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Emergency Medicine > Trauma Assessment & Management > Flashcards

Trauma Assessment & Management Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Assessment and Management Priorities

A

Rapid primary survey
Resuscitation of vital functions
Detailed secondary survey
Initiate definitive care

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2
Q

Components of Primary Survey

A 
A: airway and c-spine control
B: breathing and ventilation
C: circulation and hemorrhage control
D: disability (neuro status)
E: exposure (completely undress patient)
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3
Q

Airway and C-Spine Control

A

Open airway
Suction airway
Insert mechanical airway
Immobilize neck

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4
Q

Diagnostic Test for Clearing of C-Spine

A

Cross-table lateral C-spine film

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5
Q

Breathing

A

Look for chest movement
Patent airway does not equal adequate ventilation
Need oxygen and volume

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6
Q

3 Conditions that Compromise Ventilation

A

Tension pneumothorax
Open pneumothorax
Large flail section with pulmonary contusion

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7
Q

Circulation

A

Hypotension: assume hypovolemia
State of consciousness
Skin color
Pulse

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8
Q

How much blood loss must occur prior to becoming unconscious?

A

50% or more

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9
Q

How much blood loss must occur to having ashen, grey skin and white, drained extremities?

A

30% or more

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10
Q

How much blood loss must occur prior to losing carotid and femoral pulses?

A

50% or more

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11
Q

Primary Survey and Obvious Bleeding

A

Control via direct pressure

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12
Q

Disability Acronym

A

AVPU

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13
Q

What does AVPU stand for?

A

A: alert
V: verbal stimuli
P: pain stimuli
U: unconscious

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14
Q

Other Tests for Disability in the Primary Survey

A

Pupil size and reaction

Decrease in LOC

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15
Q

Exposure

A

Completely undress patients
Cut away clothing, shoes, etc.
Remove all field dressing and assess

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16
Q

Resuscitation Phase of Trauma Assessment and Management

A 
Airway/ventilation/oxygenate
IV lines/warm fluids
Shock management
Manage life-threatening injuries
Foley catheter and NG tube
17
Q

What EKG changes may indicate cardiac contusion?

A

Atrial fibrillation
PVCs
ST segment changegs

18
Q

What EKG change may indicate tamponade, tension pneumothorax, or class IV hemorrhage?

A

PEA

19
Q

What EKG change may be due to hypo perfusion or hypothermia?

A

Bradycardia

20
Q

Secondary Survey: Head

A 
Pupil size and reactivity
Fundi for hemorrhage
Lens for dislocation, evidence of conjunctival laceration or penetrating trauma
REMOVE CONTACTS
Maxillofacial trauma
21
Q

Secondary Survey: Neck/C-Spine

A

All blunt injury to maxillofacial area
Absence of neurological deficit or pain does NOT rule out injury
All helmets must be removed while maintaining immobilization
Penetrating trauma through platysma should be assessed in the OR

22
Q

Secondary Survey: Chest

A

Visually inspect
Palpate entire chest: ribs, clavicles, sternum
Auscultate chest: apex, bases

23
Q

Secondary Survey: Abdomen

A

Recognize abdominal injury has occurred
Serial exams over several hours
Call surgeons early and frequently
FAST

24
Q

Secondary Survey: Rectal Exam

A 
Assess presence of blood in bowel lumen
High-riding prostate
Presence of pelvic fracture
Integrity of rectal wall
Quality of sphincter tone
25
Q

Secondary Survey: Fractures

A

Visualize extremities
Palpate bones: tenderness, crepitation, abnormal movements
Document peripheral pulses and distal neurological status
Thoracic and lumbar spine injuries

26
Q

Secondary Survey: Neurological

A

Motor and sensory check
Evidence of paralysis or paresis
Evidence of epidural/subdural hematoma, depressed skull fractures, or other intracranial injuries
Glascow Coma Scale

27
Q

Eye Opening of Glasgow Coma Scale

A

4: spontaneous
3: speech
2: pain
1: none

28
Q

Verbal Response of Glasgow Coma Scale

A

5: oriented
4: confused
3: inappropriate
2: incomprehensible
1: none

29
Q

Motor Response of Glasgow Coma Scale

A

6: obeys commands
5: localizes to pain
4: withdraws from pain
3: flexion to pain
2: extension to pain
1: none

30
Q

Definitive Care Phase

A

Comprehensive management
Fracture stabilization
Operative intervention
Stabilization and transfer

31
Q

AMPLE History

A 
A: allergies
M: medications
P: past illnesses/surgeries
L: last intake
E: events leading up to event
32
Q

Energy Waves in Blunt Trauma

A

Extends from blunt trauma

33
Q

Energy Waves in Missile Trauma

A

Extends lateral from missile trauma

34
Q

Likely Frontal Impact Injuries

A

C-spine
Central flail chest
Myocardial contusion
Fractures spleen/liver

35
Q

Likely Side Impact Injuries

A 
Contralateral neck sprain or cervical fracture
Lateral flail chest
Pneumothorax
Acceleration injury to aorta
Fractured pelvis or acetabulum
36
Q

Penetrating Trauma/GSW

A 
Region of body
Distance of object from source
Temporary cavitation
Missile deformity after entering body
Tissues impacted

Emergency Medicine (17 decks)

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