Trauma General

Question 1

4 indications for intubation in trauma

Answer 1

Gcs < 8
Loss of airway reflexes in setting of intoxication
Severe facial or airway trauma
Burns or inhalational injury w risk obstruction

Question 2

4 life threatening injuries identified during Breathing assessment

Answer 2

Flail chest
Tension pneumothorax
Open pneumothorax (sucking chest wound)
Massive hematoma

Question 3

4 things to look for on exam during primary survey or breathing

Answer 3

Chest rise, signs external trauma
Air entry bilaterally, tracheal deviation
Crepitus
Prominent neck veins

Question 4

5 types of shock in trauma

Answer 4

Hypovolemic (hemorrhagic)
Obstructive (tamponade, tension pneumo)
Neurogenic (spinal cord injury)
Cardiogenic (direct cardiac injury)
Dissociative (CO, CN)

Question 5

In massive transfusion protocol (> pt’s body weight or >10L) what ratio of blood products do you give?

Answer 5

1:1:1 pRBC, platelets, fresh frozen plasma

Question 6

Name motor components of GCS scale

Answer 6

6= obeys commands 
5= localizes to pain 
4= withdraws to pain
3= flexor posturing 
2= extensor posturing 
1= none

Question 7

Verbal component of GCS

Answer 7

5=oriented
4=confused
3= inappropriate speech
2= incomprehensible sounds 
1= none

Question 8

Eye component of gcs

Answer 8

4 opens spontaneously
3 opens to speech
2 opens to pain
1 none

Question 9

Components of exposure of primary survey

Answer 9

Undress patient
Maintain c spine, log roll
Examine soft tissues of back and perineum 
Cover with warm blanket 
Core temperature

Question 10

4 goals of ED Thoracotomy

Answer 10

Cross clamp aorta (preserve blood to Brain)
Open cardiac massage/compression/ Intracardiac epi
Relieve tamponade (pericardotomy)
Direct repair of cardiac/lung injuries

Question 11

What are considered signs of life

Answer 11

Pupillary response 
Palpable pulse 
Respiratory effort 
Spontaneous movement
Electrical activity on ECG monitor

Question 12

Indications for thoracotomy in blunt trauma

Answer 12

Prehospital/hospital signs of life with loss less than 10 mins
Cardiac tamponade on ultrasound and Persistenth hypotension sbp < 70 despite resuscitative efforts
Rapid exsanguination chest tube >1500 cc

Question 13

Contraindications to thoracotomy in blunt trauma

Answer 13

CPR > 10 mins
Asystole presenting rhythm with no cardiac tamponade on ultrasound
Significant head trauma

Question 14

Thoracotomy indications penetrating trauma

Answer 14

Signs of life <15 mins cpr
Unresponsive hypotension <70 despite resuscitative efforts
Cardiac tamponade on ultrasound

Question 15

Contraindications ED thoracotomy in penetrating trauma

Answer 15

CPR> 15 mins
Asystole as rhythm with no tamponade on US
Significant head trauma