Trauma Management (19) Flashcards
Dr. Thompson
What is involved in a primary survey of a trauma case?
- rapid assessment for life-threatening problems
- target critical organs by priority
- 2 minutes or less
What should you assess initially on a trauma patient?
- level of consciousness, attitude, behavior
- unusual activity
- unusual body or limb postures
What is the old method for initial assessment?
ABC
Airway
Breathing
Circulation
Neurologic
Wounds
What is apoptosis?
the natural process of old cells dying and being replaced by new ones
What is necrosis?
toxins, radiation, heat, trauma, lack of oxygen due to the interruption of blood flow
What do the ABCs have in common?
all pertain to red blood cells
How are red blood cells lost in trauma?
hemorrhage
compressible
non compressible
What is the new acronym for initial assessment?
M^2ARCH^2E
What are the Ms for M^2ARCH^2E?
massive hemorrhage and muzzle
What are the Hs for M^2ARCH^2E?
head injury and hypothermia
Name all of the M^2ARCH^2E
How do you deal with massive hemorrhage?
pressure!!!!
stop significant bleeding - [pressure, tourniquet, hemostatic dressings
What are the types of tourniquets?
C-A-TL Combat Application Tourniquet
SOF-T SPecial Operations Forces Tourniquet
What are the hemostatic bandages?
- combat gauze
- chitogauze
- hemcon
How do you assess the airway?
- check for patent airway: abnormal sounds, deformity
- restrain!
- reposition jaw, tongue, head/neck if needed
- clear airway of objects, blood
- listen for labored and noisy breathing
- feel the throat area and trachea in the front-center part of the neck
What is this assessing?
feeling for something blocking the airway
look for masses, wounds, swelling, or deformities that may cause airway obstruction
When you open the mouth to assess airway, what should you do?
examine the inside as far back into the throat area as possible to look for:
- masses
- foreign objects
- swelling
- deformities that may cause airway obstruction
What is the 2-finger sweep?
sweep vomit, blood clots, foreign objects from the mouth to clear the airway of obstructions
How do you remove?
pull tongue straight out between lower canine and gently pull bone up from chin to dislodge
How do you perform a tube tracheotomy?
make a transverse incision through the annular ligament between the 3rd and fourth (or fourth and fifth) tracheal cartilages
What should you not do during a tube tracheotomy?
do not extend the incision around more than half the circumference of the trachea
After incising the annular ligament, what is next?
facilitate tube placement by depressing the proximal cartilages with a hemostat
After depressing the proximal cartilages with a hemostat, what is next in a tube tracheotomy?
elevate the distal cartilages with an encircling suture
insert a tracheostomy tube that does not completely fill the lumen
What are the last steps to a tube tracheotomy?
appose the sternohyoid muscles, SQ tissue, and skin cranial and caudal to the tube
secure the tube by tying it with gauze or umbilical tape around the neck
How do you assess respiration?
observe the chest and abdomen
do not remove the vest by cutting
What are the landmarks for a tension pneumothorax for needle decompression?
landmarks and technique (7th to 10th intercostal space)
What does this show?
needle decompression of tension pneumothorax
Which method to relieve tension pneumothorax is this?
thoracocentesis
What two methods relieve tension pneumothorax?
- needle decompression
- thoracocentesis
What does deep, labored breathing suggest?
lung trauma or problems, such as pulmonary contusion
What does shallow, rapid breathing suggest?
air, blood, or some other fluid in spaces of the lungs that don’t normally contain air, blood, or fluids
Irregular breathing may indicate ______
brain injury
What is the major portion of M^2ARCH^2E?
M^2, A, R
How do you assess circulation on a trauma patient?
- recheck bandages to ensure control of massive bleeding
- address smaller wounds if necessary
- initiate IVs and IO devices if needed
- fractures: immobilize joint
How do you assess circulation - pulse?
rate, character - strong or weak, rhythm
What else do you assess for circulation?
mucous membrane color & CRT
What symptoms regarding circulation suggest shock, major trauma, or a serious medical problem?
rapid heart rate or pulse with prolonged capillary refill time
How do you address hypothermia in trauma patients?
space blankets, rescue blankets
assess level of consciousness
observe equality between pupils
What else should you assess with the dog?
notice the spinal column, abdominal region, flank, and limbs for signs of trauma
Summarize how to manage trauma
- visually assess
- MARCHE
- rest of the dog
What is compressible hemorrhage?
bleeding that can be controlled by applying direct pressure, usually from external wounds like cuts or lacerations
“compression of R auricle of heart during surgery”
What is noncompressible hemorrhage?
bleeding that occurs deep inside the body, such as in the chest, abdomen, or pelvis, where pressure cannot effectively stop it
hole in vena cava, gun shot wound
