TRAUMA Flashcards
What is silver trauma?
major trauma in a patients >65yrs
What are the signs of OCCULT HAEMORRHAGE
- A heart rate > 90 bpm
*Altered GCS (different from the patient’s baseline)
*The systolic blood pressure less than 110 mmHg
SIGNS OF SHOCK!
What is Rhabdomyolysis
serious medical condition that occurs when damaged muscle tissue releases its proteins and electrolytes (myoglobin, creatine kinase (CK), aldolase, and lactate) into the blood.
Potassium (K+) builds up due of Muscle Dystrophy
Myoglobin enters bloodstream and damages organs
what is kinematics
Kinematics is the branch of mechanics that studies the motion of objects without considering the forces that cause the motion
What is displacement?
The change in position of an object.
Example: The movement of a vehicle during a collision
What is velocity?
The speed of an object in a given direction.
Example: The speed at which a patient was ejected from a vehicle
What is acceleration?
The rate of change of velocity
.Example: Deceleration forces experienced during a sudden stop
What is a blunt trauma?
impact without penetration
What is a penetrating trauma?
Object pierces the skin and enters the body
What is newtons 1st law of motion?
A body in motion will remain in motion and a body at rest will remain at rest unless acted on by an outside force
What is newtons 2nd law of motion?
second law, the force on an object is equal to its mass times its acceleration.
Mass x acceleration / deceleration = Force
What is newtons 3rd law of motion?
For every action there is an equal and opposite reaction.
What are shearing injuries?
(tearing) of the internal lining, tissues, and blood vessels leading to internal -
*Organs affected – Brain, abdominal organs (especially liver, spleen)
*Bones – Ankles, Femurs especially when in conjunction with trapped patients
What is Waddel’s Triad
injuries relating to paediatric patients involved in RTA
Waddell’s Triad consists of three primary injuries:
Femoral Fracture: This is a break in the thigh bone, one of the most robust bones in the body. In a pedestrian-vehicle collision, this injury is usually caused by the vehicle’s direct impact on the child’s leg.
Intra-abdominal or intra-thoracic injury includes damage to internal organs such as the liver, spleen, or lungs. These injuries occur due to the blunt force of the collision and the secondary impact of the body against the ground or other objects.
Head Injury: This can range from mild concussions to severe traumatic brain injuries (TBI). The head injury results from the child being thrown to the ground or hitting a hard surface post-impact.
3 stages of recovery?
Primary
*Barotrauma, Shrapnel, ENT trauma, Shearing injuries
Secondary
*Shrapnel, blunt force trauma from debris
Tertiary*Blunt force trauma, Crush injuries, Falling debris of objects
How many bones in the body?
206
Anatomy of a long bone?
Diaphysis
Shaft, compact bone
Periosteum
Fibrous connective tissue covering bones
Epiphyses
‘Ends’, compact bone enclosing spongy boneArticular cartilage
Epiphyseal line
Remnant of epiphyseal plate, growth
Yellow marrow (medullary cavity)
Fat store
Red marrow
Also in medullary cavity of infantsIn cavities of spongy bone (flat bones and epiphyses of long bones) in adults
Define Fracture
the break in the continuity of a bone, *complete or incomplete.
A simple Fracture?
involves a clean break with little damage to surrounding tissues and no break in the overlying skin
Pathology fracture?
a fracture through diseased or abnormal bone, usually resulting from a force insufficient to fracture a normal bone. Tumour, infection, congenital bone defects, and osteoporosis are among the causes).
Dislocation
abnormal separation of joint surfaces, they can occur in isolation or be associated with a fracture/s. since joints are kept in place by soft tissues such as ligaments, these will have been injured for a dislocation to occurred
Soft tissue injury
damage to the muscles, ligaments, and/or tendons. The result can be pain, swelling, bruising, and damage. Soft-tissue injuries are classified as the following: contusions (bruises), sprains; tendonitis; bursitis; stress injuries; strains.
What is the approximate internal blood loss associated with a unilateral femur fracture?
1000-2000mls
Define sprain?
Stretching or tearing of ligament
Define strain
Stretching or tearing of Muscles and tendons
Pelvic injury signs and symptoms?
*Pain in pelvis
*Loss of urine / bowel control
*Unstable pelvis
*Short / rotated limbs
*Obvious deformity
What is the C1 also known as
Atlas
What is the C2 also known as
Axis
What is a flexion injury?
*Forward movement- rapid deceleration
*C1-C2 unstable dislocation or fracture
*Forces can cause wedge or vertebral body fractures
*Facet Joint Dislocation
*Partial Dislocation termed a Subluxation
What is subluxation
partial separation of a joint?
How would a lumbosacral injury present?
paralysis and loss of sensation in the lower extremities.
These injuries may also result in loss of bowel control, loss of bladder contr
How would cervical/thoracic injuries present?
may result in loss of function of the upper extremities leading to tetraplegia.
Injuries above C5 may also cause respiratory compromise due to loss of innervation of the diaphragm
What is L1-L2 also known as
Cauda Equina- a collection of nerve roots, which are horsetail-like in appearance
what are circumferential burns
burns that cover a whole region
ie. torse, digit, forearm
What are the burn areas? (red box)
i don’t know how to phrase this question
FHFFP
FACE
HANDS
FEET
FLEXION POINTS
PERINIUM
What oxygen therapy would you consider for burns?
humidified oxygen
What is AcBC for crush injuries?
Airway
Cervical Spine
Breathing
Circulation
PEEP
Posture
Elevation
Examination
Pressure
For what injury is a traction splint used?
mid-shaft femur fracture
What is ACTIVE spinal motion restriction?
using inline techniques with or without spinal management devices to reduce spinal column motion
What is PASSIVE spinal motion restriction?
requesting the patient to minimise his/her movements without external intervention and allowing the patient to adopt a position of comfort
What are low risk factors for spinal injury
Any two or more of:
- involved in minor rear-end motor collision
- comfortable in a sitting position
- ambulatory (walking around) at any time since the injury
- no midline cervical spine tenderness
- no spinal column/midline pain
AND are able to actively rotate their neck 45º to the R/L
What are high risk factors for spinal injury?
- dangerous mechanism of injury
- fall from height of greater than 1m/ 5 steps
- axial load to head/base of spine
- impaired awareness (ALOC/ intoxication/ unco-operative)
- 65+
- ≤2yrs
What are spinal injury rule in considerations?
- any significant distracting injuries
- impaired awareness (ALOC/ intoxication/ unco-operative)
- immediate onset of spinal/midline back pain
- hand/foot weakness
- altered/absent sensation in hand/foot
- priapism
- history of spinal problems
- unable to actively rotate neck 45º to L/R
For a submersion/immersion incident:
why may higher pressure ventilations be required?
poor compliance resulting from pulmonary oedema
An increase in ICP results in what?
Cushings Triad:
-Increased Pulse Pressure
- decreased HR (bradycardia)
- Irregular respiration
What is Cheynes Stokes Breathing?
Abnormal Pattern of breathing seen in patients with impending death
Presents: fast shallow breathing/ deep slow breathing resulting in apnea
SEEN IN PATIENTS WITH:
- heart failure
-stroke
-TBI
-dying process
What is the primary concern of circumferential burns
CSM compromise
How long do you cool a normal burn?
10-15 mins
How long do you cool a chemical burn?
20 mins
How long do you cool a chemical burn?
20 mins
What solution is commonly used for the irrigation of splash and chemical product burns?
Diphoterine
