trauma midterm review Flashcards by Tristan Wiebe

how many different types of kinematic energy are there?

mechanical 
chemical
thermal
electrical 
barometric

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kinetic energy

associated with bodies in motion

half the mass x the square of velocity

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what factors might affect the type of injury a person might sustain

external factors:

amount of force/energy delivered

duration/direction

rate of force application

positioning

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blunt trauma

spreading of impact

forceful impact

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if you arrive at a MVC and you see a cracked windshield/ dashboard damage what should you be mindful of

C spine injuries
fractured ankles/feet

can determine ABC outcome

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t/f internal injuries can be hard to recognize

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what can you do to help determine the injuries sustained

MOI

you are the eyes and ears of the trauma centre

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what injuries would require you to go to a level 1 trauma centre?

GCS under 13
SBP under 90
RR under 10 over 29

head injuries 
flail chest
2+ proximal bone fractures
amputation 
crushed/pulseless extremity 
pelvic fracture
skull fracture 
paralysis

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what happens when you suddenly decelerate

dissipates tremendous forces thus causing major injuries

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3 reasons for hypothermia

evaporation of sweat
cold induced diuresis
increased respiratory heat/fluid loss from dry air

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cold induced diuresis

skin vasoconstriction from cold exposure

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contact freeze injury

touching something that is cold

tongue on pole

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chilblains

nonfreezing cold injury from cold air
itchy tender lesions
bluish/redish

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snow blindness

dry air/bright light exposure burns skin/eyes

happens more at higher altitudes

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snow blinding symptoms

swollen eyelids
red eyes
pain looking at the light
severe pain

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snow blindness treatment

patch eyes
eye drops
antibiotics/analgesics

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nonfreezing cold injuries

types

damage to peripheral tissues from cold/wet stimulus (not frozen)

trench foot
immersion foot

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trench foot

in military people

cold and restricted circulation

doesn’t involve water

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immersion foot

prolonged immersion if extremities in cold moisture

common in homeless

0-15C

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soft tissue foot injuries are known as

maceration

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why don’t tissues freeze at 0C

electrolytes and other solutes

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superficial frost bite

first/second

blister when rewarmed

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deep frostbite

third/fourth
affects skin and muscle tone
hemorrhagic blisters when rewarmed

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accidental hypothermia

under 35C

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primary hypothermia

healthy individuals in temp well above freezing are unprepared

secondary hypothermia

when a patient has a medical disorder

hypothermia

losing more heat then we are getting

triad of death

hypothermia acidosis coagulopathy

__% of level 1 trauma patients were hypothermic at one point

death % when body is below 32.2 C

40-100%

immersion hypothermia

falling into cold water worst if water is under 25C

phases when entering cold water

first - cold shock response second - cold incapacitation third - onset of hypothermia fourth - circumrescue collapse

what happens to body in hypothermia heart/ecg

bradycardia | J waves on ECG

where's J wave on ECG

in QRS

when does heart become irritable to hypothermia

under 30C that's when changes occur

mild hypo

35-32 shivering vasoconstriction tachypneac ataxia

moderate hypo

32-28 loss of coordination confusion Brady

sever hypo

28-24 coma

profound

under 24 cardiac arrest

hypothermia management***

prevent further heat loss initiate transport rewarming gentle handling high flow O2 since they have decreased O2 delivery IV saline 5% dextrose warmed up to 42.8C

hypothermia defibrillate

once 120-200 biphasic joules CPR wait until body temp is 30C

what happens first in wound healing

``` vasoconstriction inflammation epitheliazation neovascurlization collagen synthesis ```

wound healing anatomical factors

skin tension lines | some meds

necrotizing fasciitis

death of tissue from more then one infection starts from staph infection

closed wound

no break in the epidermis

open wound

break in the epidermis

ecymosis

tear in small blood vessels causing bruising closed wound

hematoma

tear in large blood vessels causing bruises closed wound

bleeding is either...

internal or external

vessel bleeding most to least

arteries veins capillaries

melena

dark red poops | lower GI bleed

hematochezia

bright red poops | colon bleed

how to manage external bleeding

direct pressure elevation turniqui

t/f patients with shock symptoms without external bleeding probably have internal bleeding

T! | rapid transport

anaerobic metabolism

not as efficient as aerobic metabolism can only run for a short time since it doesn't produce was much energy

how long can brain heart and lungs last without O2

4-6 min

how long can kidneys liver and GI tract last without O2

45-90 min

how long can muscle bone and skin live without O2

4-6 hours

definition of shock

change in cellular function from aerobic metabolism to anaerobic metabolism ' bodies O2 needs aren't meant

the fick principle

what components are necessary to get O2 to the cells | diffusion

how to manage an internal hemorrhage

``` supine ABC O2 blankets to maintain heat IV 250 bolus analgesics watch out for shock ```

determinate of cellular perfusion

heart fluid volume vessels

how many types of shock

3 types of shock

hypovolemic distributive cardiogenic

most common type of shock

hypovolemic assume its always this type unless proven otherwise

decrease left atrial filling

causes ADH

average person has _L of circulating blood volume

electrolyte ratio for blood loss

3 litres electrolytes solution per 1 litre of blood loss

what can happen from to much electrolyte solution during shock

decreased O2 transfer

what type of electrolyte solution is prescribed for shock

ringers can cause hyperchloremia

neurogenic shock

hypotension | spinal cord injury interrupts the sympathetic nervous system

cariogenic shock | intrinsic causes

heart muscle damage | valvular disruption

cariogenic extrinsic causes

cardiac tamponade | pneumothorax

cariogenic extrinsic causes

cardiac tamponade tension pneumothorax

axial skeleton

central part of the body

appendicular skeleton

upper/lower part of the body

musculoskeletal trauma 3 main types

life threatening non life threatening isolated non life threatening