Trauma patient: triage Flashcards
Descrie the management of pneumothorax
re-expansion of the collapsed lung and improvement in venous return and cardiac output
- thoracocentesis or thoracostomy tube placement
What is the target for a pulse oximeter?
over 94% at least
Describe primary injury of traumatic brain injury
Concussion (no histologic lesion)
Contusion (parenchymal haemorrhage and oedema)
Laceration- resulting in haematoma formation and brain compression
Describe secondary injury of traumatic brain jury
Combination of intracranial and systemic insults leading to neuronal cell death
Systemic insults-: hypotension, hypoxia, systemic inflammation, hypercapnia, hypocapnia, hyperglycaemia, electrolyte imbalances and acid base disturbances
Intracranial insults- increased intercranial pression, seizures, cerebral oedema, compromise fo blood brain barrier
How can the severity of Traumatic Brain Injury be assessed?
Glasgow Coma Scale Level of consciousness Brain stem reflexes (pupil size, PLRS and eye movement) Respiratory pattern Limb movement and postural reactions Blood pressure and heart rate
What are the goals of therapy of TBI?
Ensure adequate oxygenation
Avoid or correct factors that can lead to secondary brain injury
Address raised ICP
What should be done for patients at risk of developing ICH?
Prevent hypercapnia by controlling PaC02 between 30-35 mmHg (may require mechanical ventilation)
Maintain Pa02> 80 mmHg
Elevate the head to 30 degrees and prevent jugular compression
Remove causes of increased intra-thoracic pressure
What are the goals of treating marked ICH?
Reduced cerebral oedema with hypersmolar therapy
Reduced cerebral metabolic rate
When would a uroabdomen be suspected?
If creatinine concentration in abdominal fluid is over 2 times peripheral blood or potassium is 1.4 (dog) or 2 (cat) times serum level
What is common in cats following RTA?
mandibular symphyseal fractures
