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Year 3 Clin Skills > Trauma and Shock > Flashcards

Trauma and Shock Flashcards

1
Q

Define shock

A

Inadequate perfusion to meet metabolic demand

Hypoxia caused by circulatory collapse

Lead to cellular injury and organ failure

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2
Q

What are the different types of shock?

A 
Hypovolaemic shock 
Obstructive
Distributive
Cardiogenic
Neurogenic
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3
Q

What are the causes of Hypovolaemic shock?

A

Haemorrhage
Fluid loss
Burns

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4
Q

What are the causes of obstructive shock?

A

Tamponade
Tension pneumothorax
PE

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5
Q

Assessment of shock

A 
ABC
Clinical signs
BP, HR, RR, UO
Lactate and Base excess
ECG, CXR, BM, FBC, U&Es, LFT, CRP
Confusion
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6
Q

Why is BP not an accurate marker of shock?

A

BP is homeostatic

Normal over a wide range or cardiac outputs

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7
Q

What is a better marker?

A

Lactate
>2 abnormal
>4 significant hypo-perfusion

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8
Q

Treatment of shock?

A

Two large bore cannula
Oxygen
Fluids (blood)
Exclude anything that needs specialist treatment e.g. arrhythmias

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9
Q

What commonly causes cardiac tamponade?

A

Penetrating injury to the right ventricle

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10
Q

Why does cardiac tamponade cause shock?

A

Obstructive
Build up of blood in pericardium
Reduces cardiac output

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11
Q

Management of cardiac tamponade?

A

Advanced trauma life support - CABCD

C = catastrophic haemorrhage

Rapid left anterio-lateral thoracotomy or clamshell

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12
Q

Classic triad in cardiac tamponade?

A

Muffled heart sounds, distended neck veins and hypotension

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13
Q

How do you diagnose cardiac tamponade?

A

Extended FAST scan

USS (mini-echo)

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14
Q

How does a tension pneumothorax cause shock?

A

Air in pleural space
Lung collapses
Increase in pressure caused tracheal shit compressing heart and reducing cardiac output

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15
Q

What is the lethal trauma triad?

A 
Coagulopathy 
Hypothermia
Acidosis
Perpetuating circle 
Prevent in all causes
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16
Q

What are signs of hypovolaemic shock?

A 
Tachycardia
Increased RR
Decreased Pulse Pressure
Anxious
Decreased UO
Decreased BP
17
Q

What is a FAST scan?

A

Focused assessment with sonography for trauma

18
Q

What are the steps of damage control resus?

A

Stop bleeding
Correct and prevent coagulopathy
Prevent hypothermia
Give TXA

19
Q

How can you stop bleeding?

A

Tourniquet
Laparotomy
Thorcotomy

20
Q

What comprises damage control surgery?

A 
Packing
Shunting
Suture repair
Staple off bowel ends
Washout
Temporary abdo wall closure

Back to theatre for definite surgery

Year 3 Clin Skills (4 decks)

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