Trauma Big Picture Flashcards
Which triage category?
i. Breathing
ii. obeys commands
iii. purposeful movement
iv. peripheral pulses
v. no resp distress/active hemorrhage
vi. minor injury only
Green: minor
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
Yellow: Delayed
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
Red: immediate
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
Black: expectant dead
ABCDEFs of primary assessment…
airway breathing circulation disability (avpu) exposure FAST exam
GCS scoring…
4,5,6
eyes, verbal, motor
massive transfusion protocol…
1:1:1 ratio PRBCs, FFP, Platelets
Step down tx for shock
1L isotonic crystalloid –> 1-2 units O neg/PRBCs –> MTP
absent central pulses is an indication for what hemorrhage intervention?
emergency thoracotomy
medical interventions for hemorrhage?
tranexamic acid + transfusion
perimortem C-section should be initiated how quickly after maternal arrest?
4 minutes… must be delivered w/in 5 mins
What categories of burns need grafts?
deep partial thickness and full thickness
modified brooke/parkland formula indication…
burns > 15% BSA peds
> 20% BSA adults
modified brooke/parkland formula
2mL-4mL x % BSA x Wt = LR volume
rate of infusion from modified brooke/parkland formula
1/2 first 8 hours
1/2 following 16 hours
Trauma PAN SCAN imaging…
Non Contrast CT:
head, face, spine
Contrast CT Chest, Abd. Pelvis
The below signs indicate…
pain paresthesia pallor poikilotherma paralysis pulselessness
compartment syndrome
Abnormal ABI for the lower extremity…
< 0.9
The below are hard or soft signs of penetrating trauma/vascular injury?
pulsatile bleed expanding hematoma pulseless limb shock compartment syndrome bruit thrills
hard–to OR
The below are hard or soft signs of penetrating trauma/vascular injury?
small/non-expanding hematoma
venous ooze
hx pulsatile bleed
unexplaine dneuro deficit
soft - Get ABI, if abnormal CT angiogram
most frequently injured organ in penetrating trauma…
liver
2nd most requently injuryed organ in blunt abd. trauma
liver
most frequent blunt trauma organ injury
spleen
3 vaccines to consider w. spleen injury/removal
pneumovax
h flu
meningococcus
Grey Turner’s sign and Cullen’s sign indicate..
retroperitoneal hemorrhage
If the below are not present, do you need head CT?
- LOC/amnesia
- age > 60
- intoxication
- visible trauma above clav.
- post-trauma seizure
no
Peds CT indications via PECARN
AMS, GCS < 15, Signs of Basilar Skull Fx
PECARN class < 2 yo
LOC > 5s
non-frontal hematoma
not acting normal
severe MOI
observation vs. CT
PECARN class > 2 yo
hx LOC
hx vomiting
severe HA
severe MOI
observation vs CT
Nexus rules state no cervical spine radiograph if what 5 factors together are present?
no midline tnederness no focal neuro deficit normal alertness no intoxication no painful distracting injury
Lethal triad trauma/shock
hypothermia
coagulopathy
acidosis
tx for acidosis in trauma
stop bleeding/ tx shock
tx for coagulopathy in trauma
permissive hypotension, blood products
GCS indication for intubation
8 or less
Which hemorrhage class?
massive increased HR, RR
massive decreased BP, UO
DecreasedGCS, PP
40% blood loss
needs massive transfusion
class IV
Which hemorrhage class?
increased HR, RR
Decreased BP, PP, UO, GCS
31-40% blood loss
needs transfusion
class III
Which hemorrhage class?
decreased PP
blood loss 15-30%
possible transfusion
class II
permissive hypotension is SBP between…
80 and 100
cricothyroidotomy is 2nd line after…
attempted ET intubation
