Trauma 3

Question 1

What do we do when a patient arrives immediately following trauma?

Answer 1

1. Rule out head and other more urgent body injuries.
2. Assess for possible aspiration.

Question 2

4 signs of head trauma?

Answer 2

1. History of loss of consciousness.
2. History of nausea/ vomiting.
3. Child acting “out of character”.
4. Visual disturbances.

Question 3

7 extraoral signs of trauma to look for?

Answer 3

• Abrasions.
• Lacerations.
• Palpate and look for signs of skeletal fractures (asymmetry).
• Inferior border of mandible.
• Zygomatic arch.
• Battle signs.
• Bilateral periorbital bruising.

Question 4

6 intraoral signs of trauma?

Answer 4

• Bruising.
• Hematoma (around side of mandible could suggest mandibular fracture).
• FOM.
• Lacerations.
• Degloving injuries.
• Soft tissue displacement. Suturing?

Question 5

What do steps in occlusion suggest?

Answer 5

Maxillary/ mandibular fracture.

Question 6

What could mandibular deviation on opening suggest?

Answer 6

Condylar fracture

Question 7

What do you do if there is doubt that an aspiration event has occured?

Answer 7

Contact local A+E/ hospital for further advice.

Question 8

What do you do if you suspect a skeletal fracture?

Answer 8

Refer to hospital with urgency.

Question 9

What do you do when in doubt that there may have been a non-accidental injury to a child?

Answer 9

• Practice policy.
• Regional health board policy.

Question 10

9 pieces of information you would like to keep in the notes for a patient with a potentially non accidental injury?

Answer 10

• Phone number.
• Current address.
• GP details.
• GDP details.
• Current school.
• Who lives at home.
• Who is legal guardian.
• Who has brought them.
• Social worker details if there is one.

Question 11

6 typical sites of accidental injury?

Answer 11

• Forehead.
• Nose.
• Chin.
• Elbow.
• Knees.
• Shins.

BONY PROMINENCES.

Question 12

What is the triangle of safety?

Answer 12

Ears, side of face and neck, top of shoulders.
INJURIES IN THIS AREA ARE UNUSUAL.

Question 13

5 things that would raise concern regarding injuries in children?

Answer 13

• Injuries to both sides of the body.
• Injuries to soft tissue.
• Injuries with particular patterns.
• Any injury that doesn’t fit the explanaiton.
• Delays in presentation/ untreated injuries.

Question 14

10 typical sites of non accidental injuries.

Answer 14

• Black eyes (esp. bilateral).
• Soft tissues of cheeks.
• Intra-oral injuries.
• Forearms.
• Chest and abdomen.
• Inner aspects of arms.
• Back and side of trunk.
• Any groin/ genital injury.
• Inner aspects of thighs.
• Soles of feet.

Question 15

What is the flowchart for when a practitioner has concerns about a childs welfare?

Answer 15

Slide 24, 25