 1500 ml blood

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24
Q

FLAIL CHEST

A

DX
Fx of 2 or more adjacent ribs

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25
Q

Cardiac Tamponade

A

Accumulation of blood in the pericardial sac
Compresses heart preventing it from pumping effectively.

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26
Q

C – Assessment of Circulation

A

BP
Pulse
Cardiac: RRR (Reg Rate and Rhythm)
Skin Color
Cap Refill
Urinary Output
Hct
CVP (Central Venous Pressure Cath)

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27
Q

C = Circulation - For effective circulation you need (volume, rhythm, and tone)

A

Adequate Volume
Good Cardiac rhythm and function
Good vessel tone and function

28
Q

C-Circulation Interventions (circulate the blood)

A

HOW MUCH BLOOD DO WE HAVE?
4-5 Liters (8 – 11 units) 450ml / unit of bld
IS THE PATIENT BLEEDING??
CONTROL BLEEDING:
Direct Pressure? – Surgery? (Internal bleeding)
Trauma pts at risk for hypovolemic shock
Monitor: BP, Pulse, cardiac monitor, Hct, cap refill
IV access: 2 + large-bore IV’s
Anti-arrhythmic meds if needed
Vaso-pressors (make sure pt is on fluids already)
If patient requires emergent blood
Give bolus warmed LR or NS and
Universal donor: Type 0 negative blood until Type and Cross matching blood.

29
Q

D = DISABILITY: (AVPU)

A

(Quick Neuro eval)
D can also stand for defibrillate and differential diagnosis
A simple mnemonic is AVPU
A = Alert
V = Responds to verbal stimuli
P = Responds to painful stimuli
U = Unresponsive

GCS: Glascow Coma Scale

30
Q

GLASCOW COMA SCALE (3 - 15 points) - don’t need to memorize these

A

BEST MOTOR RESPONSE POINTS
Obeys simple commands 6
Localizes noxious stimulus 5
Flexion withdrawal 4
Abnormal flexion (decorticate) 3
Abnormal extension (decerebrate) 2
No motor response 1

31
Q

E = EXPOSE

A

ALL trauma pts…. Completely remove all clothes

32
Q

SECONDARY ASSESSMENT

A

Completed only after all immediate life-threatening injuries are stabilized in ABCDE

Secondary Assessment:
FGH

33
Q

F=Fahrenheit

A

Completely undress pt.
Keep warm w/ heated blankets, warm IV fluids.
Risk for hypothermia.

F can also mean
Fingers
Foley
Flip

34
Q

G = Get Vital signs

A

VS, O2 sat, Cardiac monitor, labs, tests, NG, Xray, CT, FAST

35
Q

H =

A

HISTORY AND HEAD TO TOE

36
Q

HISTORY

A

MIVT (Mech of injury
suspected Injuries) Usually done by the paramedics

VS
Treatments

SAMPLE
Signs and Symptoms
Allergies
Meds
PMH
Last meal
Events preceding illness or injury.
head to toe

37
Q

EARS: (ears battle)

A

Battle’s sign (bruising behind ear = possible basilar skull fx)
runny nose - CSF (Cerebral Spinal Fluid) otorrhea
Racoon eyes (periorbital and cheek ecchymosis

38
Q

neck

A

MAINTAIN CERVICAL SPINE IMMOBILIZATION

Cleared by Xray or palpation by MD or NP

39
Q

EXTREMITIES:

A

Injuries, edema, skin temp…
CSM
Color, sensation, motion
5 P’s
pulses, parasthesias, paralysis, pain, pallor
Compartment Syndrome

40
Q

ABDOMEN

A

Distention, pain, guarding, firmness?
Bowel sounds, bruits?

41
Q

Most common organ injured in blunt trauma

A

spleen

42
Q

Cullen’s sign

A

Ecchymosis around Umbilicus
(Intra-Abd & Retroperitoneal Bleeds)

43
Q

DIAGNOSTIC TESTS FOR ABDOMINAL TRAUMA - (abdominal trauma is FAST)

A

FAST (Focused Abdominal Sonogram for Trauma)
CT
DPL

44
Q

BLUNT ABDOMINAL TRAUMA

DIAGNOSTIC TESTS

A

DPL
Diagnostic Peritoneal Lavage (not used now)
Check for bleeding from blunt trauma

45
Q

IF SEVERE ABDOMINAL TRAUMA SUSPECTED (lap up the severe abdominal trauma)

A

Immediate Exploratory Laporatomy
Or
INTERVENTIONAL RADIOLOGY

46
Q

Stable Abd Trauma

A

May go to interventional radiology

Or admit for observation

47
Q

PVA

A

pedestrian v. auto

48
Q

any fall greater than 25 ft

A

is a major trauma

49
Q

gunshots

A

Mech: GSW (gunshot wound)
Force: Hi and Lo velocity
Pattern: Trajectory of bullet

50
Q

Bullet wounds (Yaw’all is long)

A

Yaw = deviation of bullet on longitudinal axis. Larger trauma

Tumbling = somersaulting rotation of bullet. Larger trauma

51
Q

B = BREATHING

A

Breathing? is breathing actually working for the pt?
Respirations effective?
ambu-bag or mechanical vent?
O2 Sat
ABG’s
Assess for 5 life threatening problems

52
Q

Pneumothorax treatment

A

(pre-medicate if possible, it’s painful) Needle thoracentesis
Chest tube placement

53
Q

look at slide

A

58

54
Q

eyes

A

check for injuries, contacts

55
Q

2nd most common injury

A

liver

56
Q

Turner’s sign (Turn the kidney)

A

Ecchymosis on either flank 
(Retroperitoneal bleeding)

57
Q

Seat Belt Sign

A

Eccyhmosis along seat belt distribution. Associated with blunt abd trauma

58
Q

symptoms of a tension pneumothorax (tension in my JVD)

A

Dyspnea, tracheal deviation, ↑ JVD, ↓ BS (breath sounds)

59
Q

open pneumothorax - s/sx (HR?)

A

Dyspnea, Tachypnea, Sucking chest wound

60
Q

massive hemothorax - s/sx (percussion?)

A

SX: Dyspnea, ↓ breath sounds, dullness to percussion, shock

61
Q

massive hemothorax - treatment

A

TX: Chest tube (question if too much blood is coming out, it’s not good)

Treat hypovolemia and control bleeding.

Thoracotomy and surgical intervention.

62
Q

flail chest - s/sx

A

Dyspnea, CP (chest pain)
Paradoxical Breathing (chest moves in with inspiration and out with expiration)

63
Q

flail chest - tx

A

Intubation
taping/splinting
O2 therapy, analgesics

64
Q

cardiac tamponade - s/sx (tampon in jugular) and heart sounds?

A

Sx’s: muffled heart sounds, ↓ BP, ↑ JVD

65
Q

cardiac tamponade - tx

A

Pericardiocentesis with surgical repair Stat

XIO (372 decks)

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