Trauma

Question 1

where is the fracture if the patient presents with raccoon/panda eyes

Answer 1

anterior cranial fossa

Question 2

where is the fracture is the patient presents with a battle sig over the mastoid area (behind ear)

Answer 2

middle cranial fossa

Question 3

GCS in coma and needs ventilation

Answer 3

GCS <9

Question 4

abnormal GCS

Answer 4

GCS <15

Question 5

which fluid given to v sick patients (eg with head trauma) contains glucose and hence reduces ICP (bc of osmosis)

Answer 5

mannitol

Question 6

what drug should you give someone who presents with seizures

Answer 6

IV lorazepam (benzodiazepine) 
PR diazepam if seizing and don't have IV access

Question 7

what is the indication of CSF drainage

Answer 7

raised ICP

Question 8

GCS eyes open spontaneously

Answer 8

4

Question 9

GCS eyes open on command

Answer 9

3

Question 10

what is the GCS out of

Answer 10

15

Question 11

a GCS ? is bad (needs ventilation, is in a coma)

Answer 11

<9

Question 12

GCS eyes open to painful stimuli

Answer 12

2

Question 13

GCS eyes don’t open

Answer 13

1

Question 14

GCS orientated verbal response

Answer 14

5

Question 15

GCS confused verbal response

Answer 15

4

Question 16

GCS inappropriate words (in response to pain)

Answer 16

3

Question 17

GCS incomprehensible sounds (in response to pain)

Answer 17

2

Question 18

GCS no sound (in response to pain)

Answer 18

1

Question 19

GCS obeys command for motor response

Answer 19

6

Question 20

GCS localizes to pain

ie if pain stimulated in supraorbital fossa, hand will go above the clavicles (localizes towards the pain)

Answer 20

5

Question 21

where should you apply painful stimuli

why

Answer 21

supraorbital fossa

if you do it on finger its hard to differentiate the motor responses

Question 22

GCS withdraws to pain (body moves away from painful stimulus, eg flinches)

Answer 22

4

Question 23

GCS abnormal flexion (decorticate) to pain

arms flex

Answer 23

3

Question 24

GCS extension to pain (arms)

Answer 24

2

Question 25

no response to painful stimuli

Answer 25

1

Question 26

someone opens their eyes to voice, makes inappropriate sounds after painful stimuli and flinches from pain

what is their GCS

Answer 26

3+3+4=10

Question 27

someone doesn’t open their eyes after painful stimulus, incomprehensible noises in response to pain and limb flexion in response to pain

Answer 27

1+2+3=6

Question 28

someone groaning in pain answering your questions, eyes open on command and obeys your request to move their arm

what is their GCS

Answer 28

5+3+6=14