Trauma/SCI 7 Q Flashcards
What order does the primary survey occur in?
ABCDE: Airway, Breathing, Circulation, Disability, Exposure
Maintain the airway by keeping the head ____ and stabilized
midline
What is one way to open the airway?
using the jaw-thrust maneuver
Assess the pt’s breathing and administer high-flow O2 via a ________, or an ambu bag for life-threatening conditions.
nonrebreather face mask
Circulation is checked via the ______ pulse
carotid
Insert two large-bore IVs and provide aggressive fluid resuscitation using ___ or ___
LR or NS
When assessing disability, we will measure the patient’s _____ with a brief neuro exam
LOC
When inspecting posterior surfaces, we need to ______ the patient while maintaining cervical spine immobilization.
logroll
When logrolling, you will need at least __ people to help, with one person responsible for keeping the head midline
4
What are the five Hs (and the additional H) of PEA?
- hypovolemia
- hypoxia
- hydrogen ion
- hyper/hypokalemia
- Hypothermia
extra = hypoglycemia
What are the five Ts of PEA?
- Toxins
- Tamponade
- Tension pneumo
- Thrombosis
- Trauma
Treatment for a pneumothorax includes
- simple = chest tube
- open = cover wound with occlusive dressing (secured on 3 sides) then chest tube
- tension = needle decompression then chest tube
What is used to determine the presence of blood in the peritoneal space?
Focused abdominal sonography for trauma (FAST)
Deceleration injuries consist of restraint injuries and great vessel disruption, what do you see with these?
- restraint = hands/face/small bowel rupture (seat belt sign)
- great vessel disruption (aortic tear) = abnormal mediastinum on X-ray
Blood loss for a closed femur fracture is..
1000 to 1500 mL
For open and unstable _____ fractures, need to immobilize and control hemorrhage
pelvis
Amount of blood loss with an unstable pelvic fracture
> 15 units of blood
Due to the disintegration of muscle that occurs with crush injuries, the patient is at risk of developing ________
rhabdomyolysis
For ____ _____, many symptoms of TBI overlap symptoms of PTSD
military personnel
The extent of injury and recovery is determined at least _______ or longer after the initial injury due to edema
72 hrs
What is given ASAP after the injury to reduce secondary spinal cord injury and has no benefit after 8 hours of injury?
Steroids (methylprednisolone / decadron)
Spinal Shock lasts days to months and is characterized by…
- decreased reflexes
- loss of sensation
- flaccid paralysis below level of injury
_____ ____ occurs in spinal cord injuries level T6 or higher, and is characterized by hypotension, bradycardia, poikilothermia, peripheral vasodilation, venous pooling, and decreased cardiac output
Neurogenic shock
What is the gold standard for SCI diagnostics?
CT scan
Bradycardia (< 60 bpm) results due to an unopposed vagal response, any increase in vagal stimulation can result in cardiac arrest. So, what can we NOT do?
suctioning, turning
An injury at or above C3 results in a total loss of respiratory function and requires ______
intubation
An injury below C3 results in ________ _______, indicating respiratory insufficiency
diaphragmatic breathing
An emergency that occurs with injuries above T6 after spinal shock subsides is…
Autonomic Dysreflexia
Most common precipitating factor of autonomic dysreflexia is
distended bladder/bowel
Management of autonomic dysreflexia includes…
position pt upright/HOB at 45+ degrees, assess for trigger and remove cause, notify MD, catheterize/remove fecal impaction using lidocaine jelly, administer vasodilators to decrease BP (Procardia, Apresoline)
