Trauma management Flashcards

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1
Q

What is Newton’s first law?

A

Laws of Inertia

A body in motion remains in motion in a straight line unless acted upon by outside force.

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2
Q

What is Newton’s second law?

A

Acceleration is dependent on mass of the object and the force upon the object.

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3
Q

What is Newton’s Third law?

A

For every action there is an equal and opposite reaction.

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4
Q

What are the types of trauma?

A

Blunt and penetrating

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5
Q

How many feet per second can high velocity weapons fire?

A

> 2000 FPS

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6
Q

What 3 factors make up the trauma triad of death?

A

Hypothermia, acidosis, coagulopathy

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7
Q

What classes of hypovolemic shock calls for blood administration?

A

Class III and IV (3 &4)

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8
Q

What are some injury patterns in trauma?

A

Side impact
Front impact
Rear impact
Rollover

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9
Q

What is Kehr’s sign and when would you see it?

A

Splenic rupture secondary to rib fracture (referred pain)

Most of the time in a side impact collision

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10
Q

Which vertebrae are the most commonly injured in rear collision?

A

T12-L1

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11
Q

What is a chance fracture?

A

T12 fracture

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12
Q

What is a hangman’s fracture?

A

Fracture of the C2 vertebrae

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13
Q

What is a Jefferson’s fracture?

A

C1 fracture from axial loading

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14
Q

What type of spinal fracture is most common in an off-road vehicle accident?

A

Hangman’s fracture

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15
Q

What should you be concerned about with lap belt injuries?

A

Cullen’s sign and internal bleeding

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16
Q

How do children tend to fall?

A

Head first

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17
Q

How many feet is considered before being associated with severe injury?

A

15-20 feet or 3x standing height

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18
Q

What injury will you see for a (FOOSH) fall on out stretched hand injury?

A

Bilateral wrist fractures

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19
Q

What is the most commonly injured solid organ in blunt trauma?

A

Spleen rupture

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20
Q

What two signs will you see positive in a splenic rupture?

A

Kehr’s sign

Ballance’s Sign

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21
Q

What is Ballance’s sign?

A

Dullness to percussion to left flank, LUQ, and shifting dullness to percussion to the right flank caused by splenic rupture.

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22
Q

What is the most commonly injured solid organ in penetrating abdominal injuries?

A

Liver

23
Q

What is the most commonly injured hollow organ in penetrating abdominal injuries?

A

Colon/Small intestine

24
Q

What is the highest risk for an unstable pelvis fracture?

A

Massive hemorrhage (exsanguination)

25
Q

What are the three different types of pelvic fractures?

A

Lateral pelvic fracture - rarely has life threatening bleeding
Open-book fracture - Anterior-posterior force
Vertical shear- Highest potential for massive bleeding

26
Q

What may the patient present with if they have fat embolism caused by long bone or lower extremity fracture?

A

Respiratory distress, Petechial rash, Diffuse infiltrates, hypoxemia, confusion, Fever, Tachycardia

27
Q

What are some contraindications for placement of a urinary catheter?

A

High riding or non palpable prostate
blood at the urethral meatus
Pelvic fracture
Blood in the labia/scrotum (Coopernail’s sign)

28
Q

What does REBOA stand for?

A

Resuscitative Endovascular Balloon Occlusion of the Aorta.

29
Q

What does REBOA do?

A

Works like an internal tourniquet to occlude blood flow from the aorta.

30
Q

What size does an open chest wound need to be in order to be considered a sucking chest wound?

A

> 2/3 of the diameter of trachea

31
Q

If you have a trauma patient that has an increase in PIP and Plateau pressure, what should you suspect?

A

Tension Pneumothorax

32
Q

What are signs of Tension Pneumothorax?

A

Dyspnea, anxiety, JVD, Tachypnea, and tracheal deviation.

JVD and deviation are late signs

33
Q

What are two approved sites for Needle decompression?

A

Between 2nd and 3rd intercostal mid clavicular line

5th intercostal space mid axillary line

34
Q

How much blood loss is considered massive hemorrhage?

A

> 1500 ml or 1/3 of patient’s blood loss

35
Q

What is the proper treatment for rib fractures?

A

Analgesic and NPPV

36
Q

What is a flail chest?

A

2 or more ribs broken in 2 or more places
Paradoxical movement
Transport injured side down

37
Q

If a trauma patient has a sunken hollow shaped abdomen and bowel sounds in chest, what would you suspect?

A

Traumatic diaphragmatic hernia

38
Q

What is Kussmaul’s sign

A

Rise in venous pressure on inspiration spontaneous breathing patient. Seen in cardiac tamponade.

39
Q

What are early and late signs of Cardiac Tamponade?

A

Early signs are pulsus paradoxus and tachycardia

Late signs are Becks Triad

40
Q

What is Beck’s triad?

A

Muffled heart tones
Narrowed pulse pressures
JVD

41
Q

How much blood accumulation around the heart lead to higher risk of mortatlity?

A

> 150 ml

42
Q

What is Hamman’s crunch?

A

Crunching, rasping sounds synchronous with the heartbeat

Subcutaneous Emphysema

43
Q

What electrolyte abnormality is a common finding in rhabdomylysis?

A

Hyperkalemia

44
Q

What is rhabdomylysis?

A

The breakdown of muscle fibers that leads to the release of muscle fiber contents (myoglobin) into the blood stream.

45
Q

What percentage of blood loss is typically when hypotension begins?

A

Starts at 30% blood loss

46
Q

List 4 adverse reactions to blood transfusions?

A

Drop in blood pressure
Fever
Tachycardia
Pallor

47
Q

Which blood products do not require Rh matching?

A

Platelets, Fresh frozen plasma and Cryoprecopitate.

48
Q

What blood type is the universal recipient?

A

AB

49
Q

Which blood type is the universal donor?

A

O

50
Q

What are the symptoms and treatment for anaphylactic reaction to blood transfusion?

A

Hypotension, Urticaria, tachycardia
STOP transfusion
Epi, steroids and Benadryl

51
Q

What are the symptoms and treatment for overload reaction to blood transfusion? (TACO)

A

Hypertension, distended neck veins
STOP transfusion
Administer Lasix

52
Q

What are the symptoms and treatment for Hemolytic reaction to blood transfusion?

A

Palpitations, Abdominal/Back pain, Syncope, Sense of Doom.
Caused by ABO incompatibility
STOP the infusion
Keep urine output high (100 ml/hr)

53
Q

What is the symptoms and treatment for Acute lung injury blood reactions? (TRALI)

A

Dyspnea, tachycardia, fever and cyanosis.
Caused by Leukocyte antibodies in plasma portion in blood.
Symptoms begin 1-6 hours after transfusion
LEADING CAUSE OF TRANFUSION DEATH
Stop transfusion