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Critical Care <3 > Trauma > Flashcards

Trauma Flashcards

1
Q

What is the first hour of emergent care called and what does it involve?

A

Golden hour
focuses on rapid assessment, resuscitation, and treatment of life threatening injuries

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2
Q

Who are part of the trauma team?

A

EMS
Trauma surgeon
emergency physician
anesthesiologist
trauma nurse leader
trauma resuscitation nurse
scribe
pharmacist
RT
lab
radiology
physician specialist

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3
Q

who is the overall team leader?

A

Trauma surgeon

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4
Q

What does a primary survey involve?

A

most crucial assessment tool within 1-2 minutes
used to identify life threatening injuries accurately, establish priorities and provide interventions

uses ABCDEFG mnemonic

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5
Q

What does the mnemonic ABCDEFG stand for?

A

Airway
Breathing
Circulation
Disability (neuro)
Exposure
Full set of vitals and family
Get resuscitation adjuncts

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6
Q

What does secondary survey involve?

A

initiated after resuscitation

Head to toe assessment
assess each region of body for any missed injuries

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7
Q

Secondary survey
MIST acronym

A

Mechanism of injury
Injuries sustained
Signs and symptoms in the field
Treatment in the field

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8
Q

Secondary survey SAMPLE acronym

A

Symptoms
Allergies
Medications
Past medical history
Last oral intake
Events and environmental factors

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9
Q

what are the three elements that are considered the trauma triad of death?

A

Hypothermia
hypotension
acidosis

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10
Q

ABCDEFG: Airway assessment

A

stridor
central cyanosis
nasal flaring
trauma to face or mouth
inability to speak

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11
Q

ABCDEFG: Breathing assessment

A

asymmetrical chest movement
open chest wounds
dyspnea
low or high resp rate

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12
Q

ABCDEFG: Circulation assessment

A

presence of pulses
weak, thready
pallor
MAP < 65
obvious hemorrhaging

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13
Q

ABCDEFG: Disability assessment

A

Neuro status
GCS < 13
posturing
lack of sensations

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14
Q

What is FAST ultrasound?

A

provides rapid means of diagnosing accumulation of blood or free fluid in peritoneal cavity or pericardial sac

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15
Q

What is E-FAST?

A

ultrasound that diagnoses accumulation of blood but also extends to chest injuries like hemothorax and pneumothorax

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16
Q

What do you need to monitor during fluid resuscitation?

A

Urine output (0.5 mL/kg/hr)
LOC
HR
BP
Pulse pressure
Labs
MAP

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17
Q

What can happen with excessive fluid resuscitation?

A

Dilutional coagulopathy
third spacing
Edema
abdominal compartment syndrome
ARDS
AKI
MODS

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18
Q

What is TEG?

A

thromboelastography
evaluates whole blood coagulation and identifies coagulopathy

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19
Q

What is the purpose of exposing the patient?

A

full body visualization

20
Q

Interventions to prevent prolonged hypothermia?

A

warmed IV fluids
warm the room
warm blankets
cover patients head

21
Q

Classic signs of cardiac tamponade?

A

Beck’s triad: hypotension, muffled or distant heart sounds, elevated venous pressure/distended neck veins

22
Q

What are some possible ECG presentations for cardiac tamponade?

A

PVCs, A-fib, bundle branch block, or ST segment changes

23
Q

What should you anticipate as the treatment for cardiac tamponade and what equipment should you obtain?

A

pericardiocentesis
obtain equipment for emergency thoracotomy in case arrest occurs

24
Q

How does the patient with a pneumothorax present?

A

resp distress
tachypnea
tachycardia
diminished breath sounds
and chest pain

25
Q

What are the interventions for pneumothorax?

A

provide oxygen
anticipate chest tube

26
Q

What is a tension pneumothorax and how does it differ from a normal pneumothorax?

A

TP is always severe and fatal
air enters the pleural cavity with no escape and air accumulates with each breath
causing mediastinal shift and collapse

27
Q

What is a pulmonary contusion?

A

bruising to lung tissue causing inflammation and edema

28
Q

what is the presentation of a pulmonary contusion?

A

worsening dyspnea
ineffective cough
hypoxia
chest wall abrasions
chest pain

29
Q

Nursing interventions for pulmonary contusion?

A

anticipate mechanical ventilation
supplemental oxygen
pain relief IV narcotics

30
Q

What are the three levels of triage?

A

emergent, urgent, and delayed

31
Q

What is the emergency severity index?

A

Tool used to categorize patients based on their needs

32
Q

Explain the tiers of the emergency severity index

A

1.) Resuscitation, immediately dying
2.) High risk
3.) two or more resources need
4.) one resource needed
5.) no resources needed

33
Q

What is flail chest?

A

Occurs when three or more ribs are broken in at least two places
stability of chest wall is disturbed

34
Q

How does flail chest impact overall health?

A

Pain
altered gas exchange
permanent chest wall deformity

35
Q

Expected manifestations of flail chest

A

severe pain
tachypnea
shallow breaths
splinting
abnormal rise of chest
retractions

36
Q

Diagnostics for flail chest

A

chest x ray
lab
hemodynamics
ABGs

37
Q

What is compartment syndrome?

A

increased pressure within muscle compressing nerves, blood vessels which can lead to necrosis

38
Q

What are the Six P’s?

A

Pain
pressure
pallor
pulses
paresthesia
paralysis

39
Q

What can you expect in the assessment of a patient with suspected compartment syndrome?

A

increased pain
no relief from analgesia
pain with extension of first digit

40
Q

What can you anticipate as the treatment for compartment syndrome?

A

fasciotomy

41
Q

what is rhabdomyolysis and what are the interventions?

A

muscle damage
aggressive fluid resuscitation to flush out myoglobin and prevent aki

42
Q

What do you do if there is no drainage from a chest tube?

A

Check for kinks or clots
assess placement
verify suction
check for air leaks

43
Q

What do you do if there is continuous bubbling in water seal chamber?

A

check connection from patient to drainage system
could mean an air leak
assess the patient

44
Q

What do you do if the chest tube gets disloged?

A

apply a sterile occlusive dressing over insertion site
put tube in sterile water

45
Q

What do you do if chest tube become clogged?

A

gently milk the tube

46
Q

What do you do if the chest tube system is not bubbling at all?

A

check suction source
assess water seal
assess patient

47
Q

When should you report to the provider on the drainage amount from chest tube?

A

more than 200 mL per hour

Critical Care <3 (16 decks)

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