Trauma and Burns Flashcards
Most common indication for intubation
Altered Mental Status
Always your first priority in the primary survey
Securing airway
Signs of basilar skull fracture
CSF rhinorrhea
Raccoon eyes
Battle’s sign
Narrowest part of adult airway
Glottis
Narrowest part of child airway
Cricoid cartilage
Preferred age for tracheostomy
Under 11 years old
This endotracheal intubation is done usually in pre hospital setting
Nasotracheal
Where do you insert your needle tension pneumothorax for adult and children?
Adult: 4th to 5th ICS MAL
Child: 2nd ICS MAL
Indications for emergency endotracheal intubation (6)
Acute airway obstruction
Hypoventilation
Severe hypoxemia despite supplemental oxygen
Altered mental status
Cardiac arrest
Severe hemorrhagic shock
Occurs when 3 or more contiguous ribs are fractured in at least 2 locations
Flail chest with underlying pulmonary contusion
Free communication between pleural space and atmosphere
Open pneumothorax (sucking chest wound)
Collection of blood in the space between the chest wall and pleural cavity
Massive Hemothorax
Definitive treatment for open pneumothorax
Closure of chest wall defect and closed tube thoracostomy remote from the wound
Treatment for flail chest
Presumptive intubation and mechanical ventilation (PEEP)
Types of tracheobronchial injury
Type 1 - within 2 cm of carina
Type 2 - almost always accompanied by pneumothorax
Classic description of neurogenic shock (4)
Paralysis
Warm and pink extremities
Bradycardia
Hypotension
At which class of shock will you start transfusing blood products?
Class III
Initial fluid resuscitation for shock patients
20 mL/kg intravenous bolus isotonic crystalloid
Where do you perform intraosseous infusion?
Proximal tibia or distal femur
Cardiac tamponade occurs more commonly in what type of injury?
Penetrating thoracic injury
Amount of pericardial blood that may cause tamponade
Less than 100 mL
Beck triad
Hypotension
Dilated neck veins
Muffled heart tones
Cardiac tamponade with an SBP of < 60 mmHg will warrant ____.
Emergency department thoracotomy
EDT is best accomplished using ____.
Left anterolateral thoracotomy