TRAUMA: Shock, Chest, Head, Spinal, Abdominal and Orthopedic Injuries Flashcards
What is the main concern with injuries to solid organs? What is the onset of death and what is it due to?
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What is the main concern with injuries to hollow organs? What is the onset of death and what is it due to?
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Define acute abdominal pain.
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Define peritoneum.
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Define referred pain.
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What is peritonitis?
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Describe somatic pain.
superficial-deep pain | well localized | throbbing/aching
What is coffee ground emesis?
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What is hematochezia?
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What is melena?
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Describe visceral pain.
to hollow organs and smooth muscle | referred pain | swelling nausea and pallor
How do you assess abdominal pain?
palpate all 4 quadrants ending in the painful quadrant | ask for last BM and oral intake
Signs and Symptoms for upper GI bleed.
melena | coffee-ground vomit | vomiting bright red blood
Signs and Symptoms for lower GI bleed.
blood in stools
Signs and Symptoms for esophageal varices.
bleeding of esophagus
What is esophageal varices?
enlarged veins and arteries in esophagus due to alcohol abuse
Signs and Symptoms for appendicitis.
sharp pain in RLQ | NV and fever/chills
Signs and Symptoms for pancreatitis.
referred back pain | abdominal distention
What is pancreatitis?
inflammation of pancreas
Signs and Symptoms for cholescystitis?
jaundice | RUQ/epigastric pain | fever/leukocytosis | abdominal distention
What is cholecystitis?
inflammation of bladder due to gallstones
Signs and Symptoms for kidney stones.
hematuria | flank pain | sharp sudden severe pain
Signs and Symptoms for splenomegaly.
LUQ palpable mass | abdominal pain
Signs and Symptoms for AAA.
abdominal and back pain | pulsating mass palpated | hypotension
Signs and Symptoms for pelvic inflammatory disease.
abnormal vaginal discharge | RUQ and lower abd pain | suprapubic tenderness | cloudy urine
Signs and Symptoms for testicular torsion.
sudden strong pain in testicles
What are ligaments?
connect bone to bone
What are tendons?
connect muscle to bone
What is a sprain?
stretching/tearing of the TENDONS or LIGAMENTS
What is a strain?
stretching/tearing of the muscle
How can you help a patient with pain?
can’t do much, ALS protocol
How would you splint an injury of a long bone?
splint joints above and below
How would you splint an injury of a joint?
splint long bones above and below
How would you position an injury?
anatomically or that of comfort
How would you treat a dislocation?
NEVER pop it back into place | position limb as you found it
How can you tell if someone has a hip fracture?
one of the legs will appear shorter
How will you splint a hip fracture?
use backboard
What are the 2 fractured bones would you be most worried about and why?
femur and pelvis = due to the amount of bleeding it will cause, very close to big arteries
What are the 3 indications for re-aligning an angulated fracture
fracture (not dislocation) | NO PULSE | angulated
How many times can you align an angulated fracture?
ONE TIME
What are the contraindications for realignment of an angulated fracture?
resistance = splint as is | extreme pain
What should you do before and after splinting an injury?
check CMS in all 4 extremities
What is the traction splint used for?
mid-shaft femur fractures on STABLE patients
What is pleuritic chest pain?
pain on inspiration
What is crepitus?
bone grinding against bone
How would you treat a rib fracture?
Give O2 | treat for shock | abdominal dressings
What would you hear on someone who has a pneumothroax?
diminished lung sounds
What is a flail chest?
paradoxical movement of chest
How would you treat a flail chest?
position supine | positive pressure ventilation
Which one is more important, ABCs or C-Spine?
ABCs
What is a pneumothorax?
air in pleura space = sucking chest wound
Signs and Symptoms of a Pneumothorax?
sucking chest wound | diminished lung sounds | mediastinal shift (JVD and tracheal deviation) | hypotension
What type of dressing do you apply to chest injuries?
occlusive dressing
What is a hemothorax?
blood in the pleural space
Signs and symptoms of a hemothorax.
Same as a pneumothorax
What is a cardiac tamponade?
the pericardial sac is damaged and is filled with blood = heart is being compressed
Signs and Symptoms of a cardiac tamponade
cyanosis | dyspnea | Beck’s Triad | pulse paradoxes
What is Beck’s Triad?
hypotension | JVD | muffled heart tones
What is pulse paradoxes?
systolic BP drops by 10 points = classic sign of cardiac tamponade
Sign and Symptom of Myocardial Contusion?
reduced cardiac output | irregular pulse | rib fractures
What is traumatic asphyxia?
compression or prolonged hypoxia
Signs and Symptoms of traumatic asphyxia
petechia | distended neck veins | cyanosis of face/neck | scleral hemorrhage
Sign and Symptoms of Basilar Skull fx
raccoon eyes and Battle’s signs | obvious deformity
What do you use to dress scalp lacerations?
4x4 dressings and direct pressure
What is a linear skull fx?
linear fracture on skull
What is a compressed skull fx
indentation of the skull due to blunt force trauma = can damage brain tissues
How to treat an open skull fracture?
Apply dressing and wrap bandage over head
What does a basilar skull fracture indicate?
significant force | domestic abuse or prolonged physical abuse to the area
What is intracranial pressure?
increase in CSF/blood or swelling within the brain
What can cause ICP?
hypoxia
What is a concussion?
temporary loss of brain function due to a short amount of hypoxia
What is intracerebral bleeding?
bleeding within the brain tissue
What is epidural bleeding?
bleeding outside of the dura mater
Significant sign/symptom of an epidural bleed
Lucid interval = patient seems to have quickly recovered and then goes back to signs of severe ICP
What is subdural bleed?
under the dura mater
Signs and Symptoms of ICP
fixed and dilated pupils | unequal pupils | decreasing LOC | posturing | Cushing’s Triad
What is Cushing’s triad?
hypertension | bradycardia | Cheyne Stokes breathing
What is posturing?
flexion/extension movements
What is the Glasgow coma scale?
designed to assess head injuries
What is the 3 categories of the GCS scale and what is the lowest number a patient (even dead patients) can get?
eye response | verbal response | motor response | lowest = 3
Signs and Symptoms of a Spinal Cord Injury
incontinence | priapism | paralysis | paraplegia/quadriplegia
How would you treat spinal injuries?
KED or backboard
What are the indications for using a KED?
stable patients
How would you use a backboard on a kid?
pad underneath shoulders
Signs and Symptoms of COMPENSATED shock?
poor skin signs | increased HR and RR | normal BP and LOC
What are the 4 categories of shock?
Distributive | Obstructive | hypovolemic | cardiogenic
What is distributive shock?
low BP = affects distribution of blood
What is obstructive shock?
prevents or limits the blood to flow
What are the 4 types of distributive shock?
neurogenic | anaphylaxis | sepsis | psychogenic
Cause of cardiogenic shock?
CHF (pump problem)
Which burn can cause hypovolemic shock?
3rd degree = unable to transport blood