Trauma Flashcards
How would you manage anaphylaxis?
Lie patent flat and raise legs
- IM 500microg Adrenaline (0.5mls of 1:1000)
- IV fluids - NOT COLLOID
- IM chlorphenamine 10mg
- IM hydrocortisone 200mg
What is diffuse axonal injury?
Rapid acceleration or deceleration causing shearing of the axon tracts
Define unconsciousness and coma.
Unconscious: Interruption of awareness of oneself and ones surroundings, lack of ability to notice or respond to stimuli in the environment
Coma: a completely unaware patient unresponsive to external stimuli with only eye opening to pain with no eye tracking or fixation and limb withdrawal ti a noxious stimulus at best
What is the first step in managing a patient with Anaphylaxis?
A-E. Call for help
Lie patient flat and raise legs to increase venous return to heart
IM adrenaline
What causes anaphylaxis?
Severe type 1 hypersensitivity reaction. Generalised and systemic
IgE causes mast cells degranulation releasing histamine and pro inflammatory cytokines
Shellfish is 1 cause
Nuts, colloids, NSAIDs, antibiotics, bee stings
What symptoms and signs might someone with anaphylaxis show?
History of allergen exposure
Urticaria and itching
Angiodema - deep swelling of face, eyes, ears
Skin rash
Abdominal pain
Haorseness, wheeze, tachycardia, hypotensive, stridor due to laryngoedema, SoB, collapse, drowsy
How long should you observe a patient in anaphylaxis for and why?
6 hours
May have a biphasic reaction
Define severe sepsis.
Sepsis + organ dysfunction
Life threatening organ dysfunction due to the bodys dysregulated response to systemic infection
Define septic shock.
Sepsis + refractory hypotension (SBP <90).
Sepsis + hypotension requiring inotropes to maintain a MAP >/=65 and a serum lactate >2 despite adequate volume resuscitation
What types of shock are described as distributive?
Anaphylactic, neurogenic, septic
All have peripheral vasodilation
In shock, how might you tell if it is due to haemorrhage or fluid losses?
Haemocrit - increased if fluid loss, reduced if haemorrhage
What is shock?
Inadequate end organ perfusion and tissue oxygenation
Pump failure - Cardiogenic
Peripheral circulation failure - hypovolaemic, septic, neurogenic, anaphylactic
What are the important points in a history in trauma?
AMPLE
Allergies, medications, past medical history, last tome eaten, events surrounding trauma
In trauma patients, the goal of resus in haemorrhage is to avoid the triad of death, what is it?
Hypothermia, acidosis, coagulopathy
What are some features of a basilar skull f#?
Anterior cranial fossa f#- Raccon eyes - periorbital oedema and ecchymosis with sparing of tarsal plates, rhionorrhoea, haemotypanum
Petrosal temporal bone - Battle sign (post auricular ecchymosis), Otorrhoea, haemotypanum, CN signs - facial palsy, deafness
Halo sign or double ring sign on clothes from csf leak
