Trauma Flashcards
what is the impact of trauma
- Lost earning
- tax revenue
- burdern to society
How do people get trauma
- Gravity
- Speed
- Deceleration
- Sharp
- Blunt
- Heat (and cold)
- Pressure (crush) • Energy transfer
what is the leading cause of death in under 50s
Trauma
How many deaths does trauma cause
- 18000 deaths/year
* 1/3 of deaths are preventable
what is the golden hour
- time where you can save there life early on - important hour
What are the basic managemnet procedures for trauma
- Safety (yours and pts)
- Primary Survey
- Secondary survey
- Concurrent management and investigation
- Life saving treatment
What is the primary survey
- looking at things that will kill patient early on ABC A = airways B = breathing C = circulation - pulse and BP
- make sure they get oxygen and manage the C spine
- manage the haemorrhage - pressure and elevation
How do you manage airways
- simple manoeuvres - lifiting the jaw up will open the airway
- adjuncts - oral pharygneal tube or naso airway into the nose
- COETT - endotracheal tube
- surgical airway - trachectomy
How do you manage breathing
Look at the
- chest wall
- lung
- heart
- vessels
- rate
- effort
- air hunger
How do you manage circulation
- Colour, sweaty
- HR, pulse strength
- BP
- Cap refill, distal perfusion
- AVPU
How do you measure disability
• AVPU
• GCS (3-15/15)
– Eyes ( out of 4) - look for pinpoint pupils
– Verbal ( out of 5)
– Motor ( out of 6)
What makes up the secondary survey
- Disability (GCS or AVPU)
- Exposure and Environment
- Radiographs
- CT
What bloods do you carry out
• FBC • U+E’s • G&S, XM • ABG – BD – Lactate – pH
What do you have to say in handover from paramedics
ATMIST - Age • Time • Mechanism • Injuries • Signs and symptoms • Treatment
what is a coma
- unrousable unresponsiveness
What are metabolic causes of coma
- drugs, poisoning (e.g. carbon monoxide, alcohol, TCA)
- Hypoglycaemia, hyperglycaemia
- hypoxia, carbon dioxide, narcosis
- septicaemia
- hypothermia
- myxoedema
- addisonian crisis
- hepatic encepahloapthy
- uraemia encephalopathy
What are neurological causes of coma
- trauma
- infection - meningitis, encephalitis, malaria, typhoid, typhus, rabies
- tumour
- vascular - stroke, subdural/subarachnoid haemorrhage, hypertensive encephalopathy
- epilepsy - non convulsive status or post-ictal state
list what makes up the Glasgow coma score
- best motor response
- best verbal response
- eye opening
Best motor response 6 - obeying commands 5 - localising to pain 4 - Withdrawing to pain 3 - Flexor response to pain 2- extensor response to pain 1 - No response to pain
Best verbal response 5 - oriented (time, place, person) 4 - confused conservation 3 - inappropriate speech 2 - incomprehensible sounds 1 - None
Eye Opening 4 - spontaneous 3 - In response to speech 2 - in response to pain 1 - None
what is a decorticate posture and what does it mean
(arms bent inwards on chest, thumbs tucked in a clenched fist, legs extended) = implies damage above the level of the red nucleus in the midbrain
What is a decelerate poster and what does it mean
decerebrate posture (adduction and internal rotation of shoulder, pronation of forearm) = implies midbrain damage below the level of the red nucleus
What is the AVPU score
A = Alert V = Voice response P = pain response U = unresponsive
