Trauma Flashcards
1
Q
What is subcutaneous emphysema?
A
Air under the skin
2
Q
Where can you get subcutaneous emphysema?
A
Anywhere air can get in; especially in the chest
3
Q
What does DIC stand for?
A
Disseminated Intravascular Coagulation
4
Q
What happens during DIC?
A
You begin bleeding from every orifice due to all of the body’s clotting factors already being used up
5
Q
What types of patients can get DIC?
A
Any patient that has a massive insult to the body. Especially prevelant in septic patients or patients that have a massive liver trauma
6
Q
What is a transected aorta?
A
An aorta that is sliced clear through
7
Q
Where does an aorta normally transect?
A
The aortic arch
8
Q
GSC scoring for eye opening
A
4 - Spontaneous
3 - Voice
2 - Pain Stimulation
1 - None
9
Q
GCS scoring for Verbal
A
5 - Oriented Conversation 4 - Confused Conversation 3 - Inappropriate Words 2 - Incomprehensible Sounds 1 - None
10
Q
GCS scoring for Motor
A
6 - Obeys Commands
5 - Localizes Pain
4 - Withdraws to Pain
3 - Abnormal Flexion of Arms & Extension of Legs (Decorticate Posturing)
2 - Abnormal Extension of Arms & Legs (Decerebrate Posturing)
1 - None
11
Q
BSA for Burnt Head?
A
9%
12
Q
BSA for Burnt Anterior Trunk?
A
18%
13
Q
BSA for Burnt Chest?
A
9%
14
Q
BSA for Burnt Abdomen?
A
9%
15
Q
BSA for Burnt Back?
A
18%
16
Q
BSA for Burnt Arm?
A
9%
17
Q
BSA for Burnt Upper Arm?
A
4.5%
18
Q
BSA for Burnt Forearm?
A
4.5%
19
Q
BSA for Burnt Leg?
A
18%
20
Q
BSA for Burnt Thigh?
A
9%
21
Q
BSA for Burnt Lower Leg?
A
9%
22
Q
BSA for Burnt Groin?
A
1%
23
Q
BSA for Burnt Palm?
A
1%
24
Q
What is the Parkland Formula?
A
4 x BSA Burnt x Weight (kg)
25
S/S of Hemothorax?
Hypovolemic Shock
Ventilatory Insufficiency
Lack of Tracheal Deviation
Dullness on Percussion
26
Diff. Diagnosis for Hemothorax?
Supportive Treatment
Rapid Transport
Fluid Resuscitation
Needle Decompression
27
S/S of Pneumothorax?
```
Diminished / Absent / Unequal Breath Sounds
Chest pain on affected side
Dyspnea
Hypoxia
Pulsus Paradoxes
```
28
Diff. Diagnosis for Pneumothorax?
Manage ABCs
O2
Inspect for Wounds
29
S/S of Open Pneumothorax?
```
Open / Bubbling / Sucking Chest Wound
Tachycardia
Tachypnea
Restlessness
Hyper Resonant Percussion Sound
```
30
Diff Diagnosis for Open Pneumothorax?
Place gloved hand over wound IMMEDIATELY
Apply Occlusive Dressing
O2
Burp wound when necessary
31
Key symptom differences between Hymothorax vs Pneumothorax?
Hypovolemia
| Percussion
32
What is Pulsus Paradoxes?
A drop in blood pressure
33
S/S of Tension Pneumothorax?
```
Absence of Breath Sounds on Affected Side
Chest Pain on Affected Side
Dyspnea
Hypoxia
Pulsus Paradoxes
```
Narrow Pulse Pressure
V-Fib
JVD
Tracheal Deviation
34
Diff. Diagnosis for Tension Pneumothorax?
Manage ABCs
O2
Inspect for Wounds
Needle Decompression
35
S/S of Cardiac Contusion?
```
Respiratory Distress
Hypoxia / CO2 Retention
Rails, Rhonchi, Wheezes, Diminished Lung Sounds on affected side
Possible Hemoptysis
Beck's Triad
```
Blunt Chest Trauma & They start throwing PVCs, it's probably a contusion
36
Diff. Diagnosis for Cardiac Contusion?
Manage ABC's
| Use caution to avoid edema when administering fluids
37
What is Beck's Triad?
Hypotension w/ Narrow Pulse Pressure
JVD
Muffled Heart Sounds
38
What is in Upper-Left Abdominal Quadrant?
Stomach
Spleen
Bowel
39
What is in Lower Right Abdominal Quadrant?
Appendix
40
What is in Upper-Right Abdominal Quadrant?
Gallbladder
Liver
Intestines
41
What is Kerhr's Sign?
Referred pain to the left shoulder from a spleen injury
42
Why does Kerhr's sign happen?
Because the sensory nerve for the left shoulder runs through the spleen
43
Which organs are solid?
Liver
Spleen
Kidneys
Pancreas
44
Which organs are injured the most during blunt or penetrating trauma?
Pancreas
45
Which organs bleed the most from trauma?
Solid organs
46
Which organ should you expect to be injured in all right sided chest & abdominal trauma?
Liver
47
Which organ should you expect to be injured in fractures of the 7th - 9th ribs?
Liver
48
Which organ is commonly injured in sports injuries?
Spleen
49
Which organ is most commonly injured during blunt trauma?
Pancreas
50
Where is the pancreas located?
Retroperitoneal space
51
Which organs are hollow?
Large & Small Intestines
Stomach
Bladder
Gallbladder
52
Which organs are most commonly injured during penetrating trauma?
Large & Small Intestines
53
Which organs are in the retroperitoneal space?
Part of intestines
Pancreas
Gallbladder
Kidneys
54
Injury to which organs rarely cause abdominal pain?
Retroperitoneal organs
55
Which signs can injury to retroperitoneal organs cause?
Grey Turner Sign
| Cullen Sign
56
What is grey turner sign?
Ecchymosis in Flanks
57
What is Cullen Sign?
Ecchymosis around the umbilicus
58
What is a Le Forte I Fracture?
Fracture just under the nose
59
What is a Le Forte II Fracture?
Fracture across bridge of nose down to corners of mouth
60
What is a Le Forte III Fracture?
Fracture across bridge of nose and around to temples
61
What is a zygomatic fracture?
Fracture of cheek bones & orbits
62
S/S of zygomatic fracture?
Flatten face appearance
Loss of sensation over cheek, nose, & upper lip
Paralysis of upward gaze may also be present
63
Treatment for open abdominal wounds?
Moist Sterile Dressing
64
Treatment of neck lacerations?
Occlusive Dressing
| Manage ABC's
65
S/S of head injuries; B/P?
B/P is elevated
66
S/S of increased ICP?
```
Hypertension
Bradycardia
***Irregular Respirations
***Unequal Pupils
***Vomiting
```
67
What is Cushing's Triad a symptom of?
That your brain is leaving your head through the Foramen Magnum
68
S/S of Cushing's Triad?
***Irregular Respirations
Hypertension
Bradycardia
69
What is Decerebrate Posturing?
Extension of arms & legs
70
What is Decorticate Posturing?
Flexion of arms & extension of legs
71
What is Beck's Triad a sign of?
Cardiac Tamponade
72
S/S of Beck's Triad?
JVD
Muffled Heart Tones
Tachycardia
73
What is Kerhr's Sign?
Referred left shoulder pain due to spleen injury
74
What is Herring-Breuer Reflex?
Stretch receptors in the lungs limiting the amount of breath you can take in
75
Treatment of Cushing's Triad?
Keep head up
Hyperventilate 20-24 breaths per minute for a short time
Keep EtCO2 30-35
Keep MAP of 60
76
Treatment of Beck's Triad?
Diesel Bolus
77
What is shock?
Hypoperfusion
78
Why does Hypovolemic Shock occur?
Not enough volume to fill the container
79
What is Neurogenic Shock?
An interruption in the sympathetic nervous system
| The sympathetic nervous system isn't working but the parasympathetic nervous system does
80
S/S of Neurogenic Shock?
Since the sympathetic nervous system doesn't work but the parasympathetic does:
- Bradycardia (No vagus nerve)
- Hypovolemia (No vessel constriction)
- Warm, Flushed Skin (Blood vessels are big and blood is leaking out everywhere)
81
Treatment of Neurogenic Shock?
Fluids (Address the fluid issue first)
Atropine
Lopressors (Dopamine)
82
What is the biggest cause of Distributive Shock?
Sepsis
83
S/S of Distributive Shock?
They go from Tachycardic & Hypertensive to hypovolemic
84
Treatment for Distributive Shock?
Fluids (Address the fluid issue FIRST)
| Levophed
85
What is Obstructive Shock?
Something's blocking the blood flow
86
What are the two most common causes of Obstructive Shock in trauma?
```
Embolus (you take a steering wheel to the chest)
Tension Pneumothorax (no negative pressure in the pleural cavity so the vena cava don't fill all of the way)
```
87
3 types of Distributive Shock?
Septic Shock
Neurogenic Shock
Anaphylaxis
88
What is Cardiogenic Shock?
Pump Failure
89
S/S of Cardiogenic Shock?
Low BP
| Altered LOC
90
Treatment for Cardiogenic Shock?
Lopressor
91
What type of shock causes fainting?
Psychogenic (Blood vessels dilate, less O2 to brain, and you faint)
92
S/S of compensated shock?
B/P is Good
93
S/S of decompensated shock?
B/P Starts dropping
Cool, Clammy, Pale Skin
Pulses Weak & Thready
94
Treatment of Impaled Objects?
Stabilize unless they're compromising airway or CPR
95
Treatment of profuse bleeding?
Direct pressure
| Maybe tourniquet
96
Causes of Laryngeal Fractures?
Direct Throat Trauma
97
S/S of Laryngeal Fractures?
Swelling, Bruising
Difficulty Speaking
Hoarse Voice
Stridor, Crepitus
98
Treatment of Laryngeal Fractures?
Manage ABC's
| DO NOT intubate unless they decompensate!
99
S/S of Ruptured Diaphragm?
Lung Sounds in Apices but Bowel sounds in bases of lungs
| Short of Breath
100
Treatment of Ruptured Diaphragm?
Transport Upright
| Maybe put OG tube down to deflate bowel
101
S/S of Pulmonary Embolism after a trauma?
```
Abrupt shortness of breath
Sharp Chest Pain
Dusky & Cyanotic from nipple line up
Bloody Sputum
Low B/P
```
102
Cause of Anaerobic Metabolism?
Hypoperfusion (body starts breaking down glycogen)
103
Treatment of Anaerobic Metabolism?
Fluids
| O2
104
Appearance of 1st Degree Burns?
Redness
| Blisters
105
Appearance of 2nd Degree Burns?
Redness
| Weeping Blisters
106
Appearance of 3rd Degree Burns?
Charred Skin
107
What are baroreceptors?
Sensors in aortic arch & carotid sinuses that detect blood pressure
108
Where are baroreceptors located?
Aortic Arch
| Carotid Sinuses
109
What do baroreceptors do to the sympathetic nervous system?
Stimulate it
110
S/S of flail segments?
Paradoxical movement
| Severe Rib Pain
111
Treatment of flail segments?
Pain Management
112
What are flail segments?
2 or more areas that fracture on the same rib
113
Treatment for Pregnant Trauma Patients?
Left Lateral Recumbent Position
114
Why do we put pregnant trauma patients in the left lateral recumbent position?
Keeps baby off inferior vena cava & improves return blood flow
115
What are the potential life-threatening complications of long bone fractures?
Fat Embolism
| Blood Loss
116
When does anterior cord syndrome occur?
When bone fragments from a blowout fracture sever the anterior chord of the spinal cord
117
S/S of Anterior Cord Syndrome?
Motor Function, Temperature, & Pain Sense loss from that fracture down
Proprioception is in tact
118
What is central cord syndrome?
Severing of the central spinal cord
119
When does central cord syndrome usually occur?
Cervical Spine Injuries
120
S/S of Central Cord Syndrome?
Extremity Weakness & Burning
| Rectal Tone In Tact (Sacral Sparing)
121
What is Sacral Sparing?
An in tact rectal tone
122
S/S of Brown-Sequard Syndrome?
One side of the body has a loss of proprioception
| Pain & Temperature loss on the opposite side
123
3 layers of brain (from outside in)?
Dura Matter
Arachnoid
Pia Matter
124
Where is a subdural hematoma located?
Below the dura matter
125
S/S of subdural hematoma?
Not many. Usually found on cat scan
| May have headache
126
S/S of Epidural Hematoma?
Initially knocked out, regains consciousness, and goes out again
Nausea
Vomiting
Headach
127
Where is an epidural hematoma located?
Above the dura matter
128
S/S of subarachnoid bleed?
Thunderclap headache
129
What is a cerebral contusion?
Bruise on the brain
130
S/S of a cerebral contusion?
Repetitive questioning
Nausea
Vomiting
131
Which has the most potential for severe damage, velocity or mass?
Velocity
132
Differentiate Decorticate & Decerebrate Posturing
DeCORticate Posturing = (CORE) Arms flexed
| Decerebrate Posturing = Arms extended
133
Which is worse, Decorticate Posturing or Decerebrate Posturing?
Decerebrate Posturing
134
Potential causes of Rhabdomyolysis?
Compartment Syndrome
135
S/S of Rhabdomyolysis?
```
Peaked T Waves
Nausea
Vomiting
Confusion
Weakness
```
136
Treatment of Rhabdomyolysis?
FLUIDS, FLUIDS, FLUIDS
Bi-Carb & Calcium
Hospital will also give Insulin
137
B/P goal for IV Fluids in Trauma?
90+ Systolic
138
Treatment / Care of Amputated Body Parts?
Wrap in Plastic & Place on Ice (not directly on ice tho)
139
3 Temperature Ranges for stages of Hypothermia
```
Mild = 89 - 95
Moderate = 82 - 89
Severe = 82 Minus
```
140
S/S of Mild Hypothermia
```
Awake, Lethargic
Shivering
Numb Extremities
Pale
Cool to Touch
```
141
S/S of Moderate Hypothermia
```
Decreased LOC
No Shivering
Bradycardic
Bradypneic
Incontenant of Urine
```
142
S/S of Severe Hypothermia
Unconscious
Rigid Muscles
Weak, Thready Pulse
143
EtCO2 Goals in ICP cases
35 or less
| Over 35 increases vasodialation & edema in brain
144
Causes of Left Shoulder Pain
Kehr's Sign
145
S/S of Retinal Detachment
EMERGENCY!!!
```
PAINFUL
Black Curtain Effect
Flashes of Light
Blurred Vision
Loose Peripheral Vision
```
146
S/S of Central Retinal Artery Occlusion
PAINLESS
Sudden loss of vision
147
S/S of Retinal Detachment vs Central Retinal Artery Occlusion
Retinal Detachment = Painful, gradual loss of vision
Central Retinal Artery Occlusion = Painless, sudden loss of vision
