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Old Officer study material > Trauma > Flashcards

Trauma Flashcards

0
Q

If a trauma facility is on bypass then where do we go?

A

To the next closest APPROVED trauma facility

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1
Q

Jump START triage is for ages?

A

1-8

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2
Q

On scene times of for trauma alerts > 10min are to be documented where?

A

in the ePCR report

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3
Q

IV fluids are to be given for SBP under ____ and at what rate?

A

less than 90 at a rate to maintain peripheral puses typically 80-90.

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4
Q

What is the minimum persons to accompany T.A.s?

A

1 paramedic and 1 EMT

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5
Q

What are the ONLY things to interrupt the primary survey?

A

Unsafe scene or Airway obstruction

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6
Q

What is the goal of START triage ?

A

greatest good for the greatest number of patients.

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7
Q

In secondary triage, where do infants start the evaluation from?

A

The Entire JUMP START algorithm.

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8
Q

What are the Gray criteria for T.A?

A

On blood thinnners with high risk of bleeding or hx, or bleeding disorder

65yrs or > blunt trauma w/ borderline criteria or symptoms
65yrs or > w/ SBP < 110mmHg
MVC > 20mph with seatbelt marks on the torso.
MVC w/ partial ejection from automobile
End stage renal ds or dialysis

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9
Q

Trauma alert ages are what?

A

Adult 16 or older

pedi 15 or younger

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10
Q

What are the Pediatric Gray criteria?

A

Musculoskeletal trauma on blood thinners w/ high risk of bleeding or hx of bleeding ds.

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11
Q

What are the T.A airway criteria in pediatrics?

A

RR < 20 in infant < 1yr.

RR< 10 in children 1-15yrs of age

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12
Q

Systolic BP in pediatric T.A criteria is?

A

BP < 50mmHg.

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13
Q

What is the height requirement for T.A in pediatrics?

A

Fall > 10ft or 2-3x height of the child

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14
Q

Resuscitation should not be attempted for trauma pts that have?

A

All 3 presumptive signs of death:
Fixed and dilated pupils
apnic
pulseless.

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15
Q

Injuries incompatible with life are:

A

Massive crush injury, decapitation, incineration

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16
Q

No resuscitation on trauma pts in cardiac arrest unless?

A
  1. Occurred in presence of Fire Rescue
  2. regained pulses after needle decompression
  3. result of electrocution or lightning injury
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17
Q

When MAY bilateral needle decompression be performed?

A

Pt’s having sustained PENETRATING chest trauma and are in cardiac arrest or arrested in the presence of fire rescue.

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18
Q

When can CELOX RAPID be used?

A

with a severe Junctional hemorrage.

ie. neck, axillary, thoracic, abd, pelvis or groin

19
Q

What size ET tubes should be considered in pedi for controlling a burn pt and why?

A

0.5-1.0 size smaller to accommodate swelling

20
Q

What is the treatment for a flail segment?

A

Bulky dressing

21
Q

What are the s/s of Tension Pneumo?

A 
Absent or diminished breath sounds on the affected side with any or all:
SOB
pluretic CP
Tracheal deviation
HYPERresonance on the affected side
JVD
poor compliance w/ BVM
hypotension
22
Q

What are the indications for Needle decompression?

A

S/S of tension pneumo and 1 or more of the following?

  1. respiratory Distress AND cyanosis
  2. decreasing LOC
  3. Loss of a radial pulse
23
Q

Where is the preferred site for needle decompression?

A

Anterior side- 2nd or 3rd intercostal space.

24
Q

Extremity fractures should be splinted how and how many attempts?

A

Splinted in place unless no pulse or unusual position of extremity.

No more than 2 attempts .

25
Q

What are the contraindications for a sager splint?

A 
Life threatening injuries
hip fx
pelvic fx
open femur fx
fx distal to the mid shaft femur
avulsion/ amputation to the ankle or foot
26
Q

Fluid resuscitation with severe head injures ( GCS of 8 or less) regardless of penetrating trauma receive fluids till?

A

SBP maintained at 110-120

27
Q

A single instance of hypotension in an adult with a brain injury increases mortality by what percent?

A

150 %

28
Q

What are the S/S of ICP and herniation?

A

decline of GCS 2 or more points
development of sluggish or non-reactive pupil
paralysis or weakness on one side of the body
Cushings triad

29
Q

Pts with ICP or herniation should be ______ at ___/____?

A

hyperventilated 20 breaths/ min

30
Q

Ventilatory rates in pediatrics w/ ICP or herniation are?

A

children 25breaths/ min

Infants 30 breaths/min

31
Q

Pediatrics BP with TBI should be maintained at:?

A

SBP normal for their age. 20mg/kg repeat PRN.

32
Q

Pediatric pt’s with a head injury should be ventilated at ______ which is different than ICP or herniation.

A

children 20 breaths / min’

infants 25 breaths / min

33
Q

Assessing the pelvis is done by?

A

gentle pressure anterior to posterior and from the sides to identify crepitus or instability. Do not repeat.

34
Q

What are the fluid bolus amts for INTERNAL hemorrage in adults?

A

500ml max of 2L

35
Q

What are the bolus amounts for Adults with ISOLATED EXTERNAL hemorrhage controlled?

A

Only enough saline to maintain peripheral perfusion 1-2L

36
Q

What are fluid resuscitation requirements for suspected internal or external hemorrhage in PEDIATRICS?

(same as post resuscitation medical)

A 
20mg/kg titrated to maintain SBP as noted.  may repeat 1x
neonates 60mmHg
Infants 70mmHg
Children 1-10yrs of age (age x2 plus 70)
Children > 10yrs 90mmHg.
37
Q

What are S/S of compensated shock in pediatrics?

A 
Anxiety, 
agitation, 
restlessness, 
normotensive,
normal to delayed cap refill
Tachycardia > 130bpm   ****except in neonates****
38
Q

What are s/s of DECOMPENSATED shock in pediatrics?

A 
Decreased LOC
hypotension
peripheral cyanosis
delayed cap refill
inequality of central to distal pulses
tachycardia going to bradycardia
39
Q

When should a cervical collar be applied?

A

complaint or finding of focal neurological deficit on motor sensory exam.

Complaint or finding of pain to the neck or back
Distracting injury
Altered LOC w/ MOI
Intoxication w/ MOI

40
Q

Helmet removal is under which circumstances?

A

Unable to manage airway
cardiac arrest
too loose to allow for proper immobilization
if the shoulder pads are removed

41
Q

What are the S/S of Neurogenic shock?

A

Skin - W/D
Hypotension with HR WNL
paralysis

42
Q

What is the tx for neurogenic shock w/ BP< 90mmHg?

A

NS 1-2L assess LS and BP q 500ml

if remains hypotensive: Dopamine 5-20mcg/kg to SBP 90mmHg.

43
Q

If a pregnant female is in cardiac arrest where is the uterus displaced to?

A

the left side for transport.

44
Q

What are the physiological changes during pregnancy?

A

HR INCREASES, and can be 15-20 bpm above normal

systolic and diaystolic Bp DROPS 5-15mmHg but may return in the 36week.

Mothers cardiac output and volume INCREASE and can loose 30-35% of blood volume before S/S appear.

45
Q

When does supine hypotension usually occur?

A

3rd trimester

46
Q

What is the consideration if pt remains HYPOtensive after displacing uterus to Left?

A

significant amt of blood loss.

Old Officer study material (30 decks)

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