Trauma Unit Flashcards
Define Triage system and its purpose
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
Define Triage system and its purpose
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
How many categories exist within the ATS and what are they
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
What assessments are undertaken to determine a persons triage category (9)
- chief complaint
- general appearance
- airway
- breathing
- circulation
- disability
- environmental
- limited history
- co- morbidities
Define major trauma
(5 points)
- 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
Define pneumothorax
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.
What is kinetic energy in the context of traumatic injury?
Give 1 example
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
Explain velocity in the context of traumatic injury
The speed at which something is moving and its direction.
The faster the movement. Higher velocity = the greater the impact
What are 3 points used to assist with identification of major trauma
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
What is range of motion
How far you can move/ stretch a joint, muscle.
What are 4 classic patterned of injury revealed via ROM testing
When does an ankle injury require imaging?
What are the 3 lat ligaments in ankle?
Which is most commonly injured?
Define hypothermia
A condition that occurs when core body temperature drops below 35’ degrees Celsius.
The body loses heat faster than it can produce it.
What is Body appropriate body
Define hypovolemic shock
A reduced volume of blood in blood vessels
3 major causes of hypovolemic shock
- External blood loss /trauma / injury
- Internal blood loss -vessels / pancreatitis/ GIB
- Fluid loss
- major burns
- vomiting
- diarrhea
- dehydration
- ascites
- diuretics
4 Signs and symptoms of hypovolaemic shock
⬇️BP
^ HR
C,P,C skin
Alt GCS
Define burns
Tissue damage caused by excessive heat, electrical, radioactivity or chemicals that destroy the proteins in the skin cells
What are the 5 classification of depths of burn
- epidermal
- superficial dermal
- mid dermal
- deep dermal
- full thickness
Define shock
-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
What is absolute fluid loss
Hypovolemic shock
- a decrease blood and body fluids leading to a decrease in preload due to loss of volume of circulating blood.
What is 3 causes of Cardiogenic shock
- heart failure-AMI ( acute myo infarction
- cardiac tamponade
- PE ( pulmonary embolism)
What is Cardiac tamponade
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.
What is cardiogenic shock
a life-threatening condition in which your heart suddenly can’t pump enough blood to meet your body’s needs
What are the 5 time Critical criteria for major trauma
HR <60 or >120
RR <10 or > 30
SBP <90
Sp02. <90%
GCS <13
What is cerebral blood flow autoregulation
The brains ability to maintain constant blood flow despite changes in perfusion pressure
Define cerebral perfusion pressure.
And what is a normal rate?
The pressure that moves oxygen to the brain
(CPP)
Normal CPP is between 60-80
Define MAP
Mean arterial pressure.
The average blood pressure in the arteries during one cardiac cycle.
Define intracranial pressure
ICP
The pressure within the skull.
Pressure between the tissue, blood and cerebrospinal fluid
What is hyperkalaemia
Increased levels of potassium in the bloodstream
What is disseminated intravascular coagulation
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
Define crush syndrome
CS is defined as severe systemic, traumatic muscle injury
Define crush injury
CI is defined as tissue injury caused by direct physical trauma and compression of the body part
What is compartment syndrome
Condition resulting from increased pressure within a confined body space.
Ie- leg
What is myoglobin?
a protein that carries and stores oxygen in muscles cells
What protein is released by damaged muscles
Myoglobin
What is rhabdomyolysis
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
Define hypoxia
Inadequate amount of oxygen reaching tissues
Crush syndrome can lead to
Acute kidney injury
Sepsis
Hypovolemic shock
Hyperkalemia
Organ failure
Rhabdomyolysis
Metablioc acidosis
IR- ischemia reperfusion injury
Define preload
The filling of the ventricles( stretch of heart )
Define preload
The filling of the ventricles( stretch of heart )
In relation to shock
Explain the difference between 1.absolute fluid loss
2. Relative fluid loss
3. Pump failure
- Blood/ fluid volume loss due to external blood / fluid loss
- Blood/fluid volume remains the same but shifts from the blood vessels into tissues / spaces due to vasodilation and ^ permeability
- Occurres during cardiogenic shock
Explain 3 stages of shock (flowchart)
compensated shock
Decompensated shock
Irreversible shock
What are the 3 factors of the triade of death
Hypothermia- pt too cold <35*
Acidosis- pH < 7.2
Coagulopathy- body can not make blood clots
Define Inertia ( traumatic terminology)
Things keep moving the same way unless something stops them
Define Inertia ( traumatic terminology)
Things keep moving the same way unless something stops them
Define blunt force trauma and 1 example
An injury caused by a blunt surface (non penetrating to skin)
Eg- bruising
Define blunt force trauma and 1 example
An injury caused by a blunt surface (non penetrating to skin)
Eg- bruising
Define Axial Load and 1 examples
When a force pushes straight along the bodies spine or bones.
Eg- falling and landing on feet or head
(Compressing the spine)
Explain acceleration injury
Occurs when sudden ^ or decrease of speed causes internal damage due to the rapid changes in motion
Explain Coup- Contercoup injury
-Head trauma
- damage at the site of impact
- damage to opposite side due to brain movements inside the skull
Explain Shear forces
Are forces that cause part of the body to slide past each other leading to tissue tearing
Explain blowout injury
When a forceful impact causes fractures of bone around structures around thr eye
Explain crush injury and give 1 example
A body part is subjected to compressive force
Eg- being caught under a building rubble after earthquake
Define Basilar Skull Fracture
Causes
5 signs n symptoms
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
List 3 comorbidities that increase risk in trauma settings
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
List 3 comorbidities that increase risk in trauma settings
1- cardiovascular disease; hypertension (high blood pressure complications haemorrhaging)
2- renal disease - disrupts fluid/ electrolytes balance (increase risk of hyperkalemia)
What is Diffuse Axonal Injury
- traumatic brain injury
- axons inside the brain are stretched and damaged
- enables communications between neurons
How does Diffuse Axonal Injury occur?
By acceleration , deceleration, rotation movement and severe blunt trauma.
Eg- MVA, sports injuries, falls, violent attacks
How does Diffuse Axonal Injury occur?
By acceleration , deceleration, rotation movement and severe blunt trauma.
Eg- MVA, sports injuries, falls, violent attacks
What is acute cerebral oedema ?
What causes it?
Accumulation of fluid on the brain which causes it to swell.
TBI- infections/ HACE
(High altitude cerebral edema)
What is intracerebral haemorrhage (ICH)
Bleeding within the Brain caused by small ruptured
blood vessels .
Leads to increase pressure ICP
What is the most common cause of intracerebral haemorrhage
Hypotension
And
Trauma
What is the most common cause of intracerebral haemorrhage
Hypotension
And
Trauma
What are 4 signs and symptoms of intracerebral haemorrhage
Sudden headaches
Nausea and vomiting
Alt cons
Seizures
Define epidural heamatoma
And cause
Type of TBI
- bleeding between inner surface of skull and dura mater layer ( outer membrane covering brain )
Caused-
Blood vessels/ arteries rupture
Define subdural harmatoma
TBI-
Bleeding between the dura mater and arachnoid mater
Caused -
Tearing of veins
Define subdural harmatoma
TBI-
Bleeding between the dura mater and arachnoid mater
Caused -
Tearing of veins
