Trauma #3

Question 1

Blast injuries: Secondary

Answer 1

Victim being struck by projectiles from blast force

-penetrating or blunt

Question 2

Blast injuries: Tertiary

Answer 2

Victim impacting the ground to another object

Question 3

CO production in burn setting

Answer 3

Any incomplete combustion

-complete combustion is rare

Question 4

Cyanide production in burn setting

Answer 4

Incomplete petroleum combustion

-especially carpet

Question 5

Adult UO goal I’m burn pt

Answer 5

30-50 ml or 0.5 ml/kg/hr

Question 6

Pediatric UO goal for burn patients

Answer 6

Babies: 2 ml/kg/hr
Kids: 1 ml/kg/hr

Question 7

When are Parkland formula or consensus formulas implemented during burn resuscitation?

Answer 7

Once desired UO are achieved

Question 8

Parkland formula

Answer 8

4 ml/kg/%BSA
1/2 over 1st 8 hours
1/2 in 16 hours

Question 9

Consensus formula

Answer 9

2-4 ml/kg/%BSA

Question 10

Burn mortality %

Answer 10

Age + BSA (2nd&3rd degree) = mortality %

-add 20% if respiratory involvement.

Question 11

Adult Rule Of 9’s

Answer 11

Head: (front) 4.5 (back) 4.5
Torso: (front) 18 (back w/ buttocks) 18
Arms: (front) 4.5 (back) 4.5
Groin: 1
Legs: (front) 9 (back) 9

Question 12

Pediatric rule of 9’s

Answer 12

Head: 18%
Trunk: 18, back: 18
Arms: 9
Groin: 1
Legs: 13.5

Question 13

Only chemical burn with which you should neutralize

Answer 13

Hydrofluoric acid.

• copious amounts of fluid,
• 10% calcium Gluconate infiltrated into tissues

Question 14

Alkali metal burns

Answer 14

React with water

Sweep off and irrigate with cooking oils (absorbs heat)

Question 15

Acid chemical burns

Answer 15

Most acids cannot penetrate deep into tissues
Cause coagulate necrosis (self limiting)
Acids denature cellular proteins and cause cellular coagulation

Question 16

Alkali chemical burns

Answer 16

• Dissolve protein and collagen causing dehydration and saponification (Turning into soap).
• tend to cause more damage and severe burns
• they’ll keep working as long as they are given elements to react with .

Question 17

Myoglobinuria

Answer 17

• Secondary to electrical burns.
• large intramuscular protein which stores O2 (slow twitching muscle)
• clogs kidneys
• can result in ATN and renal failure
• tx with fluids to maintain UO to 100 ml/hr, osmotic diuresis, bicarbonate solution.

Question 18

Why is a bicarbonate soln administered to myoglobinuria?

Answer 18

Causes proteins to become less polar
Diffused easier into glomerier structures
Diffuses into urine, urine becomes more polarized.
Proteins cannot escape urine

Question 19

Categorizations of triage tags

Answer 19

Green: walking wounded: level III: priority 3
Yellow: delayed: level II: priority 2
Red: immediate: level I: priority 1
Black: Dead: Priority 0

Question 20

Triage immediate criteria

Answer 20

Respirations: abnormal rate, WOB, distress
Perfusion: central cap refill >2 seconds
Mentation: ALOC 
Also:
-penetrating trunk trauma 
-injured rescuers

Question 21

Triage delayed criteria

Answer 21

Respirations: normal pattern or agonal
Perfusion: central cap refill normal
Mentation: Alert and oriented x3

Question 22

How much time should be spent with each patient in a triage situation?

Answer 22

15-30 seconds

Question 23

Blast injuries Primary injuries

Answer 23

Injuries due to primary blast,

Air containing organs (lungs, bladder, stomach, ears)