Trauma Presentations

Question 1

You attend a pt with severe burns to their head, right leg and genitalia. Using the rule of 9s calculate the TBSA of the burns

Answer 1

28%

Question 2

What makes a burns pt time critical?

Answer 2

> 20% TBSA or >10% if <15 yrs
Suspected airway burns
1000 V electrical burns

Question 3

What is the first line of management for burns and how is it carried out?

Answer 3

Burn cooling - 20 minutes, gentle running water 5-15 degrees. Stop if pt shivering or temp <35

Question 4

What is the primary dressing used in treatment of burns?

Answer 4

Cling wrap - longitudinally

Question 5

What is another important factor to consider when dealing with a burns pt?

Answer 5

Minimising heat loss - maintaining normothermia

Question 6

How do you manage adult severe pain?

Answer 6

IV opioid (morphine/fentanyl)
AND IN ketamine

Question 7

How would you manage a pelvic fracture?

Answer 7

1. Provide analgesia
2. Apply pelvic binder (Anatomically splint legs)

Question 8

How would you manage a NoF fracture?

Answer 8

1. Analgesia
2. Anatomical splinting

Question 9

How would you manage a chest injury (open/closed pneumothorax)?

Answer 9

1. Monitor for deterioration
2. Don’t occlude open pneumothorax

Question 10

How would you manage a TBI?

Answer 10

1. Bed at 30 degrees
2. Provide fluid resuscitation targeting BP > 120
3. Manage airway/breathing

Question 11

How would you manage a tension pneumothorax?

Answer 11

Needle thoracotomy on affected side if responsive to pain or unconscious and BP > 70

Question 12

How would you manage an isolated spinal cord injury?

Answer 12

Fluid resuscitation targeting BP > 120, spinal immobilisation, administer prophylactic anti-emetic