Trauma Flashcards
How many trauma-related deaths occur each year?
5,000,000
This works out to almost ten per minute!
One crucial aspect of the primary survey ABCDEs is that _____________.
they should be done in order; that is, stabilize the patient’s airway prior to controlling their hemorrhage
What are the primary survey ABCDEs?
A: airway (maintain a patent airway with cervical spine stabilization)
B: breathing (check to see if the patient is breathing; if not, ventilate)
C: circulation (assess for bleeding or shock)
D: disability (neurologic impairment)
E: exposure (was this caused by an external source that might be causing harm?)
How should you assess airway?
With a few different tools:
•Ask the patient to speak. If they speak in a normal voice, then the airway is likely patent. If there is stridor or voice changes, then the airway might be compromised.
•Look for things that might be occluding the airway (e.g., foreign bodies, pooling secretions).
• Assess facial or throat injury.
What do you do in case of a compromised airway?
- Immobilize the C-spine and thrust jaw forward
- Intubate
- Cricothyrotomy
How do you assess breathing?
- Inspect: Is the patient breathing? Is there accessory muscle use? Is the chest asymmetrically rising?
- Auscultate: Stridor and breath sounds
- Percuss: dullness, hyper-resonance, etc.
Where are needles inserted in tension pneumothorax?
Mid-clavicular line, second intercostal space, superior to the rib
What are some ways to assess circulation?
- Is the patient bleeding?
- Feel the pulses
- Check cap refill
Why might a person in shock not mount a tachycardic response?
- If they are a conditioned athlete
- If they are taking drugs that lower catecholamine response (e.g., beta-blockers or CCBs)
- Neurogenic shock
- Weak heart (like in the elderly)
Typically, you need to lose about ______ percent of your blood to become hypotensive.
30
How is disability assessed?
AVPU Is the patient... Alert? Vocal responsive? Pain responsive? Unresponsive?
After the ABCDEs, you’re supposed to “log roll” a patient. Why?
Using special boards to stabilize the patient, you’re supposed to roll them over to feel the spine for sudden drop-offs.
What is the “exposure/environment” assessment?
Disrobe the patient to check for hidden injuries.
What does FAST stand for?
Focused Assessment Sonography in Trauma
Most spinal injuries are _______________.
cervical
What is a flail chest?
Two or more fractures in contiguous ribs that leads to a free-floating segment of chest that moves in the opposite direction as the rest of the chest wall during inspiration and expiration.
What is Grey-Turner’s sign?
Bruising along the flanks that suggests retroperitoneal hemorrhage
What are the five P’s of compartment syndrome?
- Pallor
- Pulseless
- Painful
- Paresthesia
- Poikilothermic
A “definitive airway” is ____________.
intubation
What is a disadvantage of bag ventilating a patient prior to an anticipated intubation?
Bagging a patient also inflates the stomach. Inflated stomach increases the risk of vomiting which may cause aspiration.
What needle gauge is used in chest tubes?
16 gauge
With tamponade, the treatment is different for blunt and penetrating causes: ______________.
penetrating trauma usually requires open-heart surgery, while blunt trauma can often be treated with pericardiocentesis
In someone with a pneumothorax, PPV can _______________.
make the pneumothorax worse
Using vitals, how can you distinguish an internal bleed in the head versus elsewhere in the body?
- Head bleeds will cause increased ICP that will lead to hypertension and bradycardia.
- Bleeds elsewhere in the body lead to hypotension and tachycardia.
True or false: retroperitoneal bleeds can be diagnosed with the FAST exam.
False. CTs are needed to determine retroperitoneal.
What is the secondary survey?
Looking head to toe for other injuries.
