Trauma/Hemo Flashcards
In a tension pneumothorax a tracheal shift is a ________ sign on external exam and a _______ sign on radiographic.
- Late
2. Early
Cyanosis is only visible with a HGB greater than _____
5
Needle Thoracostomy can be done at:
- 2nd Intercostal Space mid calvicular.
2. 4th or 5th Intercostal Space, anterior or mid-axillary line.
Tube Thoracostomy is done at:
4th Intercostal Space Anterior Axillary Line.
For purpose of the Exam
Hold off on ______ and _______ on tension pneumo as long as possible.
Positive Pressure Ventilation
Intubation
Trachea is ______ with a hemothorax
Midline
Open Pneumothorax treatment:
- Occlusive Dressing placed upon EXHALATION taped on 3 side only until a chest tube is placed
- Seal 4th side post chest tube.
Flail Chest treatment
Consider Intubation with PEEP
Injured Side Down
Limit Fluids as able
Beck’s Triad
Muffled Heart Tone
JVD
Narrowed Pulse Pressure
Pulsus Paradoxus
Pulse Quality changes with respiration when palpating
Early Tamponade S/S
Sinus Tach
Pulsus Paradoxus
Late Tamponade S/S
Severe Hypotension
Beck’s Triad
Aortic Rupture
Harsh Systolic Murmur
Aortic Ruptur CXR finding
Widening Mediastiunum
Diaphragmatic Rupture S/S
- Dyspnea
- Bowel Sound in Chest
- Cyanosis
- Scaphoid Abdomen
Diaphragmatic Rupture
NGT/OGT
Strict NPO
Tracheobronchioal Disruption S/S
- Continuous Air Leak or persistent pneumothorax
- Rapidly progressing subcutaneous emphysema
- Pneumomediastinum
Newton’s First Law
An object in motion will remain in motion and an object at rest will remain at rest, unless acted on by an outside force
Newton’s Second Law
F=ma
Newton’s Third Law
For every action there is an equal and opposite reaction.
Rear End Collision Predictable Inj
**T12-L1 Back Injury
**C2 Fx of Neck
** Evaluate for 2nd Impact Injury Patters
Femur Fx
Tib/Fib Fx
Ankle Fx
Rollovers cause the _______
Most lethal injury
If you suspect a liver lac or caval lac you should:
Establish an IV above and below the diaphragm
Falls occurs in primarily _____ and ______
Adults and children under the Age 5
High Velocity bullets travel at ______
*****> 2000 feet per second
Primary Injury
Initial air blast
Secondary Injury
Projectile from blast force
Tertiary Injury
Victim impacting the ground or another object
In Burns Urinary Output should be _____ in adults and _____ in children.
30-50 ml/hr
1-2 ml/kg/hr in children
Only ___ and ____ degree burns are calculated
2nd and 3rd
Parkland Formula
4ml/kg x %BSA
Give 1/2 over the first 8 hours post burn
Consensus Formula
2-4/kg x %BSA
Burn Mortality
Age + %BSA (2nd & 3rd Degree)
Add 20 if respiratory involvement
Hydrofluoric Acid Treatment
Copious Water
Infliltrated in burned tissue 10% Calcium Gluconate
Alkali Metal Burn Treatment
Reacts with water
Absorb heat with oil
Brush off
Irrigate with oil
Acid Chemical Burns cause ______
***** Coagulative Necrosis
Alkali Chemical Burns cause _____
*****Saponification
Turning something into soap
Two Step Decon
- Remove all clothing
- Wash and Rinse with soap and water
- Reposition out of the runoff and repeat step 2.
(Used in “Fast Break Scenario”
Myoglobinuria is_____
a problem due to massive muscle damage.
If untreated will result in ATN and renal failure
Myoglobinuria treatment :
- Maintain UO at Minimum 100 ml/hr
- Osmotic Diuretics
- Alkalinize the urine with bicarb
Start Triage you assess:
- Resp
- Perfusion (cap refill at the core)
- Mentation
“When you mind starts racing remember your RPMs.”
Start Triage Categories
Immediate Level I/Priority 1 Red
Delayed Level II/Priority 2 Yellow
Walking Wounded Level III Pri 3 Green
Dead Priority 0 Black
How long is the assessment in Start Triage
15-30 sec
In Start Triage all penetrating trunk trauma is ______
Immediate
In Start Triage any injured rescuer are considered _____-
Immediate
For an open chest wall injury to preferentially entrain air, it must at least be ____ the size of the narrowest part of the airway.
1/3
_______ is a late sign in thoracic trauma
Cyanosis
If a patient with an open chest wound is intubated the 3 sided dressing should be placed at end-________
inhalation
The primary treatment for early pericardial tamponade is
Preload augmentation
A harsh murmur would be indicative of which pathology?
Aortic Rupture
What would find on an AP CXR that is indicative of aortic disruption?
Widen Mediastinum
Up and Over Injury Pattern
Brain
Spine
Lungs
Heart
The most common presenting sign for LeForte Fx is ____
Epistaxisis
BP will not typically drop until the trauma victim experience ____% of blood loss
30-40%
For rapid infusion you want a catheter with the _____ bore and the ______ length
Biggest
Shortest
Women stab _____
Downward
High velocity bullets are classified as any projectile traveling:
Faster then 2000 feet per sec
The primary injury are ______
those caused by the initial blast wave striking the body and compressing air filled cavities causing ruptures
The secondary injuries are caused by
Debris and shrapnel
The tertiary injuries are those caused by ____
the body being knocked to the ground from the blast itself with subsequent blunt trauma resulting
Normal Urine Output for Adult, Peds, Neo
0.5 ml/kg/hr Adult
1 ml/kg/hr Peds
2 ml/kg/hr Neo
Normal platelet count
150-400k
Blood loss should be replaced with crystalloid solutions in a ratio of ____
3:1
