trauma guest lecture

Question 1

1st impact in trauma kinetics

Answer 1

car hitting pole

Question 2

2nd impact in trauma kinetics

Answer 2

chest hitting steering wheel

Question 3

3rd impact in trauma kinetics

Answer 3

internal organs continuing forward and hitting other structures

Question 4

snoring in brain injuries

Answer 4

means the brain is swelling causing loss of airway tone

Question 5

hemorrhagic shock

Answer 5

decreased preload and increased afterload
- hypotensive (MAP less than 65)
- tachycardic
- hypoxic
hypothermic
metabolic acidosis

Question 6

trauma triad of death

Answer 6

Hypothermia
Coagulation
Acidosis

Question 7

hemorrhage treatment

Answer 7

crystalloid fluids
blood products
tranexamic acid

Question 8

fat embolism syndrome

Answer 8

complication of fracture occurring 24-72 hours after injury
Mostly long bone open fractures due to fat entering bloodstream

Question 9

signs and symptoms of fat embolism syndrome

Answer 9

dyspnea, tachypnea, hypoxemia, confused, petechial rash

Question 10

treatment of fat embolism syndrome

Answer 10

oxygen, fluids- most resolve on their own

Question 11

treatment of DVT and PE

Answer 11

D-dimer lab test
heparin/enoxaparin
compression stockings
early ambulation

Question 12

screening test for DVT

Answer 12

ultrasound

Question 13

screening test for PE

Answer 13

CT study

Question 14

compression stockings vs pneumatic compression

Answer 14

both prevent clots but pneumatic mimics muscle contraction

Question 15

signs of PE

Answer 15

sharp pain with deep breathing

Question 16

parietal pleura

Answer 16

outer lining attached to chest wall

Question 17

visceral pleura

Answer 17

inner lining covering lungs

Question 18

lungs

Answer 18

are always inflated due to more negative pressure inside than outside which creates a vacuum

Question 19

lung collapse

Answer 19

occurs when inside pressure = outside pressure

Question 20

pneumothorax

Answer 20

presence of air in the pleura
- can be open or closed/spontaneous

Question 21

closed/spontaneous pneumothorax

Answer 21

most commonly seen in young, tall and thin males
- air bleb ruptures at top of long apex and moves from high pressure in alveoli to low pressure in pleural space

Question 22

open pneumothorax

Answer 22

chest wall is damaged leading to air entering pleural space
- air enters pleural space with inspiration and exits during expiration

Question 23

tension pneumothorax

Answer 23

occurs in penetrating or blunt trauma where intrapleural pressure is greater than atmospheric pressure and air can enter but cannot exit

Question 24

signs and symptoms of tension pneumothorax

Answer 24

mediastinal shift, tracheal deviation, no preload, high afterload

Question 25

closed pneumothorax treatment

Answer 25

chest tube

Question 26

tension pneumothorax treatment

Answer 26

needle decompression followed by chest tube insertion

Question 27

compartment syndrome

Answer 27

increased pressure which compromises circulation due to muscle not being able to stretch and occurs most often in soft tissue injuries and fractures
- necrosis can occur within 4 hours

Question 28

6 P’s of compartment syndrome

Answer 28

1. PAIN OUT OF PROPORTION
2. paresthesia
3. poikilothermia
4. pallor
5. pulselessness
6. paralysis

Question 29

treatment of compartment syndrome

Answer 29

remove restrictive devices, elevate limb to heart level (not higher), fasciotomy

Question 30

complex regional pain syndrome

Answer 30

pain more severe than the injury warrants

Question 31

signs and symptoms of complex regional pain syndrome

Answer 31

skin color changes, increased sweating, loss of bone density

Question 32

treatment of complex regional pain syndrome

Answer 32

prevent through early mobilization, antidepressants, Gabapentin

Question 33

laceration

Answer 33

disruption in skin continuity and often occurs secondary to trauma

Question 34

laceration treatment

Answer 34

check tetanus, suture

Question 35

localized hemorrhage

Answer 35

ecchymosis will form

Question 36

contusion treatment

Answer 36

cool compress to vasoconstrict