Trauma/Musculoskeletal Flashcards
What’s the dichroic notch represent on an arterial line tracing?
Aortic valve closure
In what order do hypotension bradycardia and tachycardia occur when during hypovolemic shock from loss of blood volume?
Tachycardia, hypotension, bradycardia
What percentage of the body surface area in a child is the chest arms head? Adult?
Just 18 in both, arms nine in both, head 18% in kids 9% in adults increase surface area in the legs and adults
What does a pulmonary contusion look like on a chest x-ray?
Consolidation that is non-specific can look like aspiration or atelectasis as well as subcutaneous emphysema
Two unique points of rib fractured in children?
Race suspicion of maltreatment, less common in children
What is the most common cause of post burn morbidlity and mortality?
Infection
Grade 6 liver injury?
Avulsion of liver where the holdover is free floating in the abdomen
What does abdominal compartment syndrome cause?
Coagulopathies, acidosis, hypothermia, bowel edema
What complication of chest trauma results in the accumulation of blood in the pleural space between lung and chest wall?
Hemothorax
What unique phenomenon can occur as a result of spinal fusion or scoliosis repair?
S i a d h due to the volume replacement and spinal manipulation
What is the treatment for toxic synovitis?
NSAIDs
What does pulses paradoxes look like on an arterial waveform?
Flattening of dicrotic notch, exclamation rises inhalation lowers overall
What are the three A’s that proceed the three P’s?
Anxiety, agitation, analgesic requirement
What is the most common cause of death in children with a blunt abdominal trauma?
Liver laceration
What is a capillary leak in the context of burns?
Fluid shifts that occur over 12 to 48 hours causing electrolyte instability. Proteins escape into the interstitial space and potassium may be released from injured cells
What is the parkland formula?
Fluid replacement strategy. First half of loss fluid in first 8 hours second half over the following 16 hours
What is the most common organism causing osteomyelitis?
Staph aureus
What unique phenomenon can occur as a result of spinal fusion or scoliosis repair?
S i a d h due to the volume replacement and spinal manipulation
What complication of trauma causes an accumulation of blood or fluid in the pericardial sac?
Cardiac tamponade
What abdominal injury presents with hematuria?
Kidney laceration
How quickly do pulmonary contusions resolve?
Improved within 24 to 48 hours resolved in 7 to 10 days
What does cardiac tamponade look like on chest x-ray and echo?
And enlarged cardiac silhouette in the heart appears black against green muscle
What is the separation of the growth plate in the proximal femoral head?
Slipped capital femoral epiphysis
What degree of burn reaches the bone and muscle?
Deep full thickness
What chest trauma complication causes a collection of air in the plural space between the lung and chest wall?
Pneumothorax
What are the five salter Harris fractures?
Across, above, below, through, crush
What differentiates a superficial from a partial thickness burn?
Blisters on partial thickness
One of the four degrees of burn damage?
Superficial, partial thickness, full thickness, deep full thickness
What condition is an inflammatory condition that affects large joint spaces usually the hip?
Toxic or transient synovitis
What abdominal organ injury presents with bruising of the flank or back?
Kidney laceration
What emergent complication to chest trauma causes a acute buildup resulting in positive pressure in the chest cavity causing a shift in the mediastinum and impacts cardio respiratory functioning?
tension Pneumothorax
What does a PVC look like on arterial line tracing?
Arterial waveform will show non-perfused PVC
What is the management of a tension pneumothorax?
Decompression
What complication of trauma results in hypertension, tactic cardiac, distention of neck pains, muscle heart sounds, pulses paradoxes?
Cardiac tamponade
What is unique about full thickness burns?
Minimal or no pain
When does a patient with a liver laceration no longer need to be on bed rest?
After AST and ALT are within normal limits
What are the three characteristics of SCFE?
Sudden pain, limited internal rotation, obligated external rotation
What diagnostic evaluation should be done after non accidental trauma?
Chest x-ray skeletal survey, retinol eye exam, CT scan brain imaging
What is the treatment of septic arthritis?
IV antibiotics
When are prophylactic antibiotics needed in the case of a splenectomy?
Children less than 4 years old and specific cases older than that
It’s the most common bacteria in a fresh burn or graft?
Group a strep
Is blood loss more impactful in the neonate or the teenager?
In the neonate as they have less to lose
What is the most common abdominal injury in childhood?
Splenic laceration
What are the three P’s of compartment syndrome?
Paralysis, pallor, pulselessness
What is an infection of the synovial space of the joint?
Septic arthritis
What is the level of venture abdominal pressure in abdominal compartments in your?
Greater than 20
What are patients with pulmonary contisions at risk for developing?
ARDS
