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6903 > Trauma- assessment, resuscitation, and stabilization > Flashcards

Trauma- assessment, resuscitation, and stabilization Flashcards

1
Q

What is the third most common cause of death in US?

A

trauma

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2
Q

What contributes significantly to mortality r/t trauma?

A

delay or failure to diagnose

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3
Q

75 percent mortality from trauma occurs what hours after the trauma?

A

within 48 hours

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4
Q

2 most common causes of early mortality trauma related? one third of these die how early after admission?

A

CNS injuries and hemorrhage; within 4 hours

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5
Q

Most common mechanism of injury and largest number of associated deaths?

A

motor vehicle injury

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6
Q

Second most common mechanism of injury?

A

falls

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7
Q

Third most common cause of trauma injury?

A

gun shot wounds

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8
Q

What type of trauma is associated w the highest percentage of death?

A

gunshot wounds

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9
Q

What is included in the primary survey?

A

presence of immediate life threatening injuries, ABCDs

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10
Q

What does ABCDE stand for?

A

airway, breathing, circulation, disability, exposure

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11
Q

6 situations in which airway is usually compromised?

A

altered LOC, smoke inhalation injury, maxillo facial injuries, penetrating wound or hematoma to neck, SQ emphysema of face, neck, upper chest, evidence of vomiting

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12
Q

3 of concern wounds related to breathing?

A

sucking chest wounds, open pneumo, flail segments

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13
Q

How do you evaluate airway?

A

is it patent?

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14
Q

How do you evaluate breathing?

A

expose, palpate, auscultate, pattern, tracheal deviation, skin color

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15
Q

How do you evaluate circulation?

A

2 large bore IVs, pulse rate, character, etc., cap refill, BP, pulse pressure, bleeding, hypovolemia, blood samples, EKG

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16
Q

A palpable radial pulse corresponds with an SBP of what?

A

> /- 80

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17
Q

A palpable femoral pulse corresponds with an SBP of what?

A

> /- 70

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18
Q

A palpable carotid pulse corresponds with an SBP greater than or equal to what?

A

60

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19
Q

Poor cerebral blood flow with an SBP less than?

A

60

20
Q

How do you evaluate disability?

A

neuro status, AVPU, check pupils

21
Q

AVPU stands for?

A

alert, responds to verbal stimulus, responds to pain, unresponsive

22
Q

3 components of GCS?

A

eyes open, best motor response, best verbal response

23
Q

How do you evaluate exposure?

A

expose the patient for complete exam

24
Q

Goal of resuscitation?

A

restore tissue oxygenation

25
Q

Anesthesia’s 3 primary concerns during assessment of trauma patient?

A

preserve CNS ftn, maintain adequate respiratory gas exchange, achieve circulatory homeostasis

26
Q

How do you preserve CNS function?

A

avoid movement of spinal cord in unstable fracture that decreases blood flow to the brain

27
Q

How do you complete c spine stabilization?

A

hold head while someone intubates and the front comes off the collar

28
Q

Avoid NTT/NGTs in patients w what type of fracture?

A

basilar skull fractures

29
Q

Whats a technique to try if pt breathing spontaneously, but it increases ICP?

A

nasal intubation

30
Q

Awake intubation should be avoided in which type of trauma pt? Why?

A

vascular neck trauma; gagging coughing can increase ICP and accelerate bleeding

31
Q

Blind nasal or oral intubation should be avoided in what patients?

A

blood in airway, maxillofacial injuries bc tissue, bone fragments, or teeth may be pushed into trachea

32
Q

Cricothyroidotomy is not recommended in which pts?

A

laryngeal fracture

33
Q

Cricothyroidotomy is reserved for what pts?

A

severe facial or upper airway obstruction

34
Q

The pt is at risk for coagulopathy if they get greater than how much of hetastarch?

A

1 L

35
Q

What lethal triad should you avoid in resuscitating a trauma pt?

A

acidosis, hypothermia, coagulopathy

36
Q

How do you know there is still bleeding if the pt has been crystalloid resuscitated with 2L?

A

hr >120

37
Q

Sign of significant blood loss and cardiac tamponade?

A

decreased pulse pressure

38
Q

Most common cause of coagulopathy in trauma pt?

A

dilutional thrombocytopenia

39
Q

Dose of Factor VII?

A

70-90 mcg/kg

40
Q

In young people hypotension will not develop until what percent of blood volume is lost?

A

30-40%

41
Q

In young people tachycardia will not develop until how much blood is lost?

A

20-25%

42
Q

Art line in what 3 cases for sure?

A

chest, neck, head

43
Q

What happens in the secondary survey?

A

complete head to toe exam including rectal

44
Q

AMPLE stands for?

A

allergies, medications, pmh, pregnancy, last meal, tetanus, and menses, events and environment r/t injury

45
Q

Ex of penetrating trauma?

A

knives, bullets, projectiles

46
Q

Ex of blunt trauma?

A

accel decel, continuous pressure, shearing, direct impact, rotary forces, disruption of conn tissue, blood vessels, nerves, seen w collisions and falls

47
Q

What do you want to know from MVA pt?

A

location, safety devices, site of impact, extent of damage

6903 (12 decks)

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