trauma guest lecture Flashcards
1st impact in trauma kinetics
car hitting pole
2nd impact in trauma kinetics
chest hitting steering wheel
3rd impact in trauma kinetics
internal organs continuing forward and hitting other structures
snoring in brain injuries
means the brain is swelling causing loss of airway tone
hemorrhagic shock
decreased preload and increased afterload
- hypotensive (MAP less than 65)
- tachycardic
- hypoxic
hypothermic
metabolic acidosis
trauma triad of death
Hypothermia
Coagulation
Acidosis
hemorrhage treatment
crystalloid fluids
blood products
tranexamic acid
fat embolism syndrome
complication of fracture occurring 24-72 hours after injury
Mostly long bone open fractures due to fat entering bloodstream
signs and symptoms of fat embolism syndrome
dyspnea, tachypnea, hypoxemia, confused, petechial rash
treatment of fat embolism syndrome
oxygen, fluids- most resolve on their own
treatment of DVT and PE
D-dimer lab test
heparin/enoxaparin
compression stockings
early ambulation
screening test for DVT
ultrasound
screening test for PE
CT study
compression stockings vs pneumatic compression
both prevent clots but pneumatic mimics muscle contraction
signs of PE
sharp pain with deep breathing
parietal pleura
outer lining attached to chest wall
visceral pleura
inner lining covering lungs
lungs
are always inflated due to more negative pressure inside than outside which creates a vacuum
lung collapse
occurs when inside pressure = outside pressure
pneumothorax
presence of air in the pleura
- can be open or closed/spontaneous
closed/spontaneous pneumothorax
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
open pneumothorax
chest wall is damaged leading to air entering pleural space
- air enters pleural space with inspiration and exits during expiration
tension pneumothorax
occurs in penetrating or blunt trauma where intrapleural pressure is greater than atmospheric pressure and air can enter but cannot exit
signs and symptoms of tension pneumothorax
mediastinal shift, tracheal deviation, no preload, high afterload
closed pneumothorax treatment
chest tube
tension pneumothorax treatment
needle decompression followed by chest tube insertion
compartment syndrome
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
6 P’s of compartment syndrome
- PAIN OUT OF PROPORTION
- paresthesia
- poikilothermia
- pallor
- pulselessness
- paralysis
treatment of compartment syndrome
remove restrictive devices, elevate limb to heart level (not higher), fasciotomy
complex regional pain syndrome
pain more severe than the injury warrants
signs and symptoms of complex regional pain syndrome
skin color changes, increased sweating, loss of bone density
treatment of complex regional pain syndrome
prevent through early mobilization, antidepressants, Gabapentin
laceration
disruption in skin continuity and often occurs secondary to trauma
laceration treatment
check tetanus, suture
localized hemorrhage
ecchymosis will form
contusion treatment
cool compress to vasoconstrict
