Trauma Flashcards
Determinants of Severity of Injury
- kinetic energy absorbed
- direction of travel
- density of structures
K=(1/2) mass x volume^2
Blast Injuries: primary, secondary, tertiary, quaternary
primary: initial blast soundwave, hollow organs (i.e. ears, bowel)
secondary: debris from blast
tertiary: impact from being thrown from blast
quaternary: other (i.e. fire, chemical)
ABCDE
A: across the room (scan), airway, always control C-spine B: breathing C: circulation D: disability E: exposure/environment
Vital Organ Perfusion AVPU
- Alert and responsive
- Verbal stimulus responsive
- Painful stimulus responsive
- Unresponsive
MIST Report
- Mechanism of injury
- Injury/Intervention
- Symptoms/Signs
- Treatments
Triage Categories
- walk
- spontaneously breathing
- respiratory rate
- perfusion
- mental status
Trauma Lethal Triad
- coagulation
- acidosis
- hypothermia
Glasgow Coma Scale ______ requires intubation
<9
Manual In-Line Stabilization (MILS)
-second provider stabilizes head and neck after c-spine collar has been removed for intubation
Needle Decompression for Tension Pneumothorax
- 2nd intercostal space at mid-clavicular line
- 4th or 5th intercostal space at anterior axillary line
**just above bottom rib of space, not below top rib
Stages of Shock
1: compensated, SNS activation
2: progressive, cardiac dysfunction
3: irreversible, ATP depleted
Hypovolemic Shock Stages
1: blood loss <15%, BP & HR normal, UO >30
2: 15-30%, HR 100-120, BP normal, pulse pressure decreased, 20-30
3: 30-40%, HR 120-140, BP & PP decreased, 5-15
4. >40%, HR >140, BP & PP decreased, negligible
acidosis is clinically significant when _____
pH <7.1
Blood Therapy: RBC
- HCT = 60%
- citrate-phosphate-dextrose with adenine (preservative)
Blood Therapy: plasma
-plasma proteins + clotting factors + fibrinogen
Blood Therapy: cryoprecipitate
- skimmed top off of plasma
- VIII + VWF + fibrinogen + XIII + fibronectin
- one pooled pack = 5-10 units
- should be given ASAP as it deteriorates in efficacy quickly
Blood Therapy: platelets
- 1 pack = 6 pooled units
- constant agitation to not clot
- easy to damage (no pump, warmer, pressure tubing)
Massive Transfusion Ratio
1 RBC: 1 plasma: 1 platelets
Massive Transfusion products given in addition to blood
- calcium
- antifibrinolytics
Glasgow Coma Scale Scores
- mild TBI 13-15
- moderate TBI 9-12
- severe TBI <8
Tier Interventions for Increased ICP
Tier 1: HOB elevated, short acting agents, CSF drainage, repeat neurologic exams, repeat CTs
Tier 2: external drain placed, hyperosmolar therapy, NMB
Tier 3: surgical evacuation, barbiturate/Propofol come, hypothermia
LOAD pneumonic for RSI
- lidocaine
- opioids
- atropine
- defasciculating agent
