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P2 Exams > Trauma Form/s,Def/s, #s > Flashcards

Trauma Form/s,Def/s, #s Flashcards

1
Q

!!!Parkland Burn Form for:
form:

A

= (BSA >20% only 2 & 3 degree burns)
= 4 mL x BSA x Weight (kg) = ½ 1st 8 Hrs & ½ next 16Hrs

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2
Q

Parkland Burn Form for:
form:

A

= (BSA >20% only 2 & 3 degree burns)
= 4 mL x BSA x Weight (kg) = ½ 1st 8 Hrs & ½ next 16Hrs

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3
Q

(60%) Fluid compartments % of water:

A

45% intracellular
15% extracellular (outside cell)
Interstitial 10.5% Intravascular 4.5%

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4
Q

(Blood vol/ loss) Pelvis:
Femur:
Humorous:

A

= 2-3Liters
= 1.5Liters per femur
= 750ml per humorous

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5
Q

(Burn depth) 2nd degree:

A

= Partial, EPi & Dermis burned: intense pain, fluid shift comes up thus blisters, RED to WHITE, moist & mottled w/ shifts

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6
Q

(Burn depth) Degrees:

A

= 1st/Superficial, 2nd/partial, 3rd/full/complete

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7
Q

(Class II Hemorrhage) 1 injuries:
2Compensation for blood:
3Blood Loss: 15 - 30%
4Pulse:
5Blood Pressure:
6Pulse Pressure:
7Capillary Refill:
8Ventilation Rate:
9Urine Output (mL/hr):
10Mental Status:

A

1= 1/2 Humorous fractures, a femur fracture, 1 full Hemopneumo
2= 1st line comp/ no longer maintain perfusion & 2ndary employed
3= 15 - 30% 750mLs-1.5L
4= > 100BPM
5= Normal
6= Starts to narrow
7= 2-3 secs
8= 20-30RR
9= (mL/hr) 20-30
10= Mildly Anxious

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8
Q

(Class III Hemorrhage)1 injuries/fractures:
2 Compensation to blood:

3 Blood Loss:
4 Pulse:
5 Blood Pressure:
6 Pulse Pressure:
7 Capillary Refill:
8 Ventilation Rate:
9 Urine Output (mL/hr):
10 Mental Status:

A

1= 2 Humorous, 1-2femur, 1 full Hemopneumo
2= Both 1&2nd comp/ responses failing to maintain perfusion & entering/in Decompensated Shock! (SBP <90)
3= Blood Loss: 30 - 40%, (1500 - 2000 mL’s)
4= >120
5= Starts to decrease
6= Narrows more
7= 3-4secs
8= 30-40
9= 5-10mL/hr
10= Anxious/Confused

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9
Q

(Class IV Hemorrhage) 1 injuries:
2= Compensation to blood:
3= blood loss:
4= Pulse:
5= Blood Pressure:
6= Pulse Pressure:
7= Capillary Refill:
8= Ventilation Rate:
9= Urine Output (mL/hr):
10= Mental Status:

A

1= GSWs, multiple major fractures, Pelvis
2= Irreversible Shock!
3= > 40% (>2000mLs) of total blood
4= > 140 & barely palpable in central arteries
5= Very low
6= Narrows more
7= > 5 seconds
8= > 40 or agonal
9= Negligible
10= Lethargic or Unconscious

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10
Q

(Critical Criteria) 3rd & 2nd Degree criteria:
Any 2nd or 3rd degree burns involving:
Burn types that’re critical & Rx:

A

= 3rd>10% & 2nd>30%
= Face, Hands, Genitalia, Circumferential, Feet, (Dipping), Airway
= Chem, high voltage, Burns w/ major trauma go trauma center 1st then burn center

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11
Q

(Non& Hemorrhagic treatment) If hemorrhage can be controlled:
If hemorrhage cannot be controlled:

Med for Sig/hemorrhage, in/external (after external controlled)

A

= IV/IO therapy (don’t delay transport) can administer 20 mL/kg bolus.
=administer just enough IV fluid to obtain a radial pulse (permissive hypotension therapy!)NO MORE SBP 80-90 (IV fluids Warm)
= Tranexamic Acid (TXA) Adult 1G/10 mins (mix in 50 mL of NS) follwed w/ 1G/8Hrs (500 mL bag) & Pediatric Not recommended

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12
Q

(Thermal burn phases) Hypermetabolic phase:

A

3rd phase Days or weeks depending on burn severity; increase in body’s demands for nutrients; begins process of repairing damaged tissue (needs Glucose, amino acids, carbohydrates, O2 to support damage)

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13
Q

(Thermal burn phases) Resolution phase:

A

4th phase Scar tissue laid down and remodeled; rehabilitate and return to normal function (weeks to months) new collagen & usually doesnt remodel to original state & makes escar (burn keloid) bc overgrowth

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14
Q

(Trauma centers) Lvl 1:
Lvl 2:

Lvl 3:
Lvl 4:

A

= 1 (18tx) med-uni teaching, best care, everything to Neurovascular
= 2 (23 tx) everything BUT neuro, area trauma, surgical care capable all times, typically not teaching
= 3 general hospital w/ some special staff, TIB-FIB, try avoid w/ severe
= 4 basic ER, can stable but bandage, foot ran over

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15
Q

(Wallace Rule of 9s) used only for:
Adult %s:
infants (0-1):
Form:

A

= burns >10%
= 1 genitals, 9 head thoracic & ABDMN, distal anterior (applies to other areas) arm 4 ½
= head 18, arm 9, legs 13.5, 18 front thoracic & ABDMN
= # of child -1 > take away from head then give to each leg (Applicable up 10y/o) For every year beyond age 1, subtract 1 from head / that # & add it evenly between the 2 legs.

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16
Q

1Lymphatic system:

2Lymph node:
3Spleen relation:
4Lymphatic pathway:
5Sign lymphatic system not working:

A

1= “body’s garbage system” macrophages eats then system of channels to tissues 1 direction, no pump, dumps into a node
2= were garbage collects
3= Carries “trash” of pathogen destruction to nodes for macrophages
4= >Vessels> nodes> spleen> up to L/R subclavian vein, to kidneys
5= Gray poop

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17
Q

Class 1 hem:
Class 2 hem:
Class 3 hem:
Class 4 hem:

A

= max15% (750 mL’s) SNS main compensatory
= 15-30% (750-1500 mL’s)RAAS
= 30-40% (1.5-2L’s) comp to decomp SBP90
= >40% (>2Ls) irreversible

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18
Q

1Stages of healing:

A

1= Hemostasis, Inflam/, Epithelialization, Neovasc/, Collagen synthesis

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19
Q

1Hemostasis:
2Inflammation:
3Epithelialization:
4Neovascular:
5Collagen synthesis:

A

1= vaso/strict, platelet aggregate, coagulation fibrin (normothermic)
2= Granulocytes, macrophages & Lymphocytes eat, Mast cells released
3= “rebuild” epithelial cells go to wound making scab ~48Hrs after cut
4= new capillaries made (neo new) via previous cap/s +exchanging
5 = fibroblasts go to wound & synthesize collagen creating scar (w/ tension lines quicker/better), Too much synthetization makes Keloid

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20
Q

2 cyanide antidote regimens are available:

Sodium nitrite dose :
Sodium thiosulfate dose:

A

= Pasadena cyanide kit (amyl nitrite, Na nitrite, & Na thiosulfate) & newer antidote Cyanokit (hydroxocobalamin)
= 300 mg sodium nitrite over 2 to 4 minutes for adults.
= administer 12.5 g of for the adult.

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21
Q

MVC) Phase 1:
Phase 2:
Phase 3:
Phase 4:
Phase 5:

A

= Vehicle collision (P1) deceleration
= Body collision (P2) decel/ of occupant
= Organ collision (P3) decel of internal
= 2ndary collision (P4) objects in car
= (P5) car rear end, trees,

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22
Q

1 (Burn depth) 3rd degree:
2 feeling & appearance:

A

1= full thickness burn down to SCT may involve M. bone & organs
2= leather, looks Charred, dark brown or white, hard to touch “painless”

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23
Q

% of all Trauma deaths:
% of GSW account for HT death:
%s of penetrating neck trauma:
%s of penetrating chest trauma are fatal:
% of great vessels injuries & due to:
minimal diameter for sucking chest wound

A

= 50% of all Trauma deaths is head trauma
= 35% GSW account for Head Trauma deaths
= 5-10% penetrating neck trauma (airway & neuro
= 70-80% penetrating chest fatal
= 90% all great vessels injuries due to a penetrating MOI
= At least ¾inch for penetrating Chest wounds to turn sucking

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24
Q

Adult Men weight from:
Adult Women weight from:

A

=50 kg + 2.3 kg X (Height (in)- 60)
=45.5 kg + 2.3 kg X (Height (in)-60)

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25
Q

1 Adults for the Rules of Nines, the head is awarded:
2 Adults for the Rules of Nines, the genitalia is awarded:
3 Adults for the Rules of Nines, the posterior trunk is awarded:
4 Adult for the Rules of Nines, each arm is awarded:
5 Adults for the Rules of Nines, each leg is awarded:
6 Adults for the Rules of Nines, the anterior trunk is awarded:

A

1= 9 % of body surface area.
2= 1 % of body surface area.
3= 9 % of body surface area.
4= 18 % of body surface area.
5= 18 % of body surface area.
6= 18 % of body surface area.

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26
Q

Afferent nerves:
Efferent nerves:

A

=sensory nerves “ahhh”
=motor “effect”

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27
Q

Any eye trauma PT:
Zofran contra=

A

= vomiting &/ B/c +ocular pressure
= prolonged QT

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28
Q

AUTOPED) 1st impact:
2nd impact:
3rd impact:
Off-road injuries:
Kids Waddell’s triad:

A

= auto strikes body
= pedestrian thrown
= body strikes ground or object
= pop increased, usually remote areas, offer less protection,
= turn toward bumper b/c stupid, bumper hits kids pelvis & femur, chest & ABDMN hit grill, head strikes ground b/c buckethead

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29
Q

Shock & perfusion definitions:

A

= Perfusion: Adequate supply of well oxygenated blood & nutrients to all vital organs
= Shock: body’s lack of perfusion

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30
Q

Beta radiation can travel and can penetrate

A

6 to 10 feet through air & a few layers of clothing.

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31
Q

blast injuries) Primary:
Secondary:
Tertiary:
Quaternary:

A

Primary: blast injuring hallow organs
Secondary: shrapnel injuring
Tertiary: thrown against something
Quaternary: damage from other AFTER BLAST

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32
Q

Pulse pressure:
MAP:
CPP Cerebral Perfusion:

A

= SBP-DBP
= (PP/3) + DBP
= (MAP-ICP) + 10

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33
Q

Blood:
Plasma:
Leukocytes:
Erythrocytes:

A

= Mixture of water, cells, proteins, & suspended elements.
= makes up 55% of the blood volume
= WBC & platelets make up the “Buffy Coat”
= RBC make up 45%

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34
Q

Blunt T. to head & neck mortality% & w/ MVC:

A

= 85% mortality (Focus head neck chest abdomen)

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35
Q

Cardiac Output:
Cardiac Output Formula:
Blood Pressure formula:

A

= amount of blood pumped by the heart in 1 min (70mL)
= SV x HR
= CO x SVR

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36
Q

Shock) Cardiogenic:
Types & defined:

A

= Pump prob/ not working
= Intrinsic: problem from w/in heart EX MI
& Extrinsic: pob from outside hurting heart EX TPT

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37
Q

Celsius# to degrees Fahrenheit form
Fahrenheit# to Celsius form

A

C# to F=(C# -32) / 1.8
F# to C= (1.8 x F) + 32

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38
Q

Child burn in water) 120 degrees
125 degrees
140 degrees
150 degrees

A

= 10 minutes 2 or 3 degree burn
= 2 minutes
= 6 secs
= 2 sec

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39
Q

1 Children for the Rules of Nines, the head is awarded:
2 Children for the Rules of Nines, each leg is awarded:
3 Children for the Rules of Nines, each arm is awarded:
4 Children for the Rules of Nines, the anterior trunk is awarded:
5 Children for the Rules of Nines, the posterior trunk is awarded:

A

1= 18 % of body surface area.
2= 13.5% of body surface area.
3= 9% of body surface area.
4= 18% of body surface area.
5= 18% of body surface area.

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40
Q

(Class I Hemorrhage) 1 injuries:
2Compensation for blood:
3Blood Loss:
4Pulse:
5Vent rate, BP & Pulse Pressure:
6Cap-Refill:
7Urine Output (mL/hr):
8Mental Status:

A

1= Broken humorous 750mL
2= Healthy PTs can easily compensate for such blood volume loss
3= Blood Loss: < 15% (<750 mL’s)
4= Pulse: Slightly Tachy
5= all Normal
6= Cap-Refill <2secs
7= 30mL/Hr or more
8= Slightly Anxious

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41
Q

Coagulation Phase of hemostasis:

A

3rd phase Clotting factors activated and released into bloodstream through a very complex cascade of events Triggers series of chemical reactions; formation of strong protein fibers (fibrin)

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42
Q

Criteria for critical/moderate burn in adult & PT:

Adult:

A

= Burns associated w/ resp injury aka inhalation burn, Chemical / high voltage, Burns w/ major trauma
Adult: Superficial: BSA >50%, Partial: BSA <30%, Full thickness: BSA <10

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43
Q

CUPS:
C:
U:
P:
S:

A

= Categories of PT severity
= Critical: ABCs FUCKed
= Unstable: hypotension, comp to decomp
= Potentially unstable: pelvic fracture, stable can unstable
= Stable: stable ex toenail fracture

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44
Q

5 types of shock and treat them appropriately:

A

Hypovolemic, Cardiogenic, Distributive, Obstructive, Respiratory/Metabolic

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45
Q

Dry dressing for burns:
Wet dressing for burns:

A

= >10%
= <10%

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46
Q

Dynamic CO:

A

=1 up other down, L diastole P = L afterload, PVR pulmonary & oil

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47
Q

(Thermal burn phases) Emergent phase:

A

Vtach, cells anaerobic Body’s initial reaction to burn; pain response (afferent nerves damage> Nor/Epi release > tachycardia ; unless on beta blockers

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48
Q

End-tidal gradient= Difference between partial pressure of arterial CO2(PaCO2) & end-tidal CO2(ETCO2). Formula=

A

PaCO2 - ETCO2 = End - Formula gradient

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49
Q

Eschar:

Can be severe enough to :

A

= Burn destroys dermal cells; Skin constricts over wound site, increasing pressure of edema beneath & restricting flow of blood
=occlude all blood flow into distal extremity (compartment syndrome)

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50
Q

Escharotomy =

A

= release pressure w/ cutting burn to relief fluid pressure

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51
Q

ETT size range~

A

Adults (6.0-9.0) women~7-8 & man~8-9
Pedi tubes(2.5-5.5)

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52
Q

Evaluation:

A

= Repeat surveillance “good on paper but what about practice”

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53
Q

Parkland Burn Form) EX: 32yo male found with 10% BSA 1st degree burns, 10% BSA 2nd degree burns, and 10% BSA 3rd degree burns. The patient is 110 pounds.
1. 4 mL x BSA x Weight (kg)
2. Total mL / 2 = (Amount to give for:
3. How many mL’s per hr?
4. How many gtts/min using a 10 gtt/mL IV drip set?
5. Know w/ formula:

A
  1. 4mL X 20 (2nd + 3rd degree burns) X 50 (kg) = 4000 mL
  2. 4000 mL / 2 = 2000 mL (Amount to give 1st 8 hours then next 16Hrs)
  3. 2000 mL / 8 = 250 mL per/hour for 1st 8 hrs
  4. 42 gtts/min
  5. Pick closest option choice for gtts & Vol calculated. Use biggest bores& macro drips
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54
Q

ETCO2 Lvs in head-injured intubated PT shouldn’t drop below:
When vent/ing a adult PT, each breath should have tidal volume of:

A

= 30 mmHg
= approximately 500mL

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55
Q

Falls:
Examine:
Axial loading:
FOOSH (Fall onto an outstretched hand)
Colles’ fracture:
Smith’s fracture: out
>20ft greater risk of
Aortic anyrusem to tear:

A

= most common blunt trauma, risk increase w/ age, sig fall 2-3x height
= height, position, surface PT landed on, physical condition of PT
= loading on axial skelton via falling (E starts heel to lumber)
= influxing wrist fractures from fall impact
= efflucing wrist fractures from fall impact “Palm out”
= internal organ damage
= pain tearing to chest shoulders back
= tearing pain from chest goes to back

56
Q

Fluid accounts for ~% of the body’s weight, Only ~% of the fluid is contained in our vascular system

A

= 60% of the body’s weight, Only about 7% of the fluid is contained in our vascular system

57
Q

Fluid resuscitation is an important part of treating serious burns. The formula for the amount of IV fluid needed to be infused includes:

A

4 mL × patient weight (kg) × BSA burned <Parklands></Parklands>

58
Q

Thermal burn phases) Fluid-shift phase:

A

2nd phase; can last up to 24 hours; larger than 15 to 20%(BSA) of total body surface area
vasodilates & capillaries more permeable for phagocytosis

59
Q

Force:
Force formula:

A

= force related to a objects mass(weight) and/or achange in velocity
= mass x Acceleration

60
Q

Frank Starling law/mechanism:

Vascular Resistance:
SVR vs. PVR:
SVR (Systemic Vascular Resistance):
PVR (Pulmonary Vascular Resistance):

A

= more myocardium is stretched the more force/greater the next contraction will be (increase in preload increases contraction)
= Resistance to overcome to push blood through circulatory system
= Body’s circulation resistance & Lung’s circulation resistance
= resistance blood faces in systemic circulation (arteries size)
= resistance blood faces in pulmonic circulation EX CHF, R ventricle

61
Q

Frank Starling law/mechanism:

A

= more myocardium is stretched the more force/greater the next contraction will be (increase in preload increases contraction)

62
Q

Vascular Resistance:

A

= Resistance to overcome to push blood through circulatory system

63
Q

SVR vs. PVR:

A

= Body’s circulation resistance & Lung’s circulation resistance

64
Q

SVR (Systemic Vascular Resistance):

A

= resistance blood faces in systemic circulation (arteries size)

65
Q

Golden Period “hour”:
Platinum 10:

A

= incident to surgery time 1 Hr from Crash to EMS to PT to surgery
= no more than 10 mins on scene

66
Q

Hemostasis:
Hemostasis order:
Factors that effect hemostasis:

A

= Body’s response to a local hemorrhage w/ 3 phases
= Vascular, Platelet, Coagulation “flow, stick, build”
= Wound type(can pull w/in>cant constrict), M-nt, Temp, Meds( most blood thinners stop/prevent fibrin) Warfrin/Coumadin), IV Fluids

67
Q

How to estimate PEDI ET tube size: Uncuffed
Cuffed

A

Uncuffed ET: (Age /4) + 4 OR (Age + 16) /4
Cuffed ET = (Age /4) + 3.5

68
Q

How to estimate pedi weight

A

(Age + 4) x 2 = Approximate weight in kg (Old Way)
(Age x 3) + 7 = Approximate weight in kg (New Way

69
Q

Hyperkalemia) 1st line med:
2) One of two 2nd line meds:
3) One of two 2nd line meds:
4) Hospital only med:
5) Hospital only med to poop:

A

1= Calcium Chloride IV 0.5-1G/3 mins (Stabilizes doesn’t fix)
2= Albuterol 10-20 mg LVN over 15 mins
3= Sodium Bicarb 50 mEq IV mil equivalent
4= Dextrose (25 grams)w/ Insulin IV (10 units)
5= Kayexalate to poop out hyperK via pull interstitial to GI

70
Q

Orthostatic hypotension

A

PT’s BP drops 20 HR+20 when moved from supine to a seated position

71
Q

Implementation:

A

= putting effective safety measures EX roads,

72
Q

Intervention dev:

A

= dev/mod of programs to reduce both incidence & seriousness of trauma

73
Q

Jacksons Theory of Thermal Burns 3 burn zones:

A

1st Zone of Coagulation 2nd Zone of Stasis 3rd Zone of Hyperemia

74
Q

Kinetic energy:
Kinetic Energy form:

A

=energy of a object in motion (by objects mass & its velocity
= (Mass x Velocity ^2)/ 2 ½ x mv^2

75
Q

Kinetic energy:
kinetic energy formula:
Increasing mass vs. velocity directly increases what:

A

= energy of an object in motion (Fn. of object’s mass & its velocity)
= Kinetic energy=Mass(weight)×Velocity(speed)22
= kinetic energy > +velocity exponentially increases kinetic energy

76
Q

1 kinetics of penetrating trauma) Study of projectiles in motion & effects on objects
2 Curved path bullet follows after fired from a gun
3 Drag from wind
4 Outward “ballooning” motion of cavity due to projectiles
5 Speed of object in motion
6 Cross-section of bullet along its direction of travel
7 shape of object

A

1= Ballistics:
2= Trajectory:
3= Drag:
4= Cavitation:
5= Velocity:
6= Profile:
7= Shape:

77
Q

Lethal blood loss=

A

40%–> class 4 hemorrhage

78
Q

Life threatening injuries %:
Most-life threatning trauma occurs to:
Vol per lung & body:
lethal blood loss:

A

= <10% traumas
= head and/or chest
= 3L per lung & 5L per body
= >40% or ~2L

79
Q

Lightning can still strike you if proximity up to:

A

up to 50yrds can strike you

80
Q

Lightning strikes frequency & strike proximity

A

~100times a sec around world & up to 50yrds can strike you

81
Q

mechanism of injury (MOI):

A

the circumstances and events by which an injury occurs.

82
Q

Moderate criteria) Superficial:
Partial thickness burns:
Full thickness burns:

A

= BSA >50%
= BSA <30%
= BSA <10%

83
Q

MOI:
Energy:
Inertia:

A

= mech of injury how the injury happened
= Ability to do work
= law of Inertia (Newton’s 1st law) helps explain how objects in motion behave

84
Q

Morphine & fent drop BP by:

A

= body releasing Histamines

85
Q

(Newtons laws) inertia) 2nd law:

force formula is summarized as:

A

= force is related to object’s mass (weight) & rate of its change in velocity (speed)
= Force=Mass (weight)×Acceleration (or deceleration)2

86
Q

Normal blood pH range=

A

7.35 - 7.45 mmHg

87
Q

Ohm’s law:

A

relationship between current (I), resistance (R), voltage (V)

88
Q

Tension pneumo & pulmonary emboli is which type of shock?
Pericardial tamponade presents w/:

A

= Obstructive
= Becks triad JVD, tachycardia, hypotension, & Muffled heart tones

89
Q

Pedi intubation ETT location=

A

ETT Insertion is 2-3 cm below the vocal cords

90
Q

Penetrating trauma:
Perforating trauma:
(3lvls of Penetrating trauma) 1st Lvl:
2nd Lvl:
3rd Lvl:
Ballistics:
Factors of bullet speed/damage:
Trajectory:
Cavitation:
Profile:

A

= object pierces the skin and enters the body
= object pierces through & through body
= Low velocity: knifes, swords, ect
= Medium: handguns
= High-velocity: Rifles
= study of projectiles in motion & effects on objects
= Trajectory, Drag, Cavitation, Velocity, Profile, Shape:
= curved path bullet follows after fired from a gun
= Outward motion of cavity due to projectiles speed & vacuums
= cross-section of bullet along its direction of travel

91
Q

Phrenic nerve location

A

C-3-5

92
Q

Platelet Phase of hemostasis:

A

2nd phase, Platelets aggregate, or collect and adhere. Slows hemorrhage from capillaries and small vessels- splint fractures to decrease of clots being broken down & bleeding again

93
Q

Preload:
Afterload:

Mean Arterial Pressure (MAP):

A

= pressure/vol/ w/in ventricles @ end of diastole “End-diastole vol/“
= resistance against which the heart must pump against (increase afterload= increase ventricular workload)
= average pressure in arteries during a single cardiac cycle = pressure that drives blood to tissues (ensuring organ perfusion)

94
Q

Public health care model:

A

= Surveillance, Risk identification, intervention dev, implement, Eval/

95
Q

Respiration ratio=

A

1 sec inhalation 2 sec exhalation

96
Q

Risk analysis:

A

= Examines & determines factors that impact dev

97
Q

RSI Ideal Body Weight) Men formula
Women formula

A

Men= 50 kg + (2.3 kg X (Height (in) - 60)
Women= 45.5 kg + (2.3 kg X (Height (in) - 60)

98
Q

Rule of palm:

A

use of PT hand = 1% of BSA (burns <10%)

99
Q

“rule of thumb” for estimating the proper depth of an ETT=

A

Depth should be ~3x ETT size

100
Q

Seat belts:
Maternal relation w/ seat belts:
Cullen’s sign:
Most common organ injuries:
SRS:

A

= vehicle restraints, reduced # of collision related deaths
= US #1 maternal death, hips/pelvis not ABDMN
= internal bleed abdominally
= Spleen adults Liver kids
= supplemental Restraint Systems (SRS) 1st used for front impacts, airbag inflation to cushion energy

101
Q

Shock) 1 Distributive:
2 Hives:

3 “warm shock/high space”:
4 Sick shock:
5 syncope:

A

1= uncontrolled vaso-dialation
2= Anaphylactic: release of histamine from Ige & b/c allergen
3= Neurogenic: warm b/c reverse shunting makes warm transient block of SNS
4= Wide spread of infection
5= Physcogenic: Sudden vasodilation physiological means EX hemophobic, arachnophobic

102
Q

Shock) 1 Obstructive & types:
2 pneumothorax:
3 Pericardium:
3 traveled Embolism to lungs:

A

1= something obstructing heart} PE, Tension/Pneumo, Pericard/tamp
2= Tension/pneum: plueras so full pushing on hearts atrium
3= Pericardial tamponade: pericardium filled with blood
4= PE: emboli so big obstructs pulmonic vein

103
Q

Shock) 1 Respiratory/Metabolic:

A

1= Disruption of O2 transfer into cells/cells unable to utilize O2 from Cyanide, CO poisoning, A change in the blood pH

104
Q

Shock) Normal S/S of shock:
Compensate shock:
Decompensated shock:
Irreversible shock:

A

= Tachypnea&cardia, AMS, lower BP
= body is compensating “fighting” to maintain homeostasis
= can no longer maintain homeostasis
= can’t come back to life

105
Q

Shock) How does hemophilia affect the body and the clotting of blood?

A

Does not have ability to properly clot due from ½ factors

106
Q

Shock) S/S of neurogenic shock:
Cushing’s Triad:

A

= warm/flush, bradyC, HyperBP, AMS, Blown and/or unequal pupils
= HyperBP, BradyC, cheyenne stokes or Biots ventalations

107
Q

Shock) Hypovolemic:
Types:

A

= fluid loss
Hemorrhagic: blood loss & Non-hemorrhagic: V/D, Sweating

108
Q

(Rad) S/S of Exposure:
First sign:
Lethal Dose Exposure:

Organ shutdown:

A

= SLUDGEM PSNS S/S
= slight nausea & fatigue
= Emesis & malaise, Epistaxis, mouth, gums, & rectum (Vomiting usually lethal exposure
= Death

109
Q

Site for pneumo decompression:
needs:
Never go under a rib b/c:
Locating decompression site:
Digital thoracostomy:

A

= Anterior 2nd ICS midclavicular/3rd rib & b/c air is always up/rising
= At least 3in catheter, attach 1way valve: Could use 3way valve, glove,
= vascular; have major thoracic arteries & nerves
= palp/ then slide over 3rd rib
= 1-2in incision between 4th & 5th ICS, ( “cut finger tube” )

110
Q

Special pop of burns:
PT’s cope less b/c:

A

= GERI, Pedi, & PTs ill/injured have >dif coping w/ burn injuries
= Fluid retention, <fluid reserves, <able to combat infection, More apt to have underlying diseases

111
Q

Specialty Centers:

A

= Neuro, Burn, Pedi trauma, Hand & limb replant microsurgery, Hyperbaric oxygen

112
Q

1staph:
2Strep:
3Lymphangitis:
4Tetanus (Lockjaw):
5Gangrene:

6Wet Gangrene:
7Dry Gangrene:

A

1= staphylococcus Anaerobic bacterium infection
2= Streptococcus Anaerobic bacterium infection
3= red lines along lymph lines b/c infection
4= Clostridium tetani>Attacks NS produces toxin >M. contrac/spasms
5= Clostridum perfringen>(diabetes>risk) <peripheral> infection lacks blood supply/flow> less WBC
6= bacteria to tissue & swells then fluids outside of tissue
7= blood supply cut off and dry</peripheral>

113
Q

Stretch blunt trauma:

Sciwora:

A

= Tendons & Fibers that (tendons stronger) hold organs & other structures together are pulled & injured or torn
= spinal cord injury with out r a (kids in wreck overstretching neck)

114
Q

Stridor w/ inhalation burns:

Bad Airway burns might might need:

A

= AKA “crowing” larynx last defense against heat then swells 2/3s so intubate asap bc only worsens (Press chest & follow bubbles)
= Might need to nasal endotracheal intubation w/ BAAM & Endotrol tube (ET w/ trigger) BAAM> High=inhale &Low=exhale

115
Q

Stroke volume:
Cardiac Output (CO):
CO form/:
3 factors that affect CO:
Dynamic CO:

A

= blood amount ejected in 1 contraction> varies 60-100mL 70average
= Amount of blood moved in 1min
= HR X SV -> 5-6 L of blood moved in 1 min
= preload, afterload, contractility
= “1 up & other down”

116
Q

Suction catheter size w/ ETT~ form:

A

ETT# x2

117
Q

Suctioning catheter sizing form/=

A

Intubation ETT size # X 2

118
Q

Suctioning time limits:

A

Adults 15 secs max,
Children= 10 secs max,
Infants=5 secs max,
ET/Trach tube= 5-10 secs max

119
Q

Surveillance:

A

= collection of data Epidemiology=study of disease based on med survey

120
Q

The blood volume of an infant or young child is proportionally:
Population most at risk for trauma & trauma death:

A

= ~20%> than that of an adult
= Young adult male

121
Q

The following burn patterns is usually seen with child abuse:

A

“Stocking burns” to lower legs, Circumferential burns on buttocks, Multiple circular burns of the same size to the arms and legs

122
Q

The most common & serious trauma associated w/ explosions is:
The most lethal explosions are those: That cause structural collapse

A

= Pulmonary injury
= That cause structural collapse

123
Q

Thermal burn phases:

A

Emergent, Fluid-shift, Hypermetabolic, & Resolution phase

124
Q

TXA) 1 Dynamics:
2 when do we admin/ it:
3 Correct dose:
4 Followed by:

A

1= Blocks fibrinolysis by binding to plasminogen, blocking plasminogen fibrin interactions.
2= Significant hemorrhage, either internal or external (after external hemorrhage has been controlled).
3= 1G/10mins (mix in 50 mL bag of NS)
4= 1G/8Hrs (500 mL bag)

125
Q

Waddells:

A

= turns to car pevils, thrown, head hits ground

126
Q

What are the 3 dif types of soft-tissue injuries?

A

Type: Open
Type: Close: Infection
Type: Burn

127
Q

What are the 3 different levels of penetrating trauma?

A

High velocity> sniper
Medium velocity> pistol
Low velocity> knife

128
Q

What are the three levels of penetrating trauma?

A

Lvl 1: entrance
Lvl 2: cavation
Lvl 3: exit

129
Q

Injury which opening occurs in skin & organs protrude through is:

A

Evisceration

130
Q

Jacksons Theory) Zone of Coagulation:

A

Area of burn nearest to the heat source (most damage & tissue necrosis)Most damaged area

131
Q

Jacksons Theory) Zone of Hyperemia:

A

surrounding Area of erythema, damage with more RBC coming to area b/c/& cap/s more permeable (increased blood supply) trying to get phagocytes to inside for healing process
Sig burns have sig swelling from shift of fluid

132
Q

Jacksons Theory) Zone of Stasis / “Ischemia”:

A

Less damaged area adjacent to the Zone of Coagulation (treatable & posible reversible damage)

133
Q

“pressure” of electric flow

A

Voltage

134
Q

Child Burn form:

A

(age#-1 from the head) / between 2 legs

135
Q

Controlled hemo/ fluid dosing

A

20mL/Kg Warm NS

P2 Exams (9 decks)

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