Trauma Flashcards
1
Q
Trauma
A
Primary cause of death in ages between 1-44 years old
-occurs when external source of energy affects the body beyond its ability to sustain and dissipate it
2
Q
Mechanical energy
A
Energy from motion-KINETIC ENERGY
3
Q
Potential energy
A
Energy an object can have when stationary
4
Q
Chemical Energy
A
Energy released as a result of a chemical reaction and can be found in an explosive or an acid
5
Q
Electrical Energy
A
Form of high voltage
6
Q
Barometric Energy
A
Sudden radical changes in pressure
7
Q
Biomechanics
A
Study of a living organism using tools
8
Q
Kinetics
A
Study of speed, mass, direction of force, and physical injury
9
Q
Organs
A
Organs that have gas inside can be easily compressed
10
Q
Types of injury
A
Depend on force and energy delivered
11
Q
Blunt Trauma
A
When skin is not broken and the force and energy is made to dissipate
12
Q
Duration of force application
A
Affects trauma because rapidly applied amounts of energy are less tolerated than an identical amount over a longer period of time
13
Q
Impact resistance of body parts
A
Determined by what is inside the organs (gas, liquid, solid)
14
Q
Index of suspicion
A
Suspecting an injury is present
15
Q
Velocity
A
Distance an object travels per unit time
16
Q
KE
A
=m/2XV2
17
Q
Phases of MVC
A
First: deceleration of vehicle Second: deceleration of occupant Third: deceleration of organs Fourth: secondary collision Fifth: additional impacts
18
Q
Head on Impact
A
Brain Injury Scalp Spinal Chest Pneumo Femoral Aortic tear -less survivors
19
Q
Rear end
A
Whiplash bleeding inside skull
-more survivors
20
Q
Abrupt deceleration forces
A
Sudden stop
- shearing, avulsing, rupturing of organs
- chest vulnerable to aortic injury
- blunt abdominal injuries
21
Q
Organs commonly affected
A
Kidneys, small intestine, liver, large intestine, pancreas and spleen
22
Q
Lateral Impact
A
Pelvis and chest
23
Q
Rotational or quarter panel impacts
A
Forward and diagonal Impact
-three angled seatbelts
24
Q
Rollovers
A
May be ejected without seatbelt
- ejection increased death by 25%
- 1 in every 13 people in ejection sustain major cervical spine damage
25
Airbags
Will not deployed unless hit from the front and won't if hit lateral quarter
- abrasions to face, arms and hands
- cornstarch used in airbags to load
- pediatrics can be killed with airbag deployment
26
Motorcycle Crashes
Helmets transmit forces to the spine
4 types of crashes:
Head on- hit and continue forward until stopped by outside force yielding bilateral femur or tibia fractures
Angular Impact- direct crushing injuries to lower extremity between object and motorcycle
Ejected rider- laying down or sliding results in road rash
27
MOI's
First: auto strikes body
Second: body hits hood
Third: body hits grund
28
Waddell Triad
Bumper hits pelvis, chest and abdomen hit grille, head strikes vehicle and ground
29
Don Juan Syndrome
Jumping down to ground
Energy transferred to heel, legs, pelvis and chest
T12-L1 and L2
-children younger than 3 have fewer injuries from falls greater than three stories than children and adults
30
Stab Wounds
Low versus high velocity.
| Depends on length, blade, and motion of weapon
31
Cavitation
Cavity formation from a bullet wound
- Entrance: bullet goes in
- Exit: bullet comes out
32
Obtain information
What caliber was used? What range was fired? What kind of bullet?
33
Primary Blast Wounds
The wave from a blast and affect hollow membranes
| -Can tell severity of ruptured pulmonary tissue by observing the tympanic membrane
34
Secondary Blast
Debris hitting a person such as shrapnel set in motion by shrapnel
35
Tertiary Blast
When a person is hurled boy the force and hits ridged objects
36
Quaternary Blast
Miscellaneous injuries acquired from primary blast
37
Quinary Blast
Biological, chemical exposure
38
RTS
```
Asses injury severity in patients with head trauma
Lowest is 0 Max is 12
-GCS, PR & Sbp
GCS
13-15 4
9-12. 3
6-8. 2
4-5. 1
3. 0
SBP
>89. 4
76-89. 3
50-75. 2
1-49. 1
0. 0
RR
10-29. 4
>29. 3
6-9. 2
1-5. 1
0. 0
```
39
Level 1 Trauma
Every injury possible
40
Level 4 Trauma
Able to provide ATLS
41
MOI criteria
```
Adults fall more than 20 feet or three times height
Children falls more than 10 feet or <10ft with LOC
High risk auto crash
Intrusion intompassenger compartment
Ejection from automobile
High risk injury
Pedestrian/bicyclist thrown
Burns with other Trauma
EMS provider judgment
```
42
Special Considerations
```
Age>55
Systolic <110 in age >65
Using anticoagulants
Pregnancy
Burns with trauma
EMS Judgement
```
43
Oxygen Dissisociation Curve
Affinity of oxygen on hemoglobin and oxygen in plasma
Spo2 and PaCo2
-too much fluid can transfer oxygen from hemoglobin to a larger plasma if there is more fluid cause an increase in paco2 and decrease in spo2
-temperature also effects (sweet tea) and how molecules dissolve
-pH also effects trauma by decreasing chance of transporting oxygen
44
Trauma Triad
Ph, hypothermia, infection
45
Pain Management
Need to so that there isn't a massive catecholamines dump
46
Coagulopathy
Free bleeders because the body uses all clotting ability when bleeding and runs out so bleeding can not clot
47
Compensated
HR increase, lethargic, skin
48
Decompensated
Pressure changes signify decompensation
49
Burns
Hypovolemia, hypothermia, infection, pain
50
Superficial
Burn to epidermis
- Red color
- Vulnerable to temp regulation
51
Partial Thickness Burns
Burn to dermis
Glands, Nerves, vessels
-Massive fluid shift ! Fluid forms in bubbles
52
Full Thickness Burn
Burn to sub
- no ability to thermos regulate
- no sensory
- no fluid containment
53
Airway Burns
Stridor, burns to pharynx, nasal hairs
| -Edema causes loss of airway
54
Parkland Burn Formula
4xBSAxkg half over first 8 then rest over last 16hours
Easy way = BSAxKg/4 = fluid over first 8 hours
55
Dry sterile dressing
Dry because the lint does not stick and because bacteria is easier to travel through water than through air. Also, water could cause further hypothermia
56
Wet sterile dressing
If moderate burns use wet to smooth. If full Thickness burns then use dry
57
Rule of Nines
Adult head 9 Child head 12 Infant Head 18
58
Palm Rule
The palm is 1% of TBSA
59
Chemical Burns Acids Examples
Battery Acid
HCl Acid
HFl Acid
-immediate pain and coagulation necrosis
60
Chemical Bases and Alkalis examples
```
Potassium
Hydroxide
Lime
Drain Cleaner
Lye
-little pain but extensive damage by liquification necrosis. Breakdown of protein, collagen, fats, dehydration of tissues, thrombosis of vessels
```
61
Oxidizing Agents
Hydrogen Peroxide
Sodium Chlorate
-can cause systemic poisoning
62
Phosphrous
Ammunition and fireworks
| -burns when exposed to air and can cause systemic posioning
63
Vesicants
Sulfur mustard
Phosgene oxide
-blister agents. Respiratory compromised if inhaled
64
Dry Lime
Alkali
-becomes corrosive with water so clean as much off as possible then irrigate with copious amounts of water with hose or shower
65
Sodium Metals
Produce cosiderable heat when mixed with water and may explode
-cover burn with oil
66
HFl
Use Calcium Chloride of 10% Solution and make a jelly to apply to site of burn
67
Eye Solution for ocular anasthetic
Put 100mg of Lidocaine in a 1000ml bag of NaCl to make a analgesic flush solution
68
Arc Flash Burn
When an arc makes connection with a person.
69
Flame Burn from electricity
When the electric current ignites someone's clothing
70
Radiation Burns
Acute Radiation Exposure is highly seen in industrial sections of work
71
Alpha Particles
Have little penetrating energy and easily stopped by the skin
72
Beta Particles
Are stronger than alpha and can penetrate skin but be blocked by very simple clothing
73
Gamma Particles
Easily passes through the body and solid materials
74
Radiation
Measured in units of RAD or Radiation Absorbed Dose
75
Acute Radiation Syndrome
Causes hematologic, CNS and GI chnages
- patients who unresponsive by radiation or manifest vomiting in 10 minutes will die
- patients who manifest vomiting less than an hour have a 30/80% chance of survival
- patients who manifest vomiting within one to two hours have a 95-100% chance of surviving
76
Radiation Contact Burns
Local soft tissue injury
