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#DAY3_SURGERY > trauma > Flashcards

trauma Flashcards

1
Q

All patients with blunt trauma require cervical spine immobilization

A

Yes

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2
Q

most common indication for intubation

A

altered mental status

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3
Q

What is the indication of emergent tracheostomy

A

laryngotracheal separation or laryngeal fractures

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4
Q

Treatment of flail chest with underlying pulmonary contusion

A

require presumptive intubation and mechanical ventilation

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5
Q

treatment of tension pneumothorax

A

CTT

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6
Q

treatment of open pneumothorax

A

closure of pneumothorax and CTT

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7
Q

What is the direction of insertion of a CTT

A

directed superiorly and posteriorly

36F Chest tube

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8
Q

where is the incision of a CTT

A

4th - 5th ICS MAL

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9
Q

pressure of carotid pulse

A

60 mmHG

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10
Q

pressure of femoral pulse

A

70 mmHg

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11
Q

pressure of radial pulse

A

80 mmHg

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12
Q

Definition of massive hemothorax

A
  1. > 1500 ml blood loss

2. 1/3 of blood volume in pediatrics

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13
Q

what is the incision on emergency department thoracotomy

A

left anterolateral thoracotomy

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14
Q

Indication of emergency department thoracotomy

A
  1. witnessed penetrating trauma with < 15 mins of prehospital CPR
  2. witnessed blunt trauma with < 5 mins of prehospital cpr

Persistent severe post injury hypotension BP <60 mmHg

  1. cardiac tamponade
  2. hemorrhage
  3. air embolism
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15
Q

Layers of the body passed by CTT

A
  1. skin
  2. suuperficial fascia
  3. serratus anterior
  4. external intercostal
  5. internal intercostal
  6. innermost intercostals
  7. endothoracic fascia
  8. parietal pleura
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16
Q

What is the most common cause of cardiogenic shock in a trauma patient

A

tension pneumothorax

17
Q

Areas in the body in performing physical exam that needs special attention

A
  1. axilla
  2. back
  3. perineum
18
Q

The big three radiographs in BLUNT trauma

A
  1. lateral cervical spine
  2. chest
  3. pelvic
19
Q

Radiograph for truncal gunshot wound

A
  1. anteroposterior and lateral chest and abdomen
20
Q

Target INR and PTT of trauma patients

A

INR < 1.5

PTT < 45 seconds

21
Q

What are the zones of the neck?

A

zone 1 - up to the level of cricoid
zone 2 - cricoid up to the angle of mandible
zone 3 - above the mandible

22
Q

What is the 5 plain radiograph views of the cervical spine

A
  1. lateral
  2. anteroposterior
  3. transoral odontoid
  4. bilateral oblique views
23
Q

Treatment of penetrating neck injury that is asymptomatic

A 
zone I
-CT scan neck and chest, CTA esophagogram, bronchoscopy
zone II
a.transcervical GSW - like zone 1
b. all others - observe
zone III
-observe
24
Q

Treatment of penetrating neck injury that is symptomatic, stable

A

zone I
-CT scan neck and chest, CTA esophagogram, bronchoscopy
zone II
a. operative exploration
zone III
-angiography - Interventional radiography embolization

25
Q

Treatment of GSW/Stab wound in the abdomen of stable patient

A

A. GSW

  1. Anterior abdomen - explore lap
  2. RUQ, tangential, back or flank - CT scan

B. Stab wound

  1. back, flank - CT scan
  2. AASW + LWE - DPL, CT or Serial Exam
26
Q

Positive Result of DPL

A
  1. WBC > 500 ml
  2. Amylase > 19
  3. ALP > 2
  4. Bilirubin >0.01
  5. RBC
    a. AASW > 100,000
    b. Thoraco abdominal >10,000

if between 1,000 - 10,000 do laparoscopy or thoracoscopy

27
Q

Areas of FAST

A
  1. subxiphoid
  2. morison’s pouch/ hepatorenal recess
  3. LUQ/ perisplenic
  4. pelvis

> 250 ml blood

28
Q

What age is cricothyroidotoy is contraindicated

A

< 8 years old can cause subglottic stenosis

29
Q

What is the immediate management of air embolism

A

Trendelenberg position to trap air in the left ventricle

30
Q

What is the blood loss of a rib fracture

A

100 to 200 ml

31
Q

What is the blood loss of a pelvic fracture

A

> 1000 ml

32
Q

What is the blood loss of a tibial fracture

A

300 to 500 ml

33
Q

What is the blood loss of a femur fracture

A

800 to 1000 ml

#DAY3_SURGERY (16 decks)

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