Trauma Flashcards
ABCDE
Airway Breathing/ventilation Circulation with hemorrhage control Disability d/t neuro Exposure/environmental control
How do you treat a tension pneumo?
Needle compression at 2ICS MCL
GCS scale breakdown and interpretation
Eye opening 4
Verbal response 5
Motor response 6
TBI: minor 13-15, moderate 9-12, severe 3-8
Eye opening GCS
4 = spontaneous 3 = to voice 2 = to pain 1 = none
Verbal response GCS
5 = normal convo 4 = disoriented 3 = words but no coherent 2 = only sounds 1 = none
Motor response GCS
6 = normal 5 = localizes to pain 4 = withdraws to pain 3 = decorticate 2 = decerberate 1 = none
Initial fluid management of unconscious patient
2 large caliber peripheral IV catheters or central line
Initial warm fluid 1-2 L for adults
Monitor for end organ perfusion
Activated Factor 7
Rescue therapy if life threatening bleeding is unresponsive to standard tx
200 mcg/kg followed by repeat dose of 100 at 1 and 3 hrs
TXA
Antifibrinolytic agent
Useful in cardiac surgery, prostatectomy, joint replacement
Early admin in trauma patients reduces mortality
Tx for hypovolemic shock
Most common cause of shock
FLuid: 2L of NS or LR, continue until stabilized
Blood: PRBC if pt is unstable after 2L of fluid (O neg)
Signs of cardiac tamponade
Tachycardia
Muffled heart sounds
Dilated engorged neck veins
Tx for cardiogenic shock
Need to maintain BP!
Dopamine/epinephrine
Vasoconstricting drugs
Dosing of dopamine
< 5 mcg/kg/min: dilation of renal and coronary beds
5-10: B1 effects inc contractility and HR
10+ alpha effects - arterial vasoconstriction, BP inc
Neurogenic shock tx
Hypotension without tachycardia or vasoconstrcition
Tx hypovolemia - NS/LR and blood products
Then spinal cord decompression
Indications for intubation
GCS 8 or less
Need airway protection: unconscious, face fracture, aspiration risk, obstruction risk
Ventilation need: apnea, inadequate respiratory effort or severe closed head injury
