Trauma Flashcards
Most common rural accident
head on
Primary stage of blast injury
pressure waves hollow organs collapse
Secondary stage of blast injury
struck by flying objects
Tertiary stage of blast injury
victim propelled through air and impact other objects
Best fluid for replacement in shock
plasma, packed cells, or whole blood
1st stage of hemorrhage in shock
up to 15% loss, BP maintained by constriction of vascular bed
2nd stage of hemorrhage in shock
15-25% loss, card output not maintained by arteriole constriction inc HR/RR, BP maintained by catecholamines. cool, pale, slight distal pulse
3rd stage of hemorrhage in shock (decompensated)
25-35% loss, tachycardia, tachypnea, hypotn, alt mentation, cool/pale skin, no distal pulse due to shunting
4th stage of hemorrhage in shock (irreversible)
loss >35%, hypotn, lethargy, squeezing of filter organs, start MODS
Abrasion
outer most layer of skin damaged with or without flap
Laceration
break in skin with jagged ends
Animal bites
always transport & report to animal control or PD
Causes of burns
thermal, electrical, chemical, radiation
Electrical burns
have entrance and exit, can cause vascular and nerve damage
Rule of nines child
Rule of nines adult
Palmar method
surface of pt hand is 1% body surface
Complications of burns
immediate - hypovolemia/hypothermia
delayed - infection
shock due to plasma loss (third spacing)
Parkland formula
4ml X wieght(kg) X BSA % burned
given over 24 hrs, 1/2 volume given in first 8 hr
Carbon monoxide inhalation s/s
headache, confusion, cherry-red lips. cyanotic with false high pulse-ox ,hypoventilating, non-responsive modled skin
Dry ice burn tx
immerse in warm water 100-104
meninges
dura mater, arachnoid, pia mater
Cerebrum
grey matter, personality, intelligence, judgement
Cerebellum
balance, coordination, muscle tone
Brain stem (mid brain, pons, medulla)
BP, HR, RR conciousness
Afferent nerves VS Efferent nerves
Afferent - sensory nerves traveling from body to brain(ascending)
Efferent - sensory nerves traveling from brain to body (descending)
Neurogenic shock
occurs with spinal injury. hypotn but not tachycardic
skin dry and warmand could be red
Hyphema
blood in anterior chamber of eye
Subdural hematoma
venous, slow altered metation over time
Epidural hematoma
arterial unconcious, then conscious, then unconcious
Subarachnoid hematoma
worst headahce of life, think its a migraine
target is femail 19-20 on the pill
Mannitol
osmotic diuretic temporary measure for inc ICP
Multiple attempts at ET with inc ICP will cause
more ICP, bradycardia and other dysrhythmias
Traumatic asphyxia
bluging eyes and tongue, cyanosis, JVD, in metabolic acidosis give bicarb
Plueral decompression
2nd and 3rd intercostal space midclavicular
decompress prior to ET, IV, or transport
Causes of flat neck veins
dehydration
hemothorax
hypovolemia
Pulsus paradoxus
as inhale distal pulse fades, as exhale pulse reappears
Flail chest
2 or more ribs in 2 or more places
paradoxical movt
definitive tx - pos pressure vent, place bulky dressing on expiration
Thoracic aorta injury
chest pain and pain between shoulder blades, unequal radial pulses
Abd injuries
peritoneum - lining of abd cavity
abd distention/rigidity 1.5 - 2 L of blood loss
Evisceration tx
moist sterile saline, keep warm
occlusive dressing
do not push back into body
Fracture/dislocation 6 P’s
pain pallor paresthesia
paralysis pressure pulse
Most commonly fractured bone
clavicle
Complications of fractures/dislocations
nerve and vascular(worst possible)
stokes basket
used to transport over difficult terrain
