Trauma/Hemo Flashcards

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1
Q

In a tension pneumothorax a tracheal shift is a ________ sign on external exam and a _______ sign on radiographic.

A
  1. Late

2. Early

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2
Q

Cyanosis is only visible with a HGB greater than _____

A

5

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3
Q

Needle Thoracostomy can be done at:

A
  1. 2nd Intercostal Space mid calvicular.

2. 4th or 5th Intercostal Space, anterior or mid-axillary line.

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4
Q

Tube Thoracostomy is done at:

A

4th Intercostal Space Anterior Axillary Line.

For purpose of the Exam

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5
Q

Hold off on ______ and _______ on tension pneumo as long as possible.

A

Positive Pressure Ventilation

Intubation

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6
Q

Trachea is ______ with a hemothorax

A

Midline

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7
Q

Open Pneumothorax treatment:

A
  1. Occlusive Dressing placed upon EXHALATION taped on 3 side only until a chest tube is placed
  2. Seal 4th side post chest tube.
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8
Q

Flail Chest treatment

A

Consider Intubation with PEEP
Injured Side Down
Limit Fluids as able

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9
Q

Beck’s Triad

A

Muffled Heart Tone
JVD
Narrowed Pulse Pressure

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10
Q

Pulsus Paradoxus

A

Pulse Quality changes with respiration when palpating

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11
Q

Early Tamponade S/S

A

Sinus Tach

Pulsus Paradoxus

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12
Q

Late Tamponade S/S

A

Severe Hypotension

Beck’s Triad

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13
Q

Aortic Rupture

A

Harsh Systolic Murmur

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14
Q

Aortic Ruptur CXR finding

A

Widening Mediastiunum

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15
Q

Diaphragmatic Rupture S/S

A
  1. Dyspnea
  2. Bowel Sound in Chest
  3. Cyanosis
  4. Scaphoid Abdomen
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16
Q

Diaphragmatic Rupture

A

NGT/OGT

Strict NPO

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17
Q

Tracheobronchioal Disruption S/S

A
  1. Continuous Air Leak or persistent pneumothorax
  2. Rapidly progressing subcutaneous emphysema
  3. Pneumomediastinum
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18
Q

Newton’s First Law

A

An object in motion will remain in motion and an object at rest will remain at rest, unless acted on by an outside force

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19
Q

Newton’s Second Law

A

F=ma

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20
Q

Newton’s Third Law

A

For every action there is an equal and opposite reaction.

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21
Q

Rear End Collision Predictable Inj

A

**T12-L1 Back Injury
**C2 Fx of Neck
** Evaluate for 2nd Impact Injury Patters
Femur Fx
Tib/Fib Fx
Ankle Fx

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22
Q

Rollovers cause the _______

A

Most lethal injury

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23
Q

If you suspect a liver lac or caval lac you should:

A

Establish an IV above and below the diaphragm

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24
Q

Falls occurs in primarily _____ and ______

A

Adults and children under the Age 5

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25
Q

High Velocity bullets travel at ______

A

*****> 2000 feet per second

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26
Q

Primary Injury

A

Initial air blast

27
Q

Secondary Injury

A

Projectile from blast force

28
Q

Tertiary Injury

A

Victim impacting the ground or another object

29
Q

In Burns Urinary Output should be _____ in adults and _____ in children.

A

30-50 ml/hr

1-2 ml/kg/hr in children

30
Q

Only ___ and ____ degree burns are calculated

A

2nd and 3rd

31
Q

Parkland Formula

A

4ml/kg x %BSA

Give 1/2 over the first 8 hours post burn

32
Q

Consensus Formula

A

2-4/kg x %BSA

33
Q

Burn Mortality

A

Age + %BSA (2nd & 3rd Degree)

Add 20 if respiratory involvement

34
Q

Hydrofluoric Acid Treatment

A

Copious Water

Infliltrated in burned tissue 10% Calcium Gluconate

35
Q

Alkali Metal Burn Treatment

A

Reacts with water
Absorb heat with oil
Brush off
Irrigate with oil

36
Q

Acid Chemical Burns cause ______

A

***** Coagulative Necrosis

37
Q

Alkali Chemical Burns cause _____

A

*****Saponification

Turning something into soap

38
Q

Two Step Decon

A
  1. Remove all clothing
  2. Wash and Rinse with soap and water
  3. Reposition out of the runoff and repeat step 2.
    (Used in “Fast Break Scenario”
39
Q

Myoglobinuria is_____

A

a problem due to massive muscle damage.

If untreated will result in ATN and renal failure

40
Q

Myoglobinuria treatment :

A
  1. Maintain UO at Minimum 100 ml/hr
  2. Osmotic Diuretics
  3. Alkalinize the urine with bicarb
41
Q

Start Triage you assess:

A
  1. Resp
  2. Perfusion (cap refill at the core)
  3. Mentation

“When you mind starts racing remember your RPMs.”

42
Q

Start Triage Categories

A

Immediate Level I/Priority 1 Red
Delayed Level II/Priority 2 Yellow
Walking Wounded Level III Pri 3 Green
Dead Priority 0 Black

43
Q

How long is the assessment in Start Triage

A

15-30 sec

44
Q

In Start Triage all penetrating trunk trauma is ______

A

Immediate

45
Q

In Start Triage any injured rescuer are considered _____-

A

Immediate

46
Q

For an open chest wall injury to preferentially entrain air, it must at least be ____ the size of the narrowest part of the airway.

A

1/3

47
Q

_______ is a late sign in thoracic trauma

A

Cyanosis

48
Q

If a patient with an open chest wound is intubated the 3 sided dressing should be placed at end-________

A

inhalation

49
Q

The primary treatment for early pericardial tamponade is

A

Preload augmentation

50
Q

A harsh murmur would be indicative of which pathology?

A

Aortic Rupture

51
Q

What would find on an AP CXR that is indicative of aortic disruption?

A

Widen Mediastinum

52
Q

Up and Over Injury Pattern

A

Brain
Spine
Lungs
Heart

53
Q

The most common presenting sign for LeForte Fx is ____

A

Epistaxisis

54
Q

BP will not typically drop until the trauma victim experience ____% of blood loss

A

30-40%

55
Q

For rapid infusion you want a catheter with the _____ bore and the ______ length

A

Biggest

Shortest

56
Q

Women stab _____

A

Downward

57
Q

High velocity bullets are classified as any projectile traveling:

A

Faster then 2000 feet per sec

58
Q

The primary injury are ______

A

those caused by the initial blast wave striking the body and compressing air filled cavities causing ruptures

59
Q

The secondary injuries are caused by

A

Debris and shrapnel

60
Q

The tertiary injuries are those caused by ____

A

the body being knocked to the ground from the blast itself with subsequent blunt trauma resulting

61
Q

Normal Urine Output for Adult, Peds, Neo

A

0.5 ml/kg/hr Adult
1 ml/kg/hr Peds
2 ml/kg/hr Neo

62
Q

Normal platelet count

A

150-400k

63
Q

Blood loss should be replaced with crystalloid solutions in a ratio of ____

A

3:1