Trauma scenarios Flashcards
When given a trauma scenario, what should be the first thing you do ?
Put out a 2222 trauma call and get the patient in to Resus / place of safety
What is involved in A of the ATLS primary survey
Airway and C Spine immobilisation
- Chest Airway patent
- C spine tripple immobilisation (Block, collar and board)
What is involved in B of the ATLS primary survey
Breathing
- inspect chest for sings of trauma
- respiratory rate
- SATs probe
- administer 15L high flow oxygen via non rebreathe mask
- Palpate chest for equal chest expansion
- percuss chest for dullness and hyper resonance
- Auscultate the chest
- ABG
- CXR
What is involved in C of the ATLS primary survey
Circulation, and control of haemorrhage + catheter
- HR
- BP
- Heart Sounds
- ECG
- Peripheral circulation
- wide bore cannula
- Bloods incl. G&S + Cross match
- IVI / blood
- assess for major bleeding sorces
- Cather
- Consider FAST scan
- Pelvic binders
What is involved in D+E of the ATLS primary survey
- GCS
- Pupil reflexes
- BM
- Palpate abdomen
- expose and check for signs of bleeding
- temperature
what are some differential diagnosis for traumatic left upper quadrant pain
- splenic injury
- renal injury
- diaphragm rupture
- traumatic bowel perf
- pancreatic tail injury
what are some differential diagnosis for frank haematura in trauma injuries
- renal injury
- ureter injury
- bladder injury
- urethral injury
in a stable trauma patient what investigations would you order
- Bloods including G&S and Cross match
- ABG
- ECG
- Beside USS
- portable chest x ray if concerns
- Trauma CT series
what would you do if you trauma patient was found to have a Renal tear?
- reassess patient to check they are haemodynamically stable
- call senior (urology reg)
- discuss patient and ask for any management plan until he arrives
- establish if patient is for theatre, and if so pre for theatre
What would be your differential diagnosis for an elderly gentleman with Right sided loin pain radiating to the back with a BP 98/62
Diagnosis: AAA
Others: Renal colic pylonephritis bowel perforation diverticulitis
what investigations would you do for a man with right sided loin pain radiating through to his back and a low BP
Bloods: Full set + G&S and cross match
Beside: ABG, ECG
Imaging: CT Aortogram
What does VITAMIN CDEF stand for in the surgical sieve?
Vascular Infection Traumatic Autoimmune Metabolic Iatrogenic Neoplasm
Congenital
Degenerative
Endocrine
Functional
why is a GCS of 8 important? what should you think about?
A GCS of 8 or below means that the patient may not be able to maintain their own airway.
Contact anaesthetics to get get a possible definitive airway
what are some of the indications for a CT head within 1 hour?
- GCS <13 on initial assessment
- suspected skull fracture
signs of basal skull fracture - post traumatic trauma
- head injury + more than 1 episode of vomiting
what are some of the indications for a CT head within 8 hours
- dangerous mechanism of injury
- more than 30 mins retrograde amnesia of events immediately before the head injury
