Trauma

Question 0

Indicate base of skull fracture

Answer 0

Raccoon eyes and Battle’s sign
Battle’s sign is mastoid ecchymosis. Look for it behind the ear
CSF rhinorrhea/otorrhea
hemotympanum

Question 1

Size of IVs used for fluid resuscitation

Answer 1

14 or 16 gauge “large bore” in the antecubital position

Question 2

Elements of the revised trauma score (RTS)

Answer 2

1. GCS
2. Systolic BP
3. Respiratory rate
   The score ranges from 1 to 8
   Survivability 60% with 4+ score

Question 3

Involves the epidermis only

Answer 3

First degree burn

Question 4

Vesicles, swelling, moist surface

Painful and hypersensitive to touch or movement of air

Answer 4

Second degree burn = partial thickness or intradermal burn

Question 5

Appear leathery, white or gray
Anesthetic to pin prick or touch
Dry

Answer 5

Third degree burn = full thickness burn

Question 6

Which burns require fluid resuscitation

Answer 6

Involving 20% or more of BSA

Question 7

How would you assess adequate fluid resuscitation?

Answer 7

Urine output 30-50 ml/ hr

Question 8

Which chemical burns are more serious

Answer 8

Alkali

Question 9

Path of least resistance in electrical burns

Answer 9

Blood vessels and nerves

Muscle closest to bone has the highest resistance and generates the most heat therefore most damage

Question 10

Special consideration for electrical burn

Answer 10

In adult maintain urine output 100ml/hr and use mannitol if nec especially with myoglobinuria

Question 11

ABCDE of trauma

Answer 11

Airway
Breathing
Circulation
Disability = GCS, loc
Exposure = remove all clothes and examine skin and back for exit wounds

Question 12

Coma cocktail

Answer 12

Dextrose
Thiamine
Naloxone
Oxygen

Question 13

cause of death in trauma

Answer 13

sepsis from hollow viscus perforation

hemorrhage

Question 14

What does hematuria suggest?

Answer 14

significant retroperitoneal injury

Question 15

tense, pale, paralyzed, paresthetic and painful extremity

Answer 15

compartment syndrome

tx: fasciotomy

Question 16

Rule for replacement of blood loss

Answer 16

3 for 1 rule: give 3 L fluid per liter of blood loss

Question 17

What does the FAST survey assess for?

Focused Assessment with sonography for trauma

Answer 17

1. hemoperitoneum
2. pericardial effusion
   Examination of 4 areas:
3. pericardium
4. perihepatic space (hepatorenal recess)
5. perisplenic space
6. pelvis

Question 18

Parkland formula

Answer 18

% BSA burned x weight (kg) x 4

Question 19

squamous cell carcinoma arising in an ulcer or burn

Answer 19

Marjolin’s ulcer

Question 20

acute duodenal ulcer seen in burn patients

Answer 20

Curling’s ulcer