Trauma Emergencies (Shock/Hemo, TBI) Flashcards
The _____ the kinetic energy of a projectile, the _____ the wounding potential.
greater; greater
Intracranial hemorrhage between the skull and dura mater
Epidural hematoma
Urine output of ____ is indicative of shock
25 mL/hr
Diffuse Axonal Injury describes an extensive damage involving a wide area of neural tissues throughout the ___ and ___; the damage involves the __________ of the neural _____ matter.
cerebrum; brainstem
innermost centroaxial areas
white
Results from a single blunt strike that creates a fissure line in the cranium
Linear fracture
A collective term describing a wide range of pathologic conditions and types of trauma involving the brain
Traumatic brain injury
Periorbital ecchymosis
Raccoon’s eyes
A distortion in the integrity of the bony skull
Skull fracture
Tissue that is _____ has a tendency to take up more _____, resulting in greater _____.
dense; energy; damage
A term that refers to inadequate tissue perfusion
Shock
Pulse in Class IV Hemorrhage
> 140 bpm
Possible causes of shock
Massive bleeding
Infection
Severe allergic reaction
Severe dehydration
Heart problems
The important indicators of determining the extent of injuries includes:
(American Trauma Life Support, 2020)
Gun’s caliber
Presumed path and velocity
Distance from the weapon to the victim’s entrance point
It is administered to maintain cardiac output, but not until volume is replaced.
Vasopressors
A life-threatening condition that occurs when the body is not getting enough blood flow
Shock
Amount of blood loss in Class I Hemorrhage
≤750 mL
It is the bruising of the brain tissue that occurs when the head suffers a direct impact with a rigid object
Contusion
Anterior Basilar Skull Fracture results from a ______ fall that damages _____ area
forward; frontal
Entrance wound is called V1 (inlet velocity) as the
maximal point of energy
It is carried by the bullet and subsequently transferred into the tissues causing damage in a GSW victim
Kinetic Energy (KE)
In blood transfusion, ____ packed RBC can be administered.
O-negative
Intracranial bleeding between the arachnoid mater and pia mater.
Subarachnoid hematoma
Occurs when the generated force is greater than the cranial vault can absorb
Head trauma
Stimulation of the gag reflex can ___ ICP
increase
Mental status in Class II Hemorrhage
Mildly anxious
CSF leak that may cause an _____ infection
ascending
Behavioral changes in primary assessment of shock
Agitation
Confusion
Unresponsiveness
The study of projectile penetration of the tissues
Wound ballistics
A perforated scalp is observed
Open skull fracture
The amount of destruction is directly related to the:
Caliber of the gun
Type of bullet
Proximity of the muzzle to the victim
Type of dressing to control bleeding
loose, bulky
If a projectile does not exit the body, then ___ its kinetic energy has been transferred to the tissues.
all
True or False: Basal Skull Fracture results from a backward fall that damages the occiput
True
Result from a fall and may result laceration of bone tissues.
Depressed skull fracture
Hypovolemic shock may result from
Hemorrhage
Burns
GI losses
Fluid shifts
The inadequacy to perfuse tissue is a result of one or more of the following:
Pump failure of the heart
Decrease circulating blood volume
Changes in the arterial resistance vessels
Changes in the capacity of the venous beds
Usually ____ liters of blood volume is loss in hemorrhage
5
True or False: Do not assume a cervical spine fracture for any patient with a significant head injury, until otherwise proven.
False; Assume
Priority nursing diagnosis for shock and hemorrhage
Altered tissue perfusion
Late signs of increased ICP:
Hypertension
Bradycardia
Fluid management in Class III Hemorrhage
Crystalloids with BT
Occurs when significant amount of fluid (blood, plasma, or electrolyte solution) is lost from intravascular space
Hypovolemic shock
A subjective feeling as a sign of shock
Impending doom
In relation to physics, KE is computed based on:
KE=WVG
Weight of the bullet
Velocity
Gravitational acceleration
Fluid of choice for the initial treatment of hemorrhage
PLR
If the bullet does not exit the body, outlet
velocity is _____
zero or V0
CSF leak
ear: _____
nose: _____
otorrhea
rhinorrhea
Intracranial bleeding between the arachnoid mater and pia mater.
Subarachnoid hematoma
Ture or False: Concussion is a direct brain injury involving neural tissue; a permanent loss of consciousness that results from a transient interruption on the brain’s normal functioning
False; temporary
Drugs for TBI:
anticonvulsants
Mannitol
antibiotics
antipyretics
If basilar skull fracture or severe midface
fractures are suspected, ___ is contraindicated.
NGT
The science of the motion of projectiles
Ballistics
The high v1 creates an _____ path along which the bullet travels, but also _____ pressure also exists behind the bullet, which _____ debris and bacteria to the wound.
inward; negative; pulls
_____ is one of the leading causes of _____, and _____ are the leading source of high-velocity penetrating trauma
Penetrating trauma; hemorrhage; gunshot wounds
Refers to rapid loss of circulating blood volume
Hemorrhage
Periauricular ecchymosis; a bluish discoloration behind the ears
Battle’s sign
Goals of treatment for hemorrhage
To decrease blood loss
To increase intravascular volume
If the projectile _____ the body, then only some of its kinetic energy has been transferred to the tissues.
exits
Significant bleeding into a space or potential space between the skull and the brain
Intracranial hemorrhage
True or False: Fluid should be restricted in TBI
True
True or False: Hypotension as a sign of shock is the fall of diastolic blood pressure.
False; SBP yon teh
Intracranial hemorrhage between the dura mater and arachnoid mater.
Subdural hematoma
