Trauma

Question 1

Differentials of cardiogenic shock in trauma

Answer 1

Tension pneumothorax, pericardial tamponade, myocardial contusion, air embolism

Question 2

Four life-threatening injuries identified in the CIRCULATION section of the primary survey

Answer 2

Massive pneumothorax, cardiac tamponade, massive hemoperitoneum, mechanically unstable pelvic fractures

Question 3

Patients who are conscious, do not show tachypnea, and have a normal voice do not require early attention to the airway EXCEPT the following:

Answer 3

Patients with penetrating injuries to the neck and an expanding hematoma
Evidence of chemical or thermal injury to the mouth, nares, or hypopharynx
Extensive subcutaneous air in the neck Complex maxillofacial trauma
Airway bleeding

Question 4

Most common indication for intubation

Answer 4

Altered mental status

Question 5

Indications for tracheostomy

Answer 5

Laryngotracheal separation

Laryngeal fractures

Question 6

Criteria for flail chest

Answer 6

3 or more contiguous ribs are fractured in at least 2 locations

Question 7

Definition of massive hemothorax (adult and pediatric)

Answer 7

> 1,500 mL of blood in adults

1/3 of blood volume in pediatric patients

Question 8

How many mL of blood can cause cardiac tamponade?

Answer 8

<100 mL

Question 9

Emergency department thoracotomy is best accomplished with which method:

Answer 9

Anterolateral thoracotomy

Question 10

EDT should be done in cardiac tamponade with a SBP of:

Answer 10

<70 mmHg

Question 11

GCS Scale:

What is the range of a mild head injury, mod injury, and severe injury respectively?

Answer 11

Mild 13-15
Mod 9-12
Severe <9

Question 12

Indications for EDT:

Salvageable postinjury cardiac arrest of:

Answer 12

Witnessed penetrating trauma <15 minutes of prehospital CPR
Witnessed blunt trauma <10 minutes prehospital CPR
Penetrating trauma to neck or extremities <5 min prehospital CPR

Question 13

Contraindications to EDT:
Penetrating trauma > ____ min of CPR
Blunt trauma > ____ min of CPR

Answer 13

Penetrating trauma - 15 min of CPR

Blunt trauma - 10 min of CPR

Question 14

Adequate urine output in infants

Answer 14

2 ml/kg/hr

Question 15

Adequate urine output in children

Answer 15

1 ml/kg/hr

Question 16

Fluid resuscitation in adult initially begins with?

In pediatric patients?

Answer 16

Adult: 2L
Pediatric: 20ml/kg
of isotonic crystalloid, usually LR

Question 17

Components of secondary survey, aka AMPLE

Answer 17

Allergies
Medications
Past illnesses or pregnancy
Last meal
Events leading to injury

Question 18

“Big three” radiographs in severe blunt trauma

Answer 18

Lateral cervical spine
Chest
Pelvic

Question 19

Management of a hemodynamically stable but symptomatic Zone II penetrating neck injury?

Answer 19

Operative exploration

Question 20

Management of a hemodynamically stable but symptomatic Zone III penetrating neck injury?

Answer 20

Angiography

Question 21

Management of a hemodynamically stable but symptomatic Zone I penetrating neck injury?

Answer 21

CT of neck/chest

Question 22

Criteria for (+) DPL for an abdominal penetrating injury

Answer 22

RBC > 100,000/mL
WBC > 500/mL
Amylase > 19 IU/L
ALP >2 IU/L
Bilirubin >0.01mg/dL

Question 23

Criteria for (+) DPL for a thoracic penetrating injury

Answer 23

RBC > 10,000/mL
WBC > 500/mL
Amylase > 19 IU/L
ALP >2 IU/L
Bilirubin >0.01mg/dL

Question 24

For each rib fracture, there is ____ mL blood loss

Answer 24

100-200 mL

Question 25

Tetanus-prone injuries:
>\_\_\_\_ hrs 
>\_\_\_\_\_ cm depth
Missile, crush, burn, frostbite injury
Signs of infection, contamination, devitalized tissue

Answer 25

More than 6 hours

More than 1 cm depth

Question 26

Most common manifestation of hemolytic transfusion

Answer 26

Oliguria

Question 27

Most common cause of abdominal pain in patients receiving anticoagulation therapy

Answer 27

Intramural bowel hematoma

Question 28

Most common complication of warfarin therapy

Answer 28

Bleeding into abdominal cavity

Question 29

First airway control maneuver in cases of craniofacial trauma but has a risk of subglottic stenosis

Answer 29

Cricothyroidotomy

Question 30

Hard signs of a penetrating neck injury

Answer 30

Massive hemoptysis

Rapidly expanding hematoma

Question 31

Most common manifestation of hemolytic transfusion reaction

Answer 31

Oliguria

Question 32

Most common cause of transfusion reaction

Answer 32

Human error

Question 33

Most common intrinsic platelet defect

Answer 33

Storage pool disease (usually dense granule deficiency)

Question 34

Patient in ICU with septic shock. What is thte threshold for Hgb transfusion?

Answer 34

<7 mg/dL

Question 35

Leading cause of transfusion-related deaths

Answer 35

TRALI

Question 36

At what pressure is operative decompression of a compartment necessary?

Answer 36

> 45 mmHg