Trauma-Eschelbach

Question 1

What is the “Golden Hour”?

Answer 1

the hour after a trauma where management is crucial to decreasing the amount of deaths from trauma

(the second peak of deaths which is a few minutes–> hour after injury)

Question 2

What are the 5 aspects of the primary survey? Does this vary between patient populations?

Answer 2

A=airway with c-spine protection
B=breathing
C=circulation/ control external bleeding
D=disability or neurological status
E=exposure (undress) and environment (temp control)

the same for everyone

Question 3

A GCS of < _____ requires the placement of a definitive airway (intubation)

Answer 3

8

Question 4

What are the 5 NEXUS requirements that need to be met to rule out the need for spinal immobilization?

Answer 4

1. No posterior midline c-spine tenderness
2. no evidence of intoxication
3. normal level of alertness
4. no focal neurological deficits
5. no painful distracting injuries

Question 5

Which trauma patients should get oxygen?

Answer 5

ALL OF THEM!

via a “mask reservoir device”….or what normal people call a non-rebreather

Question 6

Which female trauma patients should get a pregnancy test?

Answer 6

all women of reproductive age

Question 7

If a woman is pregnant, should you avoid essential x-rays in order to protect the fetus?

Answer 7

NO!

the patient is your first priority

Question 8

What are the 5 things that should be included in the history of a trauma patient (AMPLE)?

Answer 8

A=allergies 
M=meds
P=PmHx/pregnancy
L=last meal 
E=events / environment related to injury

Question 9

When should a trauma patient be intubated?

Answer 9

if there is any doubt about the patient’s ability to maintain airway integrity

(should be secured when there is a potential for airway compromise)

Question 10

What is the most common cause of shock in a trauma pt?

Answer 10

Hemorrhage

Question 11

What are the 4 classes of blood loss based on initial presentation? What is the blood lost, % blood lost, pulse, systolic blood pressure, respiratory rate, mental status and initial fluid replacement needed for each class? (know the chart on slide 51)

Answer 11

Class I:

• up to 750 mL blood lost
• up to 15%
• pulse 2000 mL
• > 40%
• pulse >140
• systolic BP Decreased
• RR >35
• mental status: confused, lethargic
• fluid: crystalloid and blood

Question 12

Is persistent infusion of large volumes of fluid in attempt to achieve normal blood volume a substitute for definitive control of bleeding?

Answer 12

NO!

control the bleeding, obviously

Question 13

What are the 3 different responses to initial fluid resuscitation? Which response likely needs surgical intervention?

Answer 13

Rapid response

Transient response (likely surgical intervention needed)

Minimal or no response (highly likely surgery needed)