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TC8-800 > Trauma Assessment per Da form > Flashcards

Trauma Assessment per Da form Flashcards

1
Q

Three phases of Combat Casualty Assessment

A
  1. Care Under Fire (CUF)
  2. Tactical Field Care Phase (TFC)
  3. Tactical Evacuation Care (TAC-EVAC)
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2
Q

What occurs during CUF?

A

Fire Superiority
Can Pt assist himself or the squad
Secure site - concealment/cover/perimeter
Treat major life-threatening extremity injuries. (HASTY)

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3
Q

What is another name for TFC?

A

Primary and Secondary Assessment

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4
Q

What is another name for Secondary assessment?

A

Detailed Physical Exam

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5
Q

Primary events during TFC? (9)

A 
BSI
Responsiveness
Blood sweep
ABC's
Vascular Access PRN
Jx wound care
Request Evac - 9 line
Reassess Interventions
Drug Allergy/Pain Mgmt/Abx
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6
Q

What occurs if the Pt is unresponsive/AMS?

A

Assess Carotid and Respirations

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7
Q

What areas are assessed during blood sweep?

A

Neck
Axillary
Inguinal
Extremities

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8
Q

During blood sweep, what also occurs in addition to identifying additional bleeds?

A

Assess previous TQs
Apply Delibrate TQ’s to new wounds
Apply Hemostatic Agents PRN

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9
Q

How long is pressure held on hemostatic agents?

A

At least 3-5m PRN

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10
Q

Where are the only sites hemostatic agents are applied?

A

Neck
Axillary
Inguinal Wounds

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11
Q

Are hemostatic/pressure dressing agents applied to the Torso?

A

No

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12
Q

What are two questions regarding airway and what should occur during Airway assessment?

A 
Is there an Airway? Will it stay open?
-
Head Tilt and look, listen, and feel
Insert adjunct as needed or perform surgical cric
Position Pt to continue airway patency
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13
Q

What is the first thing that MUST happen during breathing assessment?

A

Expose Torso and assess

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14
Q

What is the primary injury to identify while assessing the torso and breathing?

A

Penetrating chest trauma

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15
Q

What must occur after identifying a penetrating chest trauma?

A

Apply occlusive dressing

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16
Q

What must also be considered with a penetrating chest wound?

A

Needle Decompression PRN per respiratory effort

Exit Wound

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17
Q

How is breathing assessed?

A

Look - Equal rise and fall of the chest

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18
Q

What is palpated during breathing assessment and for what?

A

DCAP-BTLS and TIC

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19
Q

What sites are checked for DCAP-BTLS and TIC during breathing assessment?

A

Shoulder Girdle
Sternum
Rib Cage
Axilla

20
Q

What is the indications of NCD?

A

Chest Trauma AND progressive respiratory effort

21
Q

Sites where NCD is inserted?

A

MCL 2-3rd intercostal space

AAL 4-5th intercostal space

22
Q

What is the size of a NCD needle?

A

14 gauge, 3.25 inch needle

23
Q

How long is NCD held before removing needle?

A

5-10 seconds - woosh of air

24
Q

What is the best position for breathing?

A

Position of comfort

25
Q

What needs to occur during circulation (C)?

A 
Pulse check - Radial Y/N > Carotid
Pack/Pressure dress significant non-pulsatile bleeds
Assess H-TQ for conversion to D-TQ
Vascular access and need for fluids
Wrap any Jx wounds
Evacuation - 9 line
Reassess Interventions
Drug allergies and Pain Mgmt/Meds
26
Q

Where is D-TQ applied?

A

2-3 inches above wound w/out binding joint

27
Q

D-TQ performance steps?

A

Apply D-TQ
Loosen H-TQ and check distal pulse
If Distal pulse present tighten D-TQ further
If Distal Pulse still present apply new D-TQ just above

28
Q

Criteria for vascular access?

A

Significant trauma

29
Q

Criteria for Saline Lock?

A

Radial Pulses present and normal mental status

30
Q

Criteria for Fluid Resuscitation?

A

Absent radial pulses and AMS

31
Q

What is 1st line fluid for combat fluid resuscitation?

A

500mL Hextend

32
Q

What are the criteria for establishing IO?

A

Two unsuccessful IV attempts

33
Q

Minimum lines to initiate 9-line?

A

3,4,5
3 - Number of pts by precedence
4 - Special Equipment required
5 - Number of patients

34
Q

Detailed Physical exam of Head includes

A

DCAP BTLS
PERRL
Inspect Ears, Eyes, Nose, Mouth

35
Q

Detailed Physical exam of Neck includes

A

DCAP BTLS - TIC

Inspect Trachea/Jugular Veins

36
Q

Detailed Physical exam of Chest includes

A

DCAP BTLS - TIC
Inspect Shoulder Girdle, Sternum, Ribs, Axilla
PRN Auscultate

37
Q

Detailed Physical exam of ABD/Pelvis includes

A

DCAP BTLS and Pelvic for TIC

Inspect perineum

38
Q

Detailed Physical exam of Lower Extremities includes

A

DCAP BTLS - TIC
Assess Motor, Sensory, Circulatory Fx
Splint PRN
Convert Hemorrhage control PRN

39
Q

Detailed Physical exam of Upper Extremities includes

A

DCAP BTLS - TIC
Assess Motor, Sensory, Circulatory Fx
Splint PRN
Convert Hemorrhage control PRN

40
Q

Detailed Physical exam of Posterior includes

A

DCAP BTLS - TIC

41
Q

What does DCAP stand for?

A

Deformities
Contusions
Abrasion
Penetrations

42
Q

What does BTLS stand for?

A

Burn
Tenderness
Lacerations
Swelling

43
Q

What does TIC stand for?

A

Tenderness
Instability
Crepitus

44
Q

What must occur during TAC-EVAC?

A 
Protect against hypothermia
Prep extraction device
SAMPLE
Baseline vitals
Document
ABX PRN
45
Q

Timeframe for ABX consideration?

A

Over 3-hour evac delay for penetrating trauma

TC8-800 (3 decks)

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