Trauma

Question 1

Describe the Primary Survey

Answer 1

ABC’s. Life threatening conditions are identified and treated.

Question 2

Primary Survey: A

Answer 2

Airway. With cervical spine control. If patient is speaking, it is patent. Assess for blood, obstruction, noisy breathing, secretions. Treat as needed. Jaw thrust, LMA, ETT, Surgical airway

Question 3

Primary Survey: B. Life threatening conditions?

Answer 3

Breathing. Aspiration, tension pneumothorax, open pneumothorax, flail chest, spinal cord injury, head injury,

Question 4

Primary Survey. C. 3 elements of observation.

Answer 4

Circulation.

1. Level of consciousness. IMparied when blood volume reduced by half
2. Skin color
3. Pulse

Question 5

Primary Survey. D.

Answer 5

Disability. Neurological status. (AVPU)
A: Alert?
V: Responds to vocal stimuli?
P: Responds to painful stimuli?
U: Unresponsive 

Assess movement of all extemities

Question 6

Primary Survey: E.

Answer 6

Exposure.

Question 7

Standard Resuscitation during primary survey

Answer 7

1. Supplemental O2
2. Two large bore IV
3. 2 Liters crystalloid then PRBCs. MTP prn
4. ECG
5. Urinary and gastric catheters.

Question 8

Secondary Survey: Head and neck

Answer 8

Eyes: Pupils
Scalp
Maxilla/Mandible
Nares and oropharynx. 
TM and external auditory canal

Neck/C-Spine: JVD. tracheal deviation, subQ air. Palpate C-spine.

Question 9

Glascow Coma Scale Scoring

Answer 9

Eye Opening:
 Spontaneous: 4
 Speech: 3
 Pain: 2
 None: 1

Motor Response
 Verbal: 6
 Pain Localizes: 5
 Withdraws: 4
 Decorticate flexion: 3
 Extensor: 2
 None: 1

Verbal Response
 Oriented: 5
 Confused: 4
 Innapropriate: 3
 Incomprehensible: 2
 None: 1

Question 10

Estimated Fluid and Blood Requirements. Class 1-4. Class 3 criteria?

Answer 10

Blood Loss: 1500-2000
Pulse: >120
BP: Decreased
Respiratory Rate: 30-40
Urine Output: 5-15 ml/hr
Mental Status: Anxious and Confused
Fluid Replacement: PRBC

Question 11

Described 9% rule for body surface in burn

Answer 11

Head and neck = 9%
Upper Trunk = 9%
Posterior Upper Trunk = 9%
Entire Arm = 9% (18%)
Lower Trunk = 9%
Posterior Lower Trunk = 9%
Leg = 18% x2