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NURS 428: Evolution > Trauma > Flashcards

Trauma Flashcards

Exam 3

1
Q

Mechanism of Injury

include:

A

Blunt injury

Penetrating injury

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2
Q

Mechanism of Injury

include: Blunt injury: What are examples?

A

Motor vehicle accidents, falls, assaults, and contact sports

Combination of forces: acceleration, deceleration, shearing, crushing, and compressive resistance

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3
Q

Mechanism of Injury

include: Penetrating injury: What are examples?

A

Foreign objects penetrating the tissue

Gunshot, stab wound

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4
Q

Initial Assessment and Management

Prehospital management: What should be maintained? What should be ensured?

A

Maintain the airway

maintain spine immobilization

ensure adequate ventilation

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5
Q

Initial Assessment and Management

Prehospital management: What should be controlled? What should be prevented?

A

control external bleeding and prevent shock

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6
Q

Initial Assessment and Management

Prehospital management: Where should the patient be transported?

A

Maintain the airway, ensure adequate ventilation, control external bleeding and prevent shock, maintain spine immobilization,

and transport to the closest appropriate facility.

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7
Q

Initial Assessment and Management

Prehospital management:

Transport to the closest appropriate facility. What does this allow for?

A

Transporting the patient to a level I facility allows definitive care to be initiated earlier in the process, thereby reducing patient mortality.

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8
Q

In-Hospital Management

What are the three surveys done?

A

Primary survey

Secondary survey

Tertiary survey

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9
Q

In-Hospital Management

Primary survey: What is included?

A

Airway, breathing, ventilation, and life-threatening injuries identified

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10
Q

In-Hospital Management

Secondary survey: What is included?

A

Detailed head-to-toe survey, plan for appropriate diagnostic tests

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11
Q

In-Hospital Management

Tertiary survey: What is included? Where are they admitted?

A

On admission to the ICU, another head-to-toe examination, assess response to interventions, labs and x-rays reviewed

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12
Q

Fluid Resuscitation:

What fluids are used?

A

Crystalloids

Colloids

Blood products

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13
Q

Fluid Resuscitation:

Crystalloids: What do they do? What kinds of fluid?

A

Expand volume status.

Isotonic, hypotonic, and hypertonic, typically at least 2 liters of isotonic (NS, LR)

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14
Q

Fluid Resuscitation:

Colloids: What do they do? What are examples?

A

Rapid volume expander

(albumin, dextran)

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15
Q

Fluid Resuscitation:

Blood products: Why are they given?

A

Hemodynamically unstable or are showing signs of tissue hypoxia despite crystalloid infusion

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16
Q

Thoracic trauma:

How do they range?

A

Minor abrasions to life threatening insults

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17
Q

Thoracic trauma:

How are they managed?

A

Managed with chest tube insertion, mechanical ventilation, aggressive pain control, and supportive care

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18
Q

Thoracic trauma:

What would result in immediate death?

A

Great vessel injuries or disruption to the heart usually results in immediate death.

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19
Q

Thoracic trauma:

What would require immediate treatment?

A

Airway obstruction, tension pneumothorax, cardiac tamponade, open pneumothorax, massive hemothorax, and flail chest require immediate treatment.

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20
Q

Thoracic trauma

What is always the priority? What should there be protection from?

A

Airway is always the priority

Oxygenation and protection from aspiration

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21
Q

Thoracic trauma

What are common causes of airway obstruction:

A

tongue,

avulsed teeth,

dentures,

secretions,

and blood.

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22
Q

Thoracic trauma

What other reasons for airway obstruction?

A

Injuries to the trachea, thyroid cartilage or cricoid process

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23
Q

Abdominal trauma:

What types exist?

A

Blunt or penetrating

24
Q

Abdominal trauma:

What areas can be injured here?

A

Peritoneal area (diaphragm, liver, spleen, stomach, transverse colon and portion covered by bony thorax)

Retroperitoneal area (aorta, vena cava, pancreas, kidney, ureters, parts of duodenum and colon)

Pelvis (rectum, bladder, uterus, iliac vessels)

25
Q

Abdominal trauma:

Peritoneal area include:

A

Peritoneal area (diaphragm, liver, spleen, stomach, transverse colon and portion covered by bony thorax)

26
Q

Abdominal trauma:

Retroperitoneal area

A

Retroperitoneal area (aorta, vena cava, pancreas, kidney, ureters, parts of duodenum and colon)

27
Q

Causes of abdominal trauma:

What is the most common cause?

A

MVAs most common

Assaults, falls, pedestrian-motor vehicle collisions, industrial accidents

28
Q

Causes of abdominal trauma:

What are symptoms?

A

Abdominal tenderness or guarding
hemodynamic instability
Lumbar spine injury
Pelvic fracture
Retroperitoneal or intraperitoneal air
Unilateral loss of psoas shadow on radiograph

29
Q

Causes of abdominal trauma:

When is the abdomen assessed?

A

During the secondary survey, the abdomen is assessed and reassessed, and laboratory and diagnostic tests are performed.

30
Q

Priorities for abdominal trauma:

What is inserted?

A

orogastric or nasogastric tube, and Foley catheter

31
Q

Priorities for abdominal trauma:

What are ways that assessments are done?

A

Local wound exploration

Laparoscopy, thoracoscopy, or exploratory laparotomy

Focused abdominal sonography for trauma (FAST), a chest radiograph, and an abdominal CT scan

32
Q

Focused Assessment with Sonography for Trauma (FAST):

What does this do?

A

Noninvasive
Determines potential sources of bleeding

33
Q

Focused Assessment with Sonography for Trauma (FAST):

Determines potential sources of bleeding- where?

A

Peritoneal cavity

Pericardial sac

34
Q

Blunt /penetrating abdominal trauma

Blunt: What does this mean?

A

damage to solid organs

35
Q

Blunt /penetrating abdominal trauma

Blunt - damage to solid organs
How?

A

Fractures of solid organ capsules and parenchyma

36
Q

Blunt /penetrating abdominal trauma

Penetrating trauma: What is it?

A

– damage to hollow organs

37
Q

Blunt /penetrating abdominal trauma

Penetrating trauma: – damage to hollow organs

What happens when hollow organs are damaged?

A

Hollow organs collapse and absorb the force

38
Q

Blunt /penetrating abdominal trauma

Penetrating trauma: – damage to hollow organs

What is vulnerable to penetrating trauma?

A

Bowel is vulnerable to penetrating trauma

39
Q

Blunt /penetrating abdominal trauma

Complications

A

Intolerance to tube feedings
Peritonitis
Post op bleeding
Hypovolemia
Fistula or obstruction

40
Q

Musculoskeletal Injuries;

How are they generally?

A

Generally not life-threatening barring traumatic amputation or pelvic fracture

41
Q

Musculoskeletal Injuries;

When is assessment for this done?

A

Assessment is done in secondary survey after hemodynamic stablilization

42
Q

Musculoskeletal Injuries;

What are causes for this?

A

Cause: MVA, falls, assaults, industrial, farming, home accidents

43
Q

Musculoskeletal Injuries;

What is important to understand?

A

Important to understand the circumstances surrounding the injury and the mechanism of injury.

44
Q

Priorities-musculoskeletal

What should be obtained?

A

Obtain films of cervical spine, chest and pelvis, CT, MRI

45
Q

Priorities-musculoskeletal

What should be monitored?

A

Cautious monitoring of limb swelling, ecchymosis or deformity is noted, extremity should be immobilized

Monitor for vascular or neurologic compromise

46
Q

Priorities-musculoskeletal

What should be checked?

A

Check capillary refill (should be < 2 seconds)

Check pulses, presence of crepitus, muscle spasm, movement, sensation, pain

47
Q

Complications of musculoskeletal injury

A

Infection

Compartment syndrome

Deep venous thrombosis

Pulmonary embolus

Fat embolism syndrome

48
Q

Maxillofacial trauma:

Degree of injury is related to what?

A

Maxillofacial trauma

49
Q

Maxillofacial trauma:

What is priority?

A

Priority- airway, breathing and circulation

50
Q

Maxillofacial trauma:

What should be assessed?

A

Assess soft tissues as well as bony structures

Assess cranial nerves

51
Q

Maxillofacial trauma:

What should be ensured?

A

Ensure tetanus vaccination for soft tissue injury

52
Q

Maxillofacial trauma:

What exam should be done?

A

Neuro exam

53
Q

Multiple trauma

What are early complications?

A

Early: severe head injury, hemorrhage

54
Q

Multiple trauma

What are late complications?

A

Late: hypovolemic shock, infection, septic shock, ARDS, SIRS, MODS

NURS 428: Evolution (13 decks)

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