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EM quiz readings > trauma trigger COPY USE THIS ONE > Flashcards

trauma trigger COPY USE THIS ONE Flashcards

1
Q

mannitol is used for what

A

increased ICP

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2
Q

open fx abx

A

rocephin

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3
Q

ruptured abdominal viscus abx

A

unasyn or zosyn

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4
Q

vaginal/rectal lacerations ABX

A

unasyn or zosyn

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5
Q

why can children <6 mo old have respiratory failure with midface trauma?

A

they are obligate nasal breathers

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6
Q

Initial approach to trauma patient acronym

A

S - s/s
A - allergies
M - medications
P - past medical hx
L - last oral intake
E - events leading up to presentation

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7
Q

what is given to a trauma patient with hypotension

A

1 L NS bolus and 1L blood products

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8
Q

If a child presents with blunt force trauma to the abdomen and you suspect they are bleeding out into their abdomen, what would you expect their vitals to look like?

A

normal BP with tachycardia

(this is supposed to be compensated shock from hemorrhage)

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9
Q

what injury are infants/neonates at a higher risk for in trauma than other populations?

A

significant intracranial injury

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10
Q

there are lower incidences of vertebral fractures in what population? why?

A

pediatric population

increased flexibility = decreased vertebral fractures

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11
Q

intrathoracic injury without external signs of trauma are present in who? why?

A

peds, becuase chest wall is more compliant and not as protetive

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12
Q

are rib fractures common in peds? why/why not? what might they suggest?

A

NO

sign of child abuse in the absence of a traumatic event. Especially if broken ribs are posterior. Ribs have increased compliance in pediatric patients, so unlikely to break w/o large force.

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13
Q

indications for CT for abdominal and GU trauma

A

suspicious MOI
tenderness on exam (wtf? just from hannahs quizlet idk)
seat belt sign
distention
vomiting
>50 RBC on UA in blunt trauma

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14
Q

what might an anterior ring pelvic fracture indicate

A

urethral or bladder injury

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15
Q

what are s/s of impending brain herniation? what would you want to maintain during this time?

A

severe HA w vomiting
HTN w brady/tachycardia
papilledema
(from UTD, dont come at me)

maintain a PaCO2 of 30-35

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16
Q

what should be obtained in almost every geriatric (65+ via google) head injury and C spine injury

A

CT brain - head injury
CT c spine - c spine injury

“liberal use of CT head” - HB quizlet

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17
Q

what is the workup for a geriatric pt with abdominal trauma

A

stable = CT
untable or + FAST = OR

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18
Q

MCC injury in geriatric population?

A

falls

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19
Q

what complication is common in the geriatric population that should make you cautious of fluid rescucitation

A

fluid overload

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20
Q

how much fluid volume can you lose before shock s/s are present

A

up to 30-35%

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21
Q

why are pregnant patients at higher risk for hemorrhage during trauma

A

uterus displaces other organs so increased risk with any penetrating upper abdominal injury

22
Q

MCC of abdominal hemorrhage

A

spleen (im assuming rupture)

23
Q

MCC of pregnancy complications

A

prreterm labor and abruption of placenta

24
Q

who are coup-countercoup injuries more common in

A

elderly due to atrophy

25
Q

what is the difference between tx of fractures of the skull (lets say isolated and linear) that are depressed vs nondepressed

A

depressed - admission w neurosurgery consult and abx

nondepressed - none

26
Q

what is a hemothorax? how would you DX and Tx it?

A
  • blood in the pleural cavity
  • DX: FAST exam and CXR
  • Tx: thoracostomy
27
Q

How would you diagnose and tx a pneumothorax?

A

Dx: auscultate, CXR, eFAST, CT
Tx: if small (<1.0cm and confined to upper chest) then none.
if large = thoracostomy

28
Q

what type of rupture is an epidural hematoma vs a subdural hematoma

A

epidural = arterial (bleeds out FAST!!!!)
subdural = venous

29
Q

LOC followed by lucidity followed by more LOC is associated with what ? what else might you find on exam?

A

epidural hematoma

may see fixed & dilated pupil on side of lesion

30
Q

CT shows a biconvex lense in the temporal aspect of the skull

A

epidural hematoma

31
Q

brian atrophy puts pts at increased risk of what conditions

A

subdural hematoma and coup-countercoup injuries

32
Q

CT shows hyperdense lesion that crosses suture lines

A

subdural hematoma CT

33
Q

what should you keep MAP above in head trauma

A

80

34
Q

what would you give to a pt who is seizing after a head injury

A

IV lorazepam and fosphophenytoin

35
Q

what are the disposition plans for patients w head injury? (home criteria, ED criteria, Admit criteria)

A
  • home w reliable caretaker - GCS 15 w normal CT and norm serial neuro exams
  • ED - GCS of 14 w normal CT
  • Admit - anyone w abnormal CT or GCS <14
36
Q

what is the NEXUS Criteria for C spine imaging

A
  • AMS
  • midline cervical tenderness or step off
  • intoxication
  • neuro deficits
  • severe distracting injury
37
Q

when can you clinically clear C spine

A
  • negative NEXUS scan
  • ROM greater than 45 degrees BIL w no pain
38
Q

if a patient has a cervical spine injury, what should you scan

A

the entire spine

39
Q

when can you clinically clear thoracic and lumbar spine

A
  • negative NEXUS
  • assess sensation in all extremities
  • assess motor fxn in all extremities
40
Q

what is contained in the 2nd zone of the neck

A

mid carotid/vertebral arteries, jugular veins, esophagus, c spine larynx, and trachea.

cricoid cartilage to angle of mandible

41
Q

what types of traumas do bowel injuries typically present with? How might a different type of trauma cause bowel injury?

A

typical - penetrating trauma

different - decelerating trauma that causes mesenteric tear or blow out injury of the antimesenteric border.

42
Q

what type of trauma are duodenal injuries most associated with

A

high speed vertical or horizontal deceleration

43
Q

what type of trauma are pancreatic injuries most assocaited with

A

rapid deceleration or crush injuries

44
Q

tx of humerus fx

A

sling, splint, analgesia

45
Q

management of olecranon fx

A

long arm posterior splint w ortho fu

46
Q

management of radial head fx

A

sling and fu w ortho

47
Q

management of forearm fx

A
  • nondisplaced - sugartong splint and ortho f/u
  • displaced: reduce and ortho f/u
48
Q

what are s/s of a hip fracture and how do you treat it

A
  • grain pain and shortening of the affected leg
  • immobilize, pain control, inline traction, monitor for blood loss, ORIF
49
Q

manmagement of femoral shaft fractures

A

ORIF

50
Q

how fast does CPK rise post muscle injury? when does it peak

A

2-12 hours

1-3 days peak

EM quiz readings (43 decks)

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