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FISDAP Trauma Study Guide > Trauma > Flashcards

Trauma Flashcards

1
Q

What is subcutaneous emphysema?

A

Air under the skin

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2
Q

Where can you get subcutaneous emphysema?

A

Anywhere air can get in; especially in the chest

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3
Q

What does DIC stand for?

A

Disseminated Intravascular Coagulation

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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

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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

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6
Q

What is a transected aorta?

A

An aorta that is sliced clear through

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7
Q

Where does an aorta normally transect?

A

The aortic arch

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8
Q

GSC scoring for eye opening

A

4 - Spontaneous
3 - Voice
2 - Pain Stimulation
1 - None

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9
Q

GCS scoring for Verbal

A 
5 - Oriented Conversation
4 - Confused Conversation
3 - Inappropriate Words
2 - Incomprehensible Sounds
1 - None
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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

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11
Q

BSA for Burnt Head?

A

9%

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12
Q

BSA for Burnt Anterior Trunk?

A

18%

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13
Q

BSA for Burnt Chest?

A

9%

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14
Q

BSA for Burnt Abdomen?

A

9%

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15
Q

BSA for Burnt Back?

A

18%

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16
Q

BSA for Burnt Arm?

A

9%

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17
Q

BSA for Burnt Upper Arm?

A

4.5%

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18
Q

BSA for Burnt Forearm?

A

4.5%

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19
Q

BSA for Burnt Leg?

A

18%

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20
Q

BSA for Burnt Thigh?

A

9%

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21
Q

BSA for Burnt Lower Leg?

A

9%

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22
Q

BSA for Burnt Groin?

A

1%

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23
Q

BSA for Burnt Palm?

A

1%

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24
Q

What is the Parkland Formula?

A

4 x BSA Burnt x Weight (kg)

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25
Q

S/S of Hemothorax?

A

Hypovolemic Shock
Ventilatory Insufficiency
Lack of Tracheal Deviation
Dullness on Percussion

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26
Q

Diff. Diagnosis for Hemothorax?

A

Supportive Treatment
Rapid Transport
Fluid Resuscitation
Needle Decompression

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27
Q

S/S of Pneumothorax?

A 
Diminished / Absent / Unequal Breath Sounds
Chest pain on affected side
Dyspnea
Hypoxia
Pulsus Paradoxes
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28
Q

Diff. Diagnosis for Pneumothorax?

A

Manage ABCs
O2
Inspect for Wounds

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29
Q

S/S of Open Pneumothorax?

A 
Open / Bubbling / Sucking Chest Wound
Tachycardia
Tachypnea
Restlessness
Hyper Resonant Percussion Sound
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30
Q

Diff Diagnosis for Open Pneumothorax?

A

Place gloved hand over wound IMMEDIATELY
Apply Occlusive Dressing
O2
Burp wound when necessary

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31
Q

Key symptom differences between Hymothorax vs Pneumothorax?

A

Hypovolemia

Percussion

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32
Q

What is Pulsus Paradoxes?

A

A drop in blood pressure

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33
Q

S/S of Tension Pneumothorax?

A 
Absence of Breath Sounds on Affected Side
Chest Pain on Affected Side
Dyspnea
Hypoxia
Pulsus Paradoxes

Narrow Pulse Pressure
V-Fib
JVD
Tracheal Deviation

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34
Q

Diff. Diagnosis for Tension Pneumothorax?

A

Manage ABCs
O2
Inspect for Wounds

Needle Decompression

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35
Q

S/S of Cardiac Contusion?

A 
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

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36
Q

Diff. Diagnosis for Cardiac Contusion?

A

Manage ABC’s

Use caution to avoid edema when administering fluids

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37
Q

What is Beck’s Triad?

A

Hypotension w/ Narrow Pulse Pressure
JVD
Muffled Heart Sounds

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38
Q

What is in Upper-Left Abdominal Quadrant?

A

Stomach
Spleen
Bowel

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39
Q

What is in Lower Right Abdominal Quadrant?

A

Appendix

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40
Q

What is in Upper-Right Abdominal Quadrant?

A

Gallbladder
Liver
Intestines

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41
Q

What is Kerhr’s Sign?

A

Referred pain to the left shoulder from a spleen injury

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42
Q

Why does Kerhr’s sign happen?

A

Because the sensory nerve for the left shoulder runs through the spleen

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43
Q

Which organs are solid?

A

Liver
Spleen
Kidneys
Pancreas

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44
Q

Which organs are injured the most during blunt or penetrating trauma?

A

Pancreas

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45
Q

Which organs bleed the most from trauma?

A

Solid organs

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46
Q

Which organ should you expect to be injured in all right sided chest & abdominal trauma?

A

Liver

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47
Q

Which organ should you expect to be injured in fractures of the 7th - 9th ribs?

A

Liver

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48
Q

Which organ is commonly injured in sports injuries?

A

Spleen

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49
Q

Which organ is most commonly injured during blunt trauma?

A

Pancreas

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50
Q

Where is the pancreas located?

A

Retroperitoneal space

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51
Q

Which organs are hollow?

A

Large & Small Intestines
Stomach
Bladder
Gallbladder

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52
Q

Which organs are most commonly injured during penetrating trauma?

A

Large & Small Intestines

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53
Q

Which organs are in the retroperitoneal space?

A

Part of intestines
Pancreas
Gallbladder
Kidneys

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54
Q

Injury to which organs rarely cause abdominal pain?

A

Retroperitoneal organs

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55
Q

Which signs can injury to retroperitoneal organs cause?

A

Grey Turner Sign

Cullen Sign

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56
Q

What is grey turner sign?

A

Ecchymosis in Flanks

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57
Q

What is Cullen Sign?

A

Ecchymosis around the umbilicus

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58
Q

What is a Le Forte I Fracture?

A

Fracture just under the nose

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59
Q

What is a Le Forte II Fracture?

A

Fracture across bridge of nose down to corners of mouth

60
Q

What is a Le Forte III Fracture?

A

Fracture across bridge of nose and around to temples

61
Q

What is a zygomatic fracture?

A

Fracture of cheek bones & orbits

62
Q

S/S of zygomatic fracture?

A

Flatten face appearance
Loss of sensation over cheek, nose, & upper lip
Paralysis of upward gaze may also be present

63
Q

Treatment for open abdominal wounds?

A

Moist Sterile Dressing

64
Q

Treatment of neck lacerations?

A

Occlusive Dressing

Manage ABC’s

65
Q

S/S of head injuries; B/P?

A

B/P is elevated

66
Q

S/S of increased ICP?

A 
Hypertension
Bradycardia
***Irregular Respirations
***Unequal Pupils
***Vomiting
67
Q

What is Cushing’s Triad a symptom of?

A

That your brain is leaving your head through the Foramen Magnum

68
Q

S/S of Cushing’s Triad?

A

***Irregular Respirations
Hypertension
Bradycardia

69
Q

What is Decerebrate Posturing?

A

Extension of arms & legs

70
Q

What is Decorticate Posturing?

A

Flexion of arms & extension of legs

71
Q

What is Beck’s Triad a sign of?

A

Cardiac Tamponade

72
Q

S/S of Beck’s Triad?

A

JVD
Muffled Heart Tones
Tachycardia

73
Q

What is Kerhr’s Sign?

A

Referred left shoulder pain due to spleen injury

74
Q

What is Herring-Breuer Reflex?

A

Stretch receptors in the lungs limiting the amount of breath you can take in

75
Q

Treatment of Cushing’s Triad?

A

Keep head up
Hyperventilate 20-24 breaths per minute for a short time
Keep EtCO2 30-35
Keep MAP of 60

76
Q

Treatment of Beck’s Triad?

A

Diesel Bolus

77
Q

What is shock?

A

Hypoperfusion

78
Q

Why does Hypovolemic Shock occur?

A

Not enough volume to fill the container

79
Q

What is Neurogenic Shock?

A

An interruption in the sympathetic nervous system

The sympathetic nervous system isn’t working but the parasympathetic nervous system does

80
Q

S/S of Neurogenic Shock?

A

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
Q

Treatment of Neurogenic Shock?

A

Fluids (Address the fluid issue first)
Atropine
Lopressors (Dopamine)

82
Q

What is the biggest cause of Distributive Shock?

A

Sepsis

83
Q

S/S of Distributive Shock?

A

They go from Tachycardic & Hypertensive to hypovolemic

84
Q

Treatment for Distributive Shock?

A

Fluids (Address the fluid issue FIRST)

Levophed

85
Q

What is Obstructive Shock?

A

Something’s blocking the blood flow

86
Q

What are the two most common causes of Obstructive Shock in trauma?

A 
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
Q

3 types of Distributive Shock?

A

Septic Shock
Neurogenic Shock
Anaphylaxis

88
Q

What is Cardiogenic Shock?

A

Pump Failure

89
Q

S/S of Cardiogenic Shock?

A

Low BP

Altered LOC

90
Q

Treatment for Cardiogenic Shock?

A

Lopressor

91
Q

What type of shock causes fainting?

A

Psychogenic (Blood vessels dilate, less O2 to brain, and you faint)

92
Q

S/S of compensated shock?

A

B/P is Good

93
Q

S/S of decompensated shock?

A

B/P Starts dropping
Cool, Clammy, Pale Skin
Pulses Weak & Thready

94
Q

Treatment of Impaled Objects?

A

Stabilize unless they’re compromising airway or CPR

95
Q

Treatment of profuse bleeding?

A

Direct pressure

Maybe tourniquet

96
Q

Causes of Laryngeal Fractures?

A

Direct Throat Trauma

97
Q

S/S of Laryngeal Fractures?

A

Swelling, Bruising
Difficulty Speaking
Hoarse Voice
Stridor, Crepitus

98
Q

Treatment of Laryngeal Fractures?

A

Manage ABC’s

DO NOT intubate unless they decompensate!

99
Q

S/S of Ruptured Diaphragm?

A

Lung Sounds in Apices but Bowel sounds in bases of lungs

Short of Breath

100
Q

Treatment of Ruptured Diaphragm?

A

Transport Upright

Maybe put OG tube down to deflate bowel

101
Q

S/S of Pulmonary Embolism after a trauma?

A 
Abrupt shortness of breath
Sharp Chest Pain
Dusky & Cyanotic from nipple line up
Bloody Sputum
Low B/P
102
Q

Cause of Anaerobic Metabolism?

A

Hypoperfusion (body starts breaking down glycogen)

103
Q

Treatment of Anaerobic Metabolism?

A

Fluids

O2

104
Q

Appearance of 1st Degree Burns?

A

Redness

Blisters

105
Q

Appearance of 2nd Degree Burns?

A

Redness

Weeping Blisters

106
Q

Appearance of 3rd Degree Burns?

A

Charred Skin

107
Q

What are baroreceptors?

A

Sensors in aortic arch & carotid sinuses that detect blood pressure

108
Q

Where are baroreceptors located?

A

Aortic Arch

Carotid Sinuses

109
Q

What do baroreceptors do to the sympathetic nervous system?

A

Stimulate it

110
Q

S/S of flail segments?

A

Paradoxical movement

Severe Rib Pain

111
Q

Treatment of flail segments?

A

Pain Management

112
Q

What are flail segments?

A

2 or more areas that fracture on the same rib

113
Q

Treatment for Pregnant Trauma Patients?

A

Left Lateral Recumbent Position

114
Q

Why do we put pregnant trauma patients in the left lateral recumbent position?

A

Keeps baby off inferior vena cava & improves return blood flow

115
Q

What are the potential life-threatening complications of long bone fractures?

A

Fat Embolism

Blood Loss

116
Q

When does anterior cord syndrome occur?

A

When bone fragments from a blowout fracture sever the anterior chord of the spinal cord

117
Q

S/S of Anterior Cord Syndrome?

A

Motor Function, Temperature, & Pain Sense loss from that fracture down
Proprioception is in tact

118
Q

What is central cord syndrome?

A

Severing of the central spinal cord

119
Q

When does central cord syndrome usually occur?

A

Cervical Spine Injuries

120
Q

S/S of Central Cord Syndrome?

A

Extremity Weakness & Burning

Rectal Tone In Tact (Sacral Sparing)

121
Q

What is Sacral Sparing?

A

An in tact rectal tone

122
Q

S/S of Brown-Sequard Syndrome?

A

One side of the body has a loss of proprioception

Pain & Temperature loss on the opposite side

123
Q

3 layers of brain (from outside in)?

A

Dura Matter
Arachnoid
Pia Matter

124
Q

Where is a subdural hematoma located?

A

Below the dura matter

125
Q

S/S of subdural hematoma?

A

Not many. Usually found on cat scan

May have headache

126
Q

S/S of Epidural Hematoma?

A

Initially knocked out, regains consciousness, and goes out again
Nausea
Vomiting
Headach

127
Q

Where is an epidural hematoma located?

A

Above the dura matter

128
Q

S/S of subarachnoid bleed?

A

Thunderclap headache

129
Q

What is a cerebral contusion?

A

Bruise on the brain

130
Q

S/S of a cerebral contusion?

A

Repetitive questioning
Nausea
Vomiting

131
Q

Which has the most potential for severe damage, velocity or mass?

A

Velocity

132
Q

Differentiate Decorticate & Decerebrate Posturing

A

DeCORticate Posturing = (CORE) Arms flexed

Decerebrate Posturing = Arms extended

133
Q

Which is worse, Decorticate Posturing or Decerebrate Posturing?

A

Decerebrate Posturing

134
Q

Potential causes of Rhabdomyolysis?

A

Compartment Syndrome

135
Q

S/S of Rhabdomyolysis?

A 
Peaked T Waves
Nausea
Vomiting
Confusion
Weakness
136
Q

Treatment of Rhabdomyolysis?

A

FLUIDS, FLUIDS, FLUIDS
Bi-Carb & Calcium
Hospital will also give Insulin

137
Q

B/P goal for IV Fluids in Trauma?

A

90+ Systolic

138
Q

Treatment / Care of Amputated Body Parts?

A

Wrap in Plastic & Place on Ice (not directly on ice tho)

139
Q

3 Temperature Ranges for stages of Hypothermia

A 
Mild = 89 - 95
Moderate = 82 - 89
Severe = 82 Minus
140
Q

S/S of Mild Hypothermia

A 
Awake, Lethargic
Shivering
Numb Extremities
Pale
Cool to Touch
141
Q

S/S of Moderate Hypothermia

A 
Decreased LOC
No Shivering
Bradycardic
Bradypneic
Incontenant of Urine
142
Q

S/S of Severe Hypothermia

A

Unconscious
Rigid Muscles
Weak, Thready Pulse

143
Q

EtCO2 Goals in ICP cases

A

35 or less

Over 35 increases vasodialation & edema in brain

144
Q

Causes of Left Shoulder Pain

A

Kehr’s Sign

145
Q

S/S of Retinal Detachment

A

EMERGENCY!!!

PAINFUL
Black Curtain Effect
Flashes of Light
Blurred Vision
Loose Peripheral Vision
146
Q

S/S of Central Retinal Artery Occlusion

A

PAINLESS

Sudden loss of vision

147
Q

S/S of Retinal Detachment vs Central Retinal Artery Occlusion

A

Retinal Detachment = Painful, gradual loss of vision

Central Retinal Artery Occlusion = Painless, sudden loss of vision

FISDAP Trauma Study Guide (1 decks)

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