Trauma Big Picture

Question 1

Which triage category?

i. Breathing
ii. obeys commands
iii. purposeful movement
iv. peripheral pulses
v. no resp distress/active hemorrhage
vi. minor injury only

Answer 1

Green: minor

Question 2

Which triage category?

i. Breathing
ii. obeys commands
iii. purposeful movement
iv. peripheral pulses
v. no resp distress/active hemorrhage
vi. POS non-minor injury

Answer 2

Yellow: Delayed

Question 3

Which triage category?

i. Breathing
ii. NEG obey commands
iii. NEG purposeful movement
iv. NEG peripheral pulses
v. POS resp distress or active hemorrhage
vi. POS survival chance if given resources

Answer 3

Red: immediate

Question 4

Which triage category?

i. Breathing
ii. NEG obey commands
iii. NEG purposeful movement
iv. NEG peripheral pulses
v. POS resp distress or active hemorrhage
vi. NEG survival chance l if given resources

Answer 4

Black: expectant dead

Question 5

ABCDEFs of primary assessment…

Answer 5

airway
breathing
circulation
disability (avpu)
exposure
FAST exam

Question 6

GCS scoring…

Answer 6

4,5,6

eyes, verbal, motor

Question 7

massive transfusion protocol…

Answer 7

1:1:1 ratio PRBCs, FFP, Platelets

Question 8

Step down tx for shock

Answer 8

1L isotonic crystalloid –> 1-2 units O neg/PRBCs –> MTP

Question 9

absent central pulses is an indication for what hemorrhage intervention?

Answer 9

emergency thoracotomy

Question 10

medical interventions for hemorrhage?

Answer 10

tranexamic acid + transfusion

Question 11

perimortem C-section should be initiated how quickly after maternal arrest?

Answer 11

4 minutes… must be delivered w/in 5 mins

Question 12

What categories of burns need grafts?

Answer 12

deep partial thickness and full thickness

Question 13

modified brooke/parkland formula indication…

Answer 13

burns > 15% BSA peds

> 20% BSA adults

Question 14

modified brooke/parkland formula

Answer 14

2mL-4mL x % BSA x Wt = LR volume

Question 15

rate of infusion from modified brooke/parkland formula

Answer 15

1/2 first 8 hours

1/2 following 16 hours

Question 16

Trauma PAN SCAN imaging…

Answer 16

Non Contrast CT:
head, face, spine

Contrast CT Chest, Abd. Pelvis

Question 17

The below signs indicate…

pain
paresthesia
pallor
poikilotherma
paralysis
pulselessness

Answer 17

compartment syndrome

Question 18

Abnormal ABI for the lower extremity…

Answer 18

< 0.9

Question 19

The below are hard or soft signs of penetrating trauma/vascular injury?

pulsatile bleed
expanding hematoma
pulseless limb
shock
compartment syndrome
bruit thrills

Answer 19

hard–to OR

Question 20

The below are hard or soft signs of penetrating trauma/vascular injury?

small/non-expanding hematoma

venous ooze

hx pulsatile bleed

unexplaine dneuro deficit

Answer 20

soft - Get ABI, if abnormal CT angiogram

Question 21

most frequently injured organ in penetrating trauma…

Answer 21

liver

Question 22

2nd most requently injuryed organ in blunt abd. trauma

Answer 22

liver

Question 23

most frequent blunt trauma organ injury

Answer 23

spleen

Question 24

3 vaccines to consider w. spleen injury/removal

Answer 24

pneumovax
h flu
meningococcus

Question 25

Grey Turner's sign and Cullen's sign indicate..

Answer 25

retroperitoneal hemorrhage

Question 26

If the below are not present, do you need head CT? - LOC/amnesia - age > 60 - intoxication - visible trauma above clav. - post-trauma seizure

Answer 26

no

Question 27

Peds CT indications via PECARN

Answer 27

AMS, GCS < 15, Signs of Basilar Skull Fx

Question 28

PECARN class < 2 yo LOC > 5s non-frontal hematoma not acting normal severe MOI

Answer 28

observation vs. CT

Question 29

PECARN class > 2 yo hx LOC hx vomiting severe HA severe MOI

Answer 29

observation vs CT

Question 30

Nexus rules state no cervical spine radiograph if what 5 factors together are present?

Answer 30

``` no midline tnederness no focal neuro deficit normal alertness no intoxication no painful distracting injury ```

Question 31

Lethal triad trauma/shock

Answer 31

hypothermia coagulopathy acidosis

Question 32

tx for acidosis in trauma

Answer 32

stop bleeding/ tx shock

Question 33

tx for coagulopathy in trauma

Answer 33

permissive hypotension, blood products

Question 34

GCS indication for intubation

Answer 34

8 or less

Question 35

Which hemorrhage class? massive increased HR, RR massive decreased BP, UO DecreasedGCS, PP 40% blood loss needs massive transfusion

Answer 35

class IV

Question 36

Which hemorrhage class? increased HR, RR Decreased BP, PP, UO, GCS 31-40% blood loss needs transfusion

Answer 36

class III

Question 37

Which hemorrhage class? decreased PP blood loss 15-30% possible transfusion

Answer 37

class II

Question 38

permissive hypotension is SBP between...

Answer 38

80 and 100

Question 39

cricothyroidotomy is 2nd line after...

Answer 39

attempted ET intubation