Traumatic Disorders and Conditions Flashcards
Abrasion
ETIOLOGY: friction with hard and rough surface scrapes away tissue
S/S: burning pain (nerve ending exposure), small amount of bleeding, foreign particles may be present, red and raw wound
TREATMENT: possible benzocaine, wash with warm germicidal soap, remove foreign particles with forceps, possible germicidal ointment, dress wound, possible prophylactic Tdap injection
PROGNOSIS: good with treatment. Risk of tetanus or other bacterial infections
Avulsion
ETIOLOGY: skin, tissue, and possibly the bone is pulled away
S/S: severe pain, bleeding, skin peeled away or completely removed from skin
TREATMENT: control bleeding and clean the wound. Prophylactic antibiotics with possible Tdap injection, wound dressing, basic fibroblast growth factor (bFGF), possible pain medications, possible skin graft
PROGNOSIS: best with prompt treatment.
Crushing Injury
ETIOLOGY: mechanical compression of skin, blood vessels, nerves, and/or bone
S/S: immobilization of affected area, pain
TREATMENT: control bleeding, clean wound, debride (remove necrotic tissue). Prophylactic antibiotics with possible Tdap injection, surgical repair
PROGNOSIS: best with prompt treatment
Puncture Wounds
ETIOLOGY: sharp object penetrates the skin, extensive bleeding may occur if removed
S/S: impaled object may be observable, minimal bleeding, pain
TREATMENT: cleansing and irrigation of wound, prophylactic antibiotics with possible Tdap injection, removal of foreign object
PROGNOSIS: varies on extent on injury, best with prompt treatment
Laceration
ETIOLOGY: sharp object cuts skin and leaves smooth (incision) or jagged opening
S/S: open wound, moderate to severe bleeding, pain
TREATMENT: cleansing and irrigation of wound, adhesive strips/butterfly dressing/taping, possible sutures to control bleeding, prophylactic antibiotics with possible Tdap injection
PROGNOSIS: best with prompt treatment
Foreign Bodies in the Ear
ETIOLOGY: (children most affected) small toys, cereal, bugs, pebbles, vegetation, or other small objects become trapped in ear canal
S/S: ear compression, possible pain, muffled hearing, “buzzing” can be heard with bugs
TREATMENT: removal by forceps, gentle irrigation with 50/50% water/H2O2 mixture, light technique with bug
PROGNOSIS: good with prompt treatment. Risk of tympanic damage
Foreign Bodies in the Eye
ETIOLOGY: small objects (dust, rust, metal fragments, insects, certain chemicals) can become trapped in eye through workplace accidents, explosions, MVA, sports injuries, or by simply rubbing the eyes
S/S: irritation, pain, and compromised vision
TREATMENT: gentle irrigation with saline solution, removal with eye spud, antibiotic eye drops, bandage both eyes
PROGNOSIS: varies with causative agent and level of involvement. Risks of corneal abrasion, compromised vision, or blindness
Foreign Bodies in the Nose
ETIOLOGY: (most common in children) small object becomes trapped in one of the nares
S/S: obstructed airflow, nasal swelling, mucosal secretion
TREATMENT: encourage patient to exhale, crush foreign material if possible, removal with forceps or suction
PROGNOSIS: good with prompt treatment
Burns
ETIOLOGY: extreme heat, chemicals, radiation, or electricity damages tissues. Any inhalation of superheated air can lead to respiratory damage
S/S: pain (varies on percent of body affected and degree of burn), red/blistered/charred skin
TREATMENT: rinse with cool water if source isn’t electrical or thermal, analgesics, possible prophylactic antibiotics, possible debriding and skin grafts
PROGNOSIS: varies on severity of burns and organ involvement, but best with immediate treatment
Electrical Shock
ETIOLOGY: electrical current makes contact with entry site, flows through path of least resistance, and leaves through exit site.
S/S: possible cardiac dysrhythmia, muscle contractions, pain, charred skin at entry/exit site,
TREATMENT: assess vascular and neurologic status, possible cardiopulmonary resuscitation, debriding and sterile dressing, treat secondary open trauma, possible prophylactic antibiotics and Tdap injection
PROGNOSIS: best with immediate treatment, unfavorable if cardiac dysrhythmia occurs.
Lightning Strikes
ETIOLOGY: Lighting may strike directly (direct strike), transfer from an object (contact strike), “jump” from an object (side splash), enter and exit from leg (stride potential), or move through ground (ground current)
S/S: visual and auditory disturbances, possible ruptured tympanic membrane, altered state of consciousness, burns, possible apnea and cardiac dysrhythmia
TREATMENT: possible cardiopulmonary resuscitation, treatment of secondary open wounds, possible prophylactic antibiotics and Tdap injection
PROGNOSIS: varies on type of lighting strike, survival dependent on respiratory function. Possible risk of future cataracts.
Hyperthermia
ETIOLOGY: (Heat exhaustion) depletion of salt and water.
(Heat Stroke) Insufficient cooling mechanisms in extreme heat leads to body rising to 105F or above, resulting in cellular damage
S/S: (Heat Exhaustion) sweating, nausea, fatigue, dizziness, headaches, muscle cramps
(Heat Stroke) irritability, hysteria, confusion, altered state of consciousness and possible seizures
TREATMENT: move to cold environment, remove clothing (except for underwear), pour cold water, give 4oz of water if heat exhaustion
PROGNOSIS: varies on duration of heat exposure and underlying conditions
Hypothermia
ETIOLOGY: prolonged exposure to cold air, wind, or water leads to body temperature falling below 95F
S/S: shivering, fatigue, confusion, slurred speech, weak pulse with bradycardia, slow and shallow breathing
TREATMENT: dress with warm clothing and blankets, keep body dry, expose to heat source, give small amounts of warm liquids if conscious
PROGNOSIS: varies on cold exposure and underlying conditions
Frostbite
ETIOLOGY: prolonged and extreme exposure to cold air, wind, or water leads to formation of ice crystals within and around cells
S/S: necrotic tissue, numbness, possible swelling and blood-filled blisters
TREATMENT: expose to warmth, pain medication, IV fluids to rehydrate debridement or amputation,
PROGNOSIS: varies on duration of exposure, age, and underlying conditions
Insect Bites
ETIOLOGY: insect bites skin and may inject venom, leading to possible immune response
S/S: (varies with insect) stinging pain, pruritis, erythema, possible system rash, possible dyspnea, edema, nausea, shock, loss of consciousness
TREATMENT: scrape away stinger, possible antivenin, clean and dress wound
PROGNOSIS: varies on type of insect and underlying pathologies. Possible risks of malaria, lyme disease, encephalitis, and Rocky Mountain spotted fever
Rocky Mountain Spotted Fever
ETIOLOGY: Rickettsia rickettsii intracellular bacterium transmitted via tick feces during host feeding and incubates for a few days to a week.
S/S: fever, headache, nausea, malaise, myalgia, systemic maculopapular rash, small vessel or systemic necrotizing vasculitis
TREATMENT: antibiotic course of doxycycline or tetracycline
PROGNOSIS: good with prompt identification and treatment
Malaria
ETIOLOGY: Plasmodium protozoa transmitted via mosquito vector then feeds on hemoglobin and reproduces in RBCs
S/S: cycle of chills/fever/sweats, nausea, headache, fatigue, myalgia, enlarged spleen and liver, anemia
TREATMENT: chloroquine (antimalarial drug), possible doxycycline or tetracycline, antipyretics, infusion of packed RBCs
PROGNOSIS: varies, may last 2-14 weeks with year-long lingering symptoms
Animal/Human Bites
ETIOLOGY: animal (domestic, farm, wild, or shark) is agitated and bites
S/S: pain, puncture wounds, bleeding, possible avulsion, localized bruising
TREATMENT: clean wound, cauterize or suture wound, rabies immunity injections if animal was rabid or unknown, Tdap, prophylactic antibiotics, possible plastic surgery
PROGNOSIS: varies on tissue damage and possible infections
Snakebites
ETIOLOGY: Poisonous (i.e. rattlesnakes, coral snakes) or non-poisonous snakes bites person, venom leads to symptoms within 1-2 days
S/S: bite mark or discoloration, burning pain, swelling, tachycardia, visual difficulties, weakness, nausea
TREATMENT: keep bitten limb below heart level, clean wound with soap and water, possible suctioning, antivenin, no tourniquet
PROGNOSIS: varies on type of snake, underlying pathologies, location of bite, and promptness of treatment
Carpal Tunnel Syndrome
ETIOLOGY: repetitive overuse of tendons surrounding median serve leads to tendon inflammation and median nerve entrapment
S/S: numbness of hand and wrist, pain that intensifies at night, wrist and hand swelling
TREATMENT: physical therapy, cease source of overuse, splint, antiinflammatory drugs, corticosteroids, possible carpal ligament division surgery
PROGNOSIS: good with compliance to treatment
Tennis Elbow
(Lateral Humeral Condylitis)
ETIOLOGY: Repetitive motion at elbow with wrist flexion leads to inflammation of extensor attachment of distal humerus
S/S: pain in outer elbow and lower arm, weakness
TREATMENT: avoid source of overuse, NSAIDs, possible elastic brace, possible steroid injections
PROGNOSIS: good with compliance to treatment
Trigger Finger
(Stenosing Tenosynovitis)
ETIOLOGY: repetitive overuse of digital flexor tendon leads to inflammation and swelling or scarring, thus limiting motion
S/S: lump on flexor tendon, interrupted finger flexion that then “snaps,” pain at base of hand
TREATMENT: ergonomic intervention, ice packs, NSAIDs, possible cortisone injections, possible surgical intervention
PROGNOSIS: good with compliance to treatment
Thoracic Outlet Syndrome
(Brachial Plexus Injury)
ETIOLOGY: repetitive hyperabduction of the arm with inflammation, a cervical rib, or continual shoulder girdle dropping leads to inflammation and compression of brachial plexus nerves
S/S: pain in one arm, paresthesia (pins and needles), weakness, possible muscular atrophy
TREATMENT: ergonomic intervention, possible surgical removal of cervical rib
PROGNOSIS: good with appropriate treatment
Nonspecific Tendinitis
ETIOLOGY: repetitive overuse, poor ergonomics, calcium deposits, or dysfunctional bursa leads to inflammation of tendon
S/S: acute nonspecific pain along the tendon, possible contractures
TREATMENT: antiinflammatory drugs, possible cortisone injection, possible surgical release of contractures
PROGNOSIS: unpredictable (factors include tendon involved and response to treatment)
Child Abuse/Neglect
ETIOLOGY: emotional immaturity of abuser, abuser being abused themselves as child, socioeconomic stress, substance abuse, and limitations of disabled child can contribute
S/S: bruises over soft tissue, finger/ring/belt marks, cigarrete or “dipping scald” burns, greenstick fractures, and social withdrawal are all possible signs and symptoms of child abuse
TREATMENT: legally required to report to appropriate agencies, unconditional emotional support for child, possible removal of child through social services, treat injuries appropriately
PROGNOSIS: VARIES. Depends on duration and extent of abuse, identification of abuser, abuser access to child, emotional attachment of child to abuser…
Shaken Infant (Baby) Syndrome
ETIOLOGY: (abuse, tossing baby, or jogging) rapid shaking of infant’s head causes brain to strike against cranial vault, leading to rupturing and hemorrhaging of cerebral blood vessels
S/S: altered state of consciousness, irritability, cyanosis, lethargy, vomiting, retinal hemorrhages
TREATMENT: control bleeding and reduce intracerebral edema
PROGNOSIS: may be fatal, immediate treatment necessary. Possibility of visual deficits, blindness, cerebral palsy, and/or intellectual developmental disorder.
Elder Abuse/Neglect
ETIOLOGY: Older adults may experience diminished mental capabilities and dependency. Caretakers may percieve them as physical, emotional, and socioeconomic stressors, leading to abuse, neglect, or financial exploitation.
S/S: Bruises, greenstick fractures, decubital ulcers, malnutrition, unnatural alopecia, elder unlikely to report abuse (emotional attachment, financial dependency, fear of abuser)
TREATMENT: treat injuries appropriately, counseling to all parties involved, possible removal of elder from abusers
PROGNOSIS: Varies. Factors include duration and extent of abuse, profile of abuser, profile of victim
Psychological/Verbal Abuse
ETIOLOGY: Partner, caregiver, or other individuals may frequently make negative comments (“you’re useless,” “you’ll never do anything,”) towards victim, leading to poor self-esteem and destructive cognitive-behavioral model
S/S: victim may deny abuse, increased risk of anorexia, bulimia, depression, self-harm, substance abuse, and suicide
TREATMENT: Prevent through public education, psychotherapy recommended (although victim may resist)
PROGNOSIS: varies on duration and management of abuse
Intimate Partner Violence (IPV)
ETIOLOGY: (multifactorial) stress, social values, substance abuse, and low-self esteem of victim can contribute to domestic abuse
S/S: bruises in different stages of healing, avoidance of eye contact, denial of abuse (embarassment, emotional attachment to abuser, fear, poor self-efficacy)
TREATMENT: treat injuries appropriately, referral to appropriate agencies (victim allowed to reject referral), listening to victim with unconditional positive regard
PROGNOSIS: varies on duration and extent of abuse, current relationship status, willingness of victim to seek help
Sexual Abuse
ETIOLOGY: (multifactorial) certain personality disorders, desire for domination or control, or a history of sexual abuse with the abuser themselves can contribute to sexual abuse
S/S: any form of nonconsensual sexual activity, possible itching in urethra and vagina if victim is young female, unusual obsession with genital region if victim a child
TREATMENT: treat injuries appropriately, possible contraceptins, possible prophylactic STD treatment, referral to law enforcement agencies (with consent of victim, or according to local policies), referral to social services if child, possible removal from environment
PROGNOSIS: varies on form, duration, and extent of abuse,
Rape/Sexual Assault
ETIOLOGY: Violent sexual crime in the form of date rape, acquaintance rape, partner rape, or unknown assailant rape
S/S: bruising, tenderness in pelvic or rectal regions, anxiety, lacerations
TREATMENT: unconditional positive regard, notify law enforcement, consider prophylaxis for pregnancy, psychotherapy
PROGNOSIS: varies. Risk of pregnancy or STDs
Suicide
ETIOLOGY: (Linked with depression) Multiple biopsychosocial factors including loss of job, poor relationships, inability to meet societal expectations
S/S: decreased motivation, expressions of poor self-esteem, giving certain items away
TREATMENT: possible antidepressent prescription, psychotherapy, call suicide hotline
PROGNOSIS: if patient commits suicide, nothing else can be done. Grief counseling for those in social network may be available
