Trauma Flashcards

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1
Q

Signs and symptoms of shoulder dislocation

A
  1. Severe pain
  2. Flattened shoulder
  3. Guarding of affected limb by holding it towards the torso
  4. Numbness of the hand due to nerve damage
  5. Impaired range of motion
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2
Q

How much blood can a patient lose from a

  1. Individual rib fracture
  2. Tibial fracture
  3. Femur fracture
  4. Pelvic fracture
A
  1. 100-200 mL
  2. 300-500 mL of blood
  3. 800 - 1000 mL
  4. 2000 mL

If the fractures are open, the figures are doubled

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3
Q

What are the signs and symptoms of head and spinal injuries

A

altered level of consciousness, seizures, nausea, vomiting, decreased movement and numbness of extremities, unequal pupils, blood ore cerebrospinal fluid leaking from ears

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4
Q

What is Paraparesis

A

a partial paralysis or weakness in both lower extremities that can affect motor or sensory function.

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5
Q

Superficial (first-degree) burn

A

Involves only epidermis

Patient presents with erythema and pain at site without blistering

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6
Q

Describe the two types of second degree burns: superficial partial-thickness and deep partial thickness burns (second degree burns)

A

Superficial partial thickness: Involves epidermis and dermis resulting in thin-walled, fluid filled burns that appear pink, moist, soft and tender

Deep partial-thickness burns: Extend into reticular dermis, skin color is mixture of red and blanched white, capillary refill is slow

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7
Q

Full thickness burns

A

Burns are dry, dark brown, charred, and feel hard to the touch

If nerve endings are destroyed, sensation may be lacking

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8
Q

What is the Rule of 9s for children

A

18% for the head
18% for the chest
18% for the back
9% for each arm
13.5% for each leg
1% for genitalia

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9
Q

What are the characteristics of severe pediatric burn injuries

A
  • partial-thickness burn > 10%
  • any full-thickness burn
  • circumferential burns
  • electrical, chemical, or inhalation injury
  • burns of critical areas such as face, hands ,feet or joints
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10
Q

What is the Rule of Nines for adults?

A

For an adult, the entire head is equal to 9% of the body’s surface area.

The front and back of each arm and hand equal 9% of the body’s surface area.

The anterior torso is equal to 18% (chest equals 9% and the abdomen equals 9%) of the body’s surface area.

The posterior torso is equal to 18% of the body surface area.

The front and back of each leg equal 18% of the body’s surface area.

The genitalia equal 1% of the body’s surface area.

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11
Q

Why are pelvic fractures life-threatening and how would you manage it.

A

Life-threatening due to a significant amount of blood loss

It can be managed by
- Stabilizing the pelvis with a pelvic binder (if protocols allow) or
- Tying a sheet around the pelvis
- Securing a long device such as a scoop stretcher or long spine board to prevent further injury during transport
- treating for shock,
- rapidly transporting to a trauma center

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12
Q

What patients do not require spinal motion restriction

A
  1. a normal level of consciousness (Glasgow Coma Score 15)
  2. no spine tenderness or anatomic abnormality
  3. no neurologic findings or complaints
  4. no distracting injury
  5. no intoxication
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13
Q

Crush syndrome

A

Can develop when an area of the body is trapped for longer than four hours and arterial blood flow is compromised

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14
Q

Primary blast injuries

A

Occur due to the pressure wave caused by the explosion. Common injuries are ruptured tympanic membrane, lung injury, and injury to hollow organs

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15
Q

Secondary blast injuries

A

result from being struck by the flying debris scattered from the explosion as projectiles.

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16
Q

Tertiary blast injuries

A

result from the patient’s body being displaced against stationary objects, such as trees, buildings, or the ground

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17
Q

Quaternary blast injuries

A

are any other injury that occurs secondary to a blast injury.

18
Q

Tension pneumothorax

A

LIfe threatening condition where air builds up in the pleural space between the lungs and chest wall, increasing pressure on the chest and compressing the heart.

Occurs with blunt force trauma to the chest

SIgns and symptoms: Characterized the most by decreased or dimished lung signs on affected side

Other signs and symptoms: Difficulty breathing, tachycardia, diminished or absent lung sounds on the affected side, and possible signs of shock

19
Q

How are penetrating injuries treated?

A

By applying an occlusive dressing to ensure air does not enter

20
Q

Flail chest

A

Occurs when two or more ribs are fractured in two or more places

  • Characterized by paradoxical motion (abnormal movement of flail segment of chest during breathing, moving in the opposite direction of the chest wall during inspiration and expiration)
  • Can also lead to respiratory failure due to inability to breath properly
21
Q

Describe the four types of skull fractures?

A

Linear, Depressed, Open, Basilar

Linear skull fractures are non-displaced fractures. They are the most common type of skull fracture.

Depressed skull fractures involve the bones of the skull being pushed into the brain.

An open skull fracture is a skull fracture that occurs when a fractured bone emerges through the skin.

A basilar skull fracture involves a break in at least one of the bones at the base of the skull.

22
Q

What is the RICE mnemonic for? What are its components?

A

RICE: Rest, Ice, Compression, Elevation.

It is four steps you can take at home to treat minor soft tissue injuries

23
Q

What are the two main types of traumatic brain injury?

A

A primary brain injury is an injury to the brain and its structures associated with the brain that is a result of an impact to the head.

A secondary brain injury refers to the processes that increase the severity of the primary injury and negatively impact the outcome. The two most common causes of secondary injury are hypotension and hypoxia.

24
Q

Almost one-third of people who are killed immediately in a vehicle accident die from what type of chest injury?

A

Traumatic rupture of aorta

25
Q

How would you treat the patient’s epistaxis (nosebleed)?

A

Have the patient lean forward while sitting
Apply direct pressure, pinching the fleshy part of the nostrils together
Apply an ice pack to the nose

26
Q

How is moderate hypothermia defined? What are its signs and symptoms

A

Moderate hypothermia is defined as core body temperature between 30° - 34° C.

Signs and symptoms include loss of coordination, stiffness in the muscles, bradypnea, bradycardia, confusion, tiredness, and lethargy.

27
Q

What are the early signs of hypothermia

A

confusion, shivering, tachypnea

28
Q

How is hypothermia treated?

A

placing patient in dry environment and covering them in dry blankets. Warm fluids can also be given

29
Q

What is passive rewarming and when should it be used?

A

Passive rewarming is an appropriate first step when dealing with a patient who has mild hypothermia, like the patient in this scenario.

Passive rewarming includes placing the patient in a warm environment (e.g., the patient compartment with the heat on); removing wet clothing; applying heat packs/hot water bottles to the groin, axillary, and cervical regions; placing dry blankets over and under the patient; and giving warm, humidified oxygen.

30
Q

What is active rewarming and when should it be used?

A

Active rewarming is used for patients with severe hypothermia and is performed by ALS providers with constant temperature monitoring.

31
Q

What is the Glasgow Coma Scale (GCS) and the parameters it measures

A

T he GCS is an evaluation tool used to assess a patient’s level of consciousness

Parameters
Eye-opening scoring
Verbal response scoring
Motor response scoring

32
Q

How should you care for an amputated hand?

A

Wrap the hand in saline-moistened gauze, seal it in a plastic bag, transport it in a cool container

33
Q

What is an abdominal evisceration and how should they be treated?

A

When a patient’s abdominal organs are exposed due to injury

Cover the open wound with sterile gauze, wet it with saline solution, and secure it with an occlusive dressing

34
Q

What are key elements for a level 1 trauma centers

A
  1. have 24-hour in-house coverage by general surgeons
  2. have coverage from physicians for all specialties
  3. have a robust continuing education program for all trauma team members and provide leadership and education in the local communities
  4. include a detailed and comprehensive QA program and research all levels of trauma
35
Q

What is a sucking chest wound? How should it be treated?

A

a chest wound that creates a hole that allows air to pass between the chest and the outside environment that can be caused by a knife or gun

It is a life threatening emergency that can lead to the development of a tension pneumothorax when air enters the chest

Treatment
After airway management, it must be covered with a vented chest seal or occlusive dressing to prevent air from entering

36
Q

Compartment syndrome

A

Occurs when localized tissue swelling occurs within the muscle compartment

Caused by excessive bleeding or swelling,. When this occurs blood flow is blocked and ischemia occurs, decrease in oxygenation to the tissues kill the muscle cells.

37
Q

A fall from what height is considered a significant MOI in children?

A

> 10 feet

38
Q

What is a hemothorax? What is it caused by? What are the signs and symptoms

A

A hemothorax is a collection of blood in the pleural space.

Caused by a gunshot wound to the chest.

Signs and symptoms: shock, diminished or absent breath sounds on the affected side, dyspnea, and collapsed neck veins.

39
Q

What are signs and symptoms of late-stage hypovolemic shock

A

nausea and vomiting, tachycardia, rapid and shallow respirations, thirst, weakness, dull eyes, dilated pupils, and delayed capillary refill.

40
Q

What is obstructive shock caused by? What is an example of obstructive shock

A

Caused by an obstruction that prevents adequate blood volume from reaching the rest of the body.

One example is cardiac tamponade since it creates a pressure that prevents adequate blood flow to the rest of the body

41
Q

What is neurogenic shock caused by? Signs and symptoms?

A

Neurogenic shock occurs from a damaged cervical spine or spinal cord injury.

Presents with hypotension, bradycardia, and warm, flushed skin.