Trauma Unit Flashcards

1
Q

Define Triage system and its purpose

A

A triage system is a structure use in hospital to help categorise all incoming emergency patients using a standard rating scale

The purpose is to ensure that the level of emergency care provided is appropriate with clinical criteria

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2
Q

Define Triage system and its purpose

A

A triage system is a in hospital structure

Which categories all incoming emergency patients a
using a rating scale

to ensure that the correct level of emergency care provided is appropriate with clinical criteria

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3
Q

How many categories exist within the ATS and what are they

A

5 category’s

Cat1- immediate life -threatening

Cat2-imminently life- threatening

Cat3- potentially life-threatening/ time critical treatment/ severe pain

Cat4- potentially life-serious/ situational urgency/ significant complexity

Cat5- less urgent

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4
Q

What assessments are undertaken to determine a persons triage category (9)

A
  • chief complaint
  • general appearance
  • airway
  • breathing
  • circulation
  • disability
  • environmental
  • limited history
  • co- morbidities
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5
Q

Define major trauma
(5 points)

A
  • death after injury
  • admission to an intensive care unit for more then 24 hours, requiring mechanical ventilation
  • serious injury to 2 or more body systems
  • ISS (injury severity score) over 12
  • urgent surgery for inter cranial, intrathoracic, or intra-abdominal injury or fixation of pelvic or spinal fractures
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6
Q

Define pneumothorax

A

When there is a presence of air in the plural cavity between the piratical and visceral layer of the lungs. The air increases the pressure on the lungs a
Causes a collapse of the lung.

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7
Q

What is kinetic energy in the context of traumatic injury?

Give 1 example

A

The energy transferred to the body when stuck by a moving object.

For example- if a person is hit by a car, the kinetic energy of the car is transferred to the person causing damage based on the speed and mass of the vehicle

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8
Q

Explain velocity in the context of traumatic injury

A

The speed at which something is moving and its direction.

The faster the movement. Higher velocity = the greater the impact

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9
Q

What are 3 points used to assist with identification of major trauma

A

Actual time critical - abnormal vital signs in setting of trauma

Emergent Time Critical- assumed/ actual injury requires trauma specialist services

Potential Time Critical - pt has sustained a high risk mechanism associated with traumatic injury

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10
Q

What is range of motion

A

How far you can move/ stretch a joint, muscle.

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11
Q

What are 4 classic patterned of injury revealed via ROM testing

A
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12
Q

When does an ankle injury require imaging?

A
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13
Q

What are the 3 lat ligaments in ankle?
Which is most commonly injured?

A
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14
Q

Define hypothermia

A

A condition that occurs when core body temperature drops below 35’ degrees Celsius.

The body loses heat faster than it can produce it.

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15
Q

What is Body appropriate body

A
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16
Q

Define hypovolemic shock

A

A reduced volume of blood in blood vessels

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17
Q

3 major causes of hypovolemic shock

A
  1. External blood loss /trauma / injury
  2. Internal blood loss -vessels / pancreatitis/ GIB
  3. Fluid loss
    - major burns
    - vomiting
    - diarrhea
    - dehydration
    - ascites
    - diuretics
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18
Q

4 Signs and symptoms of hypovolaemic shock

A

⬇️BP
^ HR
C,P,C skin
Alt GCS

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19
Q

Define burns

A

Tissue damage caused by excessive heat, electrical, radioactivity or chemicals that destroy the proteins in the skin cells

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20
Q

What are the 5 classification of depths of burn

A
  • epidermal
  • superficial dermal
  • mid dermal
  • deep dermal
  • full thickness
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21
Q

Define shock

A

-A life threatening condition

-caused by a reduction of blood flow and
decrease in oxygen to cells and organs.

-inadequate perfusion

-imbalance between o2 supply and demand

  • decrease in BP
  • cardiac output
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22
Q

What is absolute fluid loss

A

Hypovolemic shock

  • a decrease blood and body fluids leading to a decrease in preload due to loss of volume of circulating blood.
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23
Q

What is 3 causes of Cardiogenic shock

A
  • heart failure-AMI ( acute myo infarction
  • cardiac tamponade
  • PE ( pulmonary embolism)
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24
Q

What is Cardiac tamponade

A

Compression of the heart caused by fluid collecting in the sac surrounding the heart.

Cardiac tamponade puts pressure on the heart and keeps it from filling properly.

The result is a dramatic drop in blood pressure that can be fatal.

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25
Q

What is cardiogenic shock

A

a life-threatening condition in which your heart suddenly can’t pump enough blood to meet your body’s needs

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26
Q

What are the 5 time Critical criteria for major trauma

A

HR <60 or >120
RR <10 or > 30
SBP <90
Sp02. <90%
GCS <13

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27
Q

What is cerebral blood flow autoregulation

A

The brains ability to maintain constant blood flow despite changes in perfusion pressure

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28
Q

Define cerebral perfusion pressure.

And what is a normal rate?

A

The pressure that moves oxygen to the brain
(CPP)

Normal CPP is between 60-80

29
Q

Define MAP

A

Mean arterial pressure.

The average blood pressure in the arteries during one cardiac cycle.

30
Q

Define intracranial pressure
ICP

A

The pressure within the skull.
Pressure between the tissue, blood and cerebrospinal fluid

31
Q

What is hyperkalaemia

A

Increased levels of potassium in the bloodstream

32
Q

What is disseminated intravascular coagulation

A

DIC- a condition where blood clots form throughout the body - blocking small blood vessels.

Clotting factors are used up, then increase bleeding happens

Clotting and bleeding simultaneously

33
Q

Define crush syndrome

A

CS is defined as severe systemic, traumatic muscle injury

34
Q

Define crush injury

A

CI is defined as tissue injury caused by direct physical trauma and compression of the body part

35
Q

What is compartment syndrome

A

Condition resulting from increased pressure within a confined body space.
Ie- leg

36
Q

What is myoglobin?

A

a protein that carries and stores oxygen in muscles cells

37
Q

What protein is released by damaged muscles

A

Myoglobin

38
Q

What is rhabdomyolysis

A

A medical condition characterised by the breakdown of skeletal muscle tissue.

  • this break down causes a release of myoglobin into the bloodstream.
  • myoglobin is a protein that can obstruct the flow of urine cause Acute Kidney Injury. AKI
  • myoglobin can have a toxic effect on the renal tubular cells leading to cell injury and death
39
Q

Define hypoxia

A

Inadequate amount of oxygen reaching tissues

40
Q

Crush syndrome can lead to

A

Acute kidney injury
Sepsis
Hypovolemic shock
Hyperkalemia
Organ failure
Rhabdomyolysis
Metablioc acidosis
IR- ischemia reperfusion injury

41
Q

Define preload

A

The filling of the ventricles( stretch of heart )

42
Q

Define preload

A

The filling of the ventricles( stretch of heart )

43
Q

In relation to shock
Explain the difference between 1.absolute fluid loss
2. Relative fluid loss
3. Pump failure

A
  1. Blood/ fluid volume loss due to external blood / fluid loss
  2. Blood/fluid volume remains the same but shifts from the blood vessels into tissues / spaces due to vasodilation and ^ permeability
  3. Occurres during cardiogenic shock
44
Q

Explain 3 stages of shock (flowchart)
compensated shock
Decompensated shock
Irreversible shock

A
45
Q

What are the 3 factors of the triade of death

A

Hypothermia- pt too cold <35*

Acidosis- pH < 7.2

Coagulopathy- body can not make blood clots

46
Q

Define Inertia ( traumatic terminology)

A

Things keep moving the same way unless something stops them

47
Q

Define Inertia ( traumatic terminology)

A

Things keep moving the same way unless something stops them

48
Q

Define blunt force trauma and 1 example

A

An injury caused by a blunt surface (non penetrating to skin)

Eg- bruising

49
Q

Define blunt force trauma and 1 example

A

An injury caused by a blunt surface (non penetrating to skin)

Eg- bruising

50
Q

Define Axial Load and 1 examples

A

When a force pushes straight along the bodies spine or bones.

Eg- falling and landing on feet or head
(Compressing the spine)

51
Q

Explain acceleration injury

A

Occurs when sudden ^ or decrease of speed causes internal damage due to the rapid changes in motion

52
Q

Explain Coup- Contercoup injury

A

-Head trauma

  • damage at the site of impact
  • damage to opposite side due to brain movements inside the skull
53
Q

Explain Shear forces

A

Are forces that cause part of the body to slide past each other leading to tissue tearing

54
Q

Explain blowout injury

A

When a forceful impact causes fractures of bone around structures around thr eye

55
Q

Explain crush injury and give 1 example

A

A body part is subjected to compressive force
Eg- being caught under a building rubble after earthquake

56
Q

Define Basilar Skull Fracture
Causes
5 signs n symptoms

A

Break in bone at base of skull

Causes- blunt force trauma eg- MVA, assaults

S+S
- raccoon eyes
- Battles sign ( behind ears)
- leaking cerebrospinal fluid from nose ears
-hearing loss
- dissy

57
Q

List 3 comorbidities that increase risk in trauma settings

A

1- cardiovascular disease; hypertension (high blood pressure complications haemorrhaging)

2- renal disease - disrupts fluid/ electrolytes balance (increase risk of hyperkalemia)

3- obesity ; risk of hypoxia as difficult airway management

58
Q

List 3 comorbidities that increase risk in trauma settings

A

1- cardiovascular disease; hypertension (high blood pressure complications haemorrhaging)

2- renal disease - disrupts fluid/ electrolytes balance (increase risk of hyperkalemia)

59
Q

What is Diffuse Axonal Injury

A
  • traumatic brain injury
  • axons inside the brain are stretched and damaged
  • enables communications between neurons
60
Q

How does Diffuse Axonal Injury occur?

A

By acceleration , deceleration, rotation movement and severe blunt trauma.

Eg- MVA, sports injuries, falls, violent attacks

61
Q

How does Diffuse Axonal Injury occur?

A

By acceleration , deceleration, rotation movement and severe blunt trauma.

Eg- MVA, sports injuries, falls, violent attacks

62
Q

What is acute cerebral oedema ?

What causes it?

A

Accumulation of fluid on the brain which causes it to swell.

TBI- infections/ HACE
(High altitude cerebral edema)

63
Q

What is intracerebral haemorrhage (ICH)

A

Bleeding within the Brain caused by small ruptured
blood vessels .

Leads to increase pressure ICP

64
Q

What is the most common cause of intracerebral haemorrhage

A

Hypotension
And
Trauma

65
Q

What is the most common cause of intracerebral haemorrhage

A

Hypotension
And
Trauma

66
Q

What are 4 signs and symptoms of intracerebral haemorrhage

A

Sudden headaches
Nausea and vomiting
Alt cons
Seizures

67
Q

Define epidural heamatoma

And cause

A

Type of TBI
- bleeding between inner surface of skull and dura mater layer ( outer membrane covering brain )

Caused-
Blood vessels/ arteries rupture

68
Q

Define subdural harmatoma

A

TBI-
Bleeding between the dura mater and arachnoid mater

Caused -
Tearing of veins

69
Q

Define subdural harmatoma

A

TBI-
Bleeding between the dura mater and arachnoid mater

Caused -
Tearing of veins