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ED/Surg > Trauma > Flashcards

Trauma Flashcards

1
Q

What is triphasic dz?

A

1) sec to min - death d/t major or severe injuries
2) min to hrs - death d/t treatable but life threatening injuries
3) days to wk - death d/t multiple organ system failure/infxn

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2
Q

What is the fatal triad?

A

hypothermia
coagulopathy
acidosis

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3
Q

What is the primary survey?

A

ABCDE

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4
Q

What is secondary survey?

A

a finger in every orfice
procedures
head to to exam

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5
Q

What is tertiary survey?

A

f/u w/in 24hrs

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6
Q

What do you use FAST?

A

unstable pt in ED

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7
Q

What are initial xrays?

A

Cpsine
CXR
pelvi

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8
Q

When to use CT scans?

A

CTA of chest and other vascular injuries

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9
Q

What to watch out for in head injuries?

A

one ep of systolic BP less than 70

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10
Q

What is GCS for intubation?

A

8

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11
Q

What to look for w/ scalp injuries?

A

basilar skull fx - battle sign, hemotympanum, raccoon eyes

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12
Q

What is cushing reflex? What does this indicate? vs cushing triad?

A

slow HR but high BP
thalamic injury
triad: slow HR, high BP, widening pulses - incr diff between systolic and diastolic

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13
Q

How to tx ICP?

A 
HYPERtonic saline
mannitol
HYPERventilation
chemical parlysis - to reduce cerebral O2 demand
surgical procedures
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14
Q

What must be r/o in eye trauma?

A

ruptured globe
orbital fracutre
EOM entrapment

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15
Q

What is retrobulbar hematoma? Tx?

A

complication of eye and eyelid surgery (orbital compartment sx)
tx: lateral canthotomy

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16
Q

What to consider for face trauma?

A

unstable midface = LeFort fx

mandible fx

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17
Q

When can you r/o C spine fx?

A

NEXUS rules:

  • no midline tenderness
  • no neurologic deficits
  • no intoxicants
  • no distracting injury
  • normal mental status
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18
Q

What is chance fracture?

A

complete anterior-posterior spinal fx

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19
Q

What is associated with chance fracture?

A

mesenteric or bowel injury

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20
Q

Wht are vascular neck injuries?

A

external hemorrhage
rapidly expanding hematoma
bruit
palpable thrill

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21
Q

Young adult w/ sudden CVA sx? Tx?

A

carotid artery dissection

tx: anticoag to prevent embolic stroke

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22
Q

Cx of aortic disruption? Tx?

A

rapid deceleration - occurs at the ligamentum arteriosum

tx: surgery asap

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23
Q

Aortic disruption - imaging?

A

widening mediastinum
apical capping
tracheal displacement

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24
Q

Open pneumothorax vs tension pneumothorax?

A

open: no air movement
tension: one way valve injury

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25
Q

What are late signs of tension pneumothorax?

A

JVD and tracheal deviation

26
Q

How to tx open vs tension pneumo?

A

open: cover hole w/ 3 sides
tension: needle decompression

27
Q

Pt has PEA, what to think of?

A

pericardial tamponade

28
Q

What to think of w/ splenectomy or grade III laceration?

A

immunization against:
h flu
menigococcus
pneumoccus

29
Q

How is the liver injured in trauma?

A

cracks then BREAKS - NO rupture

30
Q

Pt is hypotensive, low urine output, firm abdomen, and high bladder pressure (30)? Tx?

A

abdominal compartment sx

laparotomy

31
Q

What labs to run if pt fell from ht?

A

ENTIRE spine + bilateral calcanei

32
Q

How to tx open fx?

A

abx

triple abx if gross or farm injury

33
Q

How to tx clavicle fx?

A

surgery

34
Q

Where can adult blood vol be lost? half of the blood vol?

A

whole blood vol: pelvic fx

half blood vol: femur

35
Q

How to tx pelvic fx?

A

close the book

36
Q

Blood at meatus, high riding prostate, perineal ecchymosis? What to check for first?

A

urethral injury

1) retrograde urethrogram
2) urinary catheter

37
Q

What ABI needs further check up?

A

less than 0.9

38
Q

Pt has petechial rash, confusion, hypoxia, bilateral pulm infiltrates, microfat in urine?

A

fat emobli from extremity injury

39
Q

What are trauma complications? Sx? Tx?

A 
compartment sx
P-allor
P-ulslessnes - late finding
P-arathesis
P-aralysis
P-ain out of proportion
tx: fasciotomy
40
Q

In what areas can pts bleed to death?

A 
C-hest
A-bdomen
R-Retroperitoneum 
T-high
S-treet/S-cene
41
Q

What emboli to worry about in extremity injury?

A

fat emboli

42
Q

What are the fluid types?

A

cyrstalloid
colloid
blood/products

43
Q

What is the ratio for fluids?

A

1:1:1

44
Q

How to tx ped trauma re: fluids?

A

1) 10-20ml/kg bolus x 2

2) blood products

45
Q

How to tx pregnant pt in trauma?

A

treat the mother = save the fetus

-prop the mom up to get off the vena cava

46
Q

What are the stages of shock?

A

early
late
irreversible

47
Q

What haps in early shock?

A

normotesnive
tachycardi
tachypnea

48
Q

What haps in late shock?

A

hypotensive
tahcy cardi
tahcypnea

49
Q

What is irreversible shock?

A

ypotensive
HR drops
RR drops

50
Q

What are the types of shock?

A

distributive
obstructive
cardiogenic

51
Q

What is distributive shock?

A

septic
neurogenic
anaphylactic
adrenal

52
Q

What are obstructive shock?

A

PE
tamponade
constrictive pericaditis

53
Q

What is the equation for BP?

A

CO x SVR

-CO depends on preload, afterload, an dcontractility

54
Q

Low SVR sx?

A

distributive shock

pink, warm bounding pulses

55
Q

High SVR sx?

A

low CO = pale, cool, thready puslses

56
Q

Sx for hypovolemic shock?

A

dec CO, Cardiovenous pressure

incr SVR

57
Q

Sx for cadiogenic shock?

A

Dec CO, LV stroke vol

incr SVR

58
Q

Sx for neurogenic shock?

A

paralysis of sympathetic shock = dec SVR, bradycardia, hypotension
pink/warm

59
Q

How to tx neurogenic shock?

A

vasopressors

O2

60
Q

What are the stages of septic shock?

A

1) SIRS
2) sepsis - infxn
3) severe sepsis - organ failure
4) shock - hypotension

61
Q

How to tx septic shock?

A

iv
abx
vasopressor
transfusions

ED/Surg (9 decks)

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