Trauma

Question 1

Crush syndrome

Answer 1

12-lead
IV
Pain - Vrsed 1-2mg IV (Max 5mg)
Trap<2hrs - NS 1L
Trap>2hrs - NS 2L, then 500cc hr
Prior extrication - Sodium Bicarb 50 mEq IV
Abnormal EKG - Sodium Bicard 50 mEq IV, Calcium chloride 1g IV, Albuterol 5mg x3

Question 2

Amputation or open fracture

Answer 2

Cefazolin/Ancef 2g IV

Question 3

Hyperventilation

Answer 3

Evidence of brain herniation:
Unilateral/bilateral pupil dilation
postureing
BVM 14-18 ETCO2 30-35

Question 4

Level 1 Trauma

Answer 4

• GCS<14
• SBP<90
• RR <10 or >29
• Penetration injury head, neck torso, proximal elbow/knee
• chest wall instability/deformity
• 2+ long bone fractures
• crushed, degloved, mangled, pulseless extremity
• amputation wrist/ankle
• pelvic fracture
• open/depressed skull fracture
• paralysis/weakness due to spinal injury
• Pedi fals >10ft or 2xheight

Question 5

Level 3 Trauma

Answer 5

-Adult falls >20ft
-Intrusion >12in at occupant site or >18in any other
-ejection
-death of passenger
vehicle telemetry
auto vs ped/bicyclist thrown >20mph
motorcycle crash >20mph
Pregancy >20 weeks w/ blunt trauma

Question 6

Radiation Hospitals

Answer 6

Rex, Duke Raleigh, Wakemed Main

Question 7

NSAIDS

Answer 7

Neuro
Significant injury
Alertness
Intoxication
Distraction injury
Spinal exam

Question 8

Thermal burn fluids calculation

Answer 8

0.25 (cc) X kg X burn%

Question 9

Burn center criteria

Answer 9

• 5-15% 2nd & 3rd degree burns
• 5% 3rd degree burns
• circumferential burns
• electrical/lightening burns
• suspicion of neglect/abuse
• inhalation injury
• chemical burns
• burns to face, hands, feet, or perineum

Question 10

Trauma cardiac arrest - Not attempt

Answer 10

PEA < 40 and severely deformed chest