Trauma Pt 2 Flashcards
What does ATMIST stand for?
Age
Time
Mechanism of injury
Injuries
Signs
Treatment
In trauma you should always use a jaw thrust to maintain a patent airway. True or False?
False
Is an OP airway contraindicated in a patient with a head injury?
No
What are the 4 different types of skull fracture
Compound fracture
Hairline fracture
Depression fracture
Base of skull fracture
What are the three factors of Cushings triad and what is it used for?
Used for assessment of Increasing Intercranial Pressure (ICP)
Bradycardia
Irregular RR
Widening Pulse Pressure
What is cardiac tamponade
Fluid buildup in the pericardial sac
Places pressure on heart
Reduces filling ability of heart chambers
Reduces cardiac output
A flail segment is: A fracture of _____ or more adjacent _____, in ______ or more places.
2 or more adjacent rib fractures in 2 or more places
What does exsanguination mean
Bleeding to death, loss of entire blood volume
What are the three factors in the triad of death
Hypothermia
Coagulopathy
Metabolic Acidosis
What does hyperfibrinolysis mean
Existing clots start to break down
The term “commotio cordis” is defined as what?
Blunt force applied to the centre of the chest causing immediate cardiac arrest.
What type of chest movement does flail chest cause
Paradoxical
What does SCENE stand for
Safety
Cause
Environment
Number of patients
Extra resources
What does DCAP-BTLS stand for regarding trauma
Deformity
Contusion
Abrasion
Penetration
Burns
Tenderness
Laceration
Swelling
What is MSC x 4
Movement
Sensation
Circulation (colour, warmth, pulse, cap refill)
x4 = in all limbs
What does COMA stand for
Clothes off
Oxygen on
Monitering
Access
What dressing should you use for an abdomen puncture (stab)
Blast dressing
Contains plastic sheet for bowel evisceration
What dressing should you use for a groin wound or an arterial wound that a tourniquet or pressure dressings aren’t indicated?
Haemostatic gauze
Pack wounds
Hold for 3 minutes
Promotes coagulation
Good for patients with severe wounds in critical vascular areas that not amenable to tourniquet use or pressure dressing alone
How long should you be on scene MAX in a major trauma
Less than 5 minutes
What is permissive hypotension and what do we do with it regarding major trauma? When should we give fluids?
Increase BP with fluid -> increase cardiac output -> Patient bleeds quicker.
BP <90mmhg WITH impaired organ perfusion - consider fluids OR BP <60mmhg WITH impaired organ perfusion in penetrating torso trauma.
What should we do with the pelvic splint
Always at same time as scoop
Splint to skin
Black to back
Minimal roll with control
Know your landmarks !!!!
What are the three factors of Becks Triad and what is it used for?
Low Blood Pressure
Jugular Vein Distension (swelling)
Muffled heart sounds
Used for assessing cardiac tamponade.
What does TWELVE stand for (a mnemonic for assessing a chest injury)?
Tracheal deviation
Wounds
Emphysema (subcutaneous)
Larynx
Veins (jugular distension)
Evaluate
Acute coronary syndromes are comprised of three conditions - what are they?
ST-Elevated Myocardial Infarction
Non-ST Elevated Myocardial Infarction
Unstable Angina
Where should each ECG lead go
V1-
V2-
V3-
V4-
V5-
V6-
V1 - 4th intercostal space, right of sternum
V2 - 4th intercostal space, left of the sternum
V3 - Between V2 and V4
V4 - 5th intercostal space, mid-clavicular line
V5 - Between V4 and V6 - anterior axillary line
V6 - 5th intercostal space, mid axillar line (same horizontal plane as V4)
What is the name for the period of confusion after a seizure?
Post ictal state
If you are presented with a patient who states their chest pain came on under exertion what condition would you consider?
Stable angina
If your patient complained of central chest pain with a ripping/tearing sensation what condition would you consider?
aortic aneurysm
What is the leading cause of death in thoracic trauma?
Hypoxia
Thoracic trauma accounts for what % of traumatic deaths?
25
Pain on breathing is also known as what?
Pleuritic pain
The optimal position for a conscious patient with isolated penetrating chest trauma is
Upright inclined toward injury
What should you use on an open pneumothorax?
A russel chest seal
What ribs are most commonly fractured in an adult?
4th - 10th
A cardiac tamponade is more likely in blunt trauma, true or false?
False
A grating sensation when two pieces of broken bone are rubbed together is known as what?
Crepitus
