Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgery > Trauma > Flashcards

Trauma Flashcards

1
Q

Assessing for airway in the primary survey?

A

check for airway compromise

  • ask pt a qn
  • stridor
  • orofacial injury or burns
  • visualise airway and use suction if necessary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what manouevres if pt is not breathing / airway obstructed?

A

Head tilt/ chin lift

Jaw thrust -> esp if potential c spine injury

Nasopharyngeal airway: in conscious pts as does not trigger gag reflex

oropharyngeal airway: prevents tongue from covering epiglottis

emergency airway: needle / surgical cricothyroidotomy

Definitive airway: endotracheal tube, tracheostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

mx of c-spine stablisation?

A

maintain in line cervical support to keep neck stable

pt in hard collar + sandbags w tape

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Assessment of breathing in primary survey?

A

SpO2, RR -> START 15L O2 via non rebreather mask

Inspection of chest

tracheal deviation?

Chest expansion

percussion

auscultation

ABG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

mx of tension pneumothorax?

A

insert large bore venflon into 2nd ICS, mid clavicular line

-> chest drain later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

mx of open sucking chest wounds?

A

convert to closed wounds by covering w damp occlusive dressive stuck down on 3 sides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

assessment of circulation in primary survey?

A

two large bore cannulae (14/16G) in each ACF

Take bloods: FBC, U+E, clotting, cross match, VBG

CRP, BP, HR, JVP

Fluid status -> IV fluids

Assess heart sounds

insert catheter -> monitor Urine output

*may need ECG/ cardiac monitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hx in Secondary survey?

A

AMPLE

Allergies

medications

PMH

Last ate/ drink

events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Examination in Secondary survey?

A

head to toe examination

examine every system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

trauma series investigations?

A

C-Spine: lateral + open mouth peg view

CXR

Pelvis

CT when pt is stable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what to asses in c spine radiograph?

A

Adequacy: must see C7-T1 junction

Alignment:

ant vertebral bodies

ant vertebral canal

post vertebral canal

tips of spinous processes

Bones: shapes of bodies, laminae, processes

cartilage: Intervertebral discs should be equal height

Soft tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Clinical clearance of c-spine injury?

A

NEXUS criteria:

fully alert and orientated

no head injury

no drugs or alcohol

no neck pain

no abnormal neurology

no distracting injury

Method:

examine for bruising or deformity

palpate for deformity and tenderness

ensure pain-free active movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If abnormal clinical exam or radiograph for c spine?

A

CT C-spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is neurogenic shock?

A

disruption of the autonomic pathways within the spinal cord

-> distributive type of shock-> in low BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

causes of neurogenic shock?

A

cord injury above T5

closed head injuries

spinal anaesthesia

hypoglycaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

presentation of neurogenic shock?

A

hypotension

bradycardia

warm extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

mx of neurogenic shock?

A

Vasopressors: vasopressin and norad

Atropine: reverse the bradycardia

18
Q

what is spinal shock?

A

temporary reduction of or loss of reflexes following a spinal cord injury

loss of sensation accompanied by motor paralysis with initial loss but gradual recovery of reflexes

most commonly due to acute spinal cord transection (loss of reflexes but gradual recovery below level of transection)

19
Q

presentation of spinal shock?

A

areflexia

loss of sensation

hypotonic paralysis

bladder retention

20
Q

mx of massive haemothorax?

A

cross match 6 units

large bore chest drain

thoracotomy if > 1.5L or > 200ml/ h

21
Q

features of flail chest?

A

ant/ lat # of 2 or more adjacent ribs in 2 or more places

flail segment moves paradoxically w respiration

decreased oxygenation -> due to underlying pulmonary contusion, decreased ventilation of affected segment

22
Q

ix of flail chest?

A

CXR/ CT chest: pulmonary contusion

serial ABGs

23
Q

mx of flail chest?

A

O2

Good Analgesia*: PCA, epidural

positive pressure ventilation

24
Q

mx of rib #?

A

good analgesia:

NSAIDS + opioids

intrapleural analgesia

intercostal block

25
Q

mx of sternal #?

A

risk of mediastinal injury

analgesia, admit, observe

cardiac monitor

troponin: rule out myocardial contusion

26
Q

ix of pulmonary contusion?

A

CXR: opacification

Serial ABGs: decreased PaO2:FiO2 ratio

27
Q

mx of pulmonary contusion?

A

may -> ARDS

O2, ventilate if necessary

28
Q

Ix of myocardial contusion?

A

ECG: abnormal, arrhythmias

raised troponin

29
Q

mx of myocardial contusion?

A

bed rest, cardiac monitoring, tx arrhythmias

30
Q

ix of aortic disruption?

A

CXR: wide mediastinum

CT

31
Q

mx of aortic disruption?

A

cardiothoracics

32
Q

ix of oesophageal disruption?

A

CXR: pneumomediastinum, surgical emphysema

CT

33
Q

Ix in abdominal trauma?

A

urine dip: haematuria suggests injury to renal tract

FAST scan: check for fluid in abdomen, pelvis and pericardium

straight to laparatomy if unexplained shock, peritonism, intraperitoneal gas, gunshout wounds etc

34
Q

what is Kehr’s sign?

A

shoulder tip pain secondary to blood in peritoneal cavity

left Kehr sign is classic symptom of ruptured spleen

ie. in splenic rupture

35
Q

mx of urethral injury?

A

suprapubic catheter

surgical repair

36
Q

features of focal contusion?

A

e.g. coup and contra coup

may have focal neurological deficit

37
Q

diffuse axonal injury?

A

shearing forces disrupt axons

may -> coma and persistent vegetative state

autonomic dysfunction -> fever, HTN, sweating

38
Q

features of concussion?

A

temporary decrease in brain function

LOC, headache, confusion, visual symptoms, amnesia, nausea

39
Q

causes of secondary brain injury following head injury?

A

hypoxia

hypercapnia

hypotension

raised ICP

infection

40
Q

cushing reflex?

A

suggests raised ICP -> imminent herniation

hypertension

bradycardia

irregular breathing

41
Q

mx of raised ICP?

A

elevate bed

neuroprotective ventilation (normocapnoea)

mannitol or hypertonic saline

42
Q

Burns Wallace rule of 9s?

A

Head and neck: 9%

Arms: 9% each

Torso: 18% each for front and back

Legs: 18% each

perineum: 1%
(palm: 1%)

Surgery (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions