trauma guest lecture Flashcards

1
Q

1st impact in trauma kinetics

A

car hitting pole

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2
Q

2nd impact in trauma kinetics

A

chest hitting steering wheel

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3
Q

3rd impact in trauma kinetics

A

internal organs continuing forward and hitting other structures

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4
Q

snoring in brain injuries

A

means the brain is swelling causing loss of airway tone

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5
Q

hemorrhagic shock

A

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

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6
Q

trauma triad of death

A

Hypothermia
Coagulation
Acidosis

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7
Q

hemorrhage treatment

A

crystalloid fluids
blood products
tranexamic acid

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8
Q

fat embolism syndrome

A

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

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9
Q

signs and symptoms of fat embolism syndrome

A

dyspnea, tachypnea, hypoxemia, confused, petechial rash

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10
Q

treatment of fat embolism syndrome

A

oxygen, fluids- most resolve on their own

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11
Q

treatment of DVT and PE

A

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

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12
Q

screening test for DVT

A

ultrasound

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13
Q

screening test for PE

A

CT study

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14
Q

compression stockings vs pneumatic compression

A

both prevent clots but pneumatic mimics muscle contraction

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15
Q

signs of PE

A

sharp pain with deep breathing

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16
Q

parietal pleura

A

outer lining attached to chest wall

17
Q

visceral pleura

A

inner lining covering lungs

18
Q

lungs

A

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

19
Q

lung collapse

A

occurs when inside pressure = outside pressure

20
Q

pneumothorax

A

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

21
Q

closed/spontaneous pneumothorax

A

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

22
Q

open pneumothorax

A

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

23
Q

tension pneumothorax

A

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

24
Q

signs and symptoms of tension pneumothorax

A

mediastinal shift, tracheal deviation, no preload, high afterload

25
closed pneumothorax treatment
chest tube
26
tension pneumothorax treatment
needle decompression followed by chest tube insertion
27
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
28
6 P's of compartment syndrome
1. PAIN OUT OF PROPORTION 2. paresthesia 3. poikilothermia 4. pallor 5. pulselessness 6. paralysis
29
treatment of compartment syndrome
remove restrictive devices, elevate limb to heart level (not higher), fasciotomy
30
complex regional pain syndrome
pain more severe than the injury warrants
31
signs and symptoms of complex regional pain syndrome
skin color changes, increased sweating, loss of bone density
32
treatment of complex regional pain syndrome
prevent through early mobilization, antidepressants, Gabapentin
33
laceration
disruption in skin continuity and often occurs secondary to trauma
34
laceration treatment
check tetanus, suture
35
localized hemorrhage
ecchymosis will form
36
contusion treatment
cool compress to vasoconstrict