Truma Flashcards
A young man was beaten many times on the face. A trial of endotracheal intubation has failed. How will you secure the airway?
A - Tracheostomy tube
B - Cricothyroidotomy
C - Orotracheal tube
D - Nasopharyngeal airway
Cricothyroidotomy
Cricothyroidotomy is preferred initially before tracheostomy in trauma.
Trauma with tension pneumothorax. GCS 8. What to do next?
A - Intubation
B - Needle thoracostomy
A - Intubation
Intubation as per ABC, Al-guwaiz got it in his 100% exam and the answer he put was intubation
Trauma Pneumothorax approach
Stable = secondary pneumothorax = X-ray»_space; Chest tube
Unstable = tension pneumothorax = Needle thoracostomy»_space; Chest tube
Adult fell from height complains of severe heel pain. He is conscious, oriented and has stable vitals. What is the next step?
A - Pain control
B - Lower limb Xray
C - Pulse palpation
Answer: C.
Pulse palpation or control bleeding are all answers for different versions of this question.
Which of the following indicates compensated shock?
A. Anuria
B. Confusion
C. Hypotension
D. pale peripheries
D
The pallor of the skin and mucous membranes (pale peripheries - Option D) is a typical sign of compensated shock. The
body’s response to reduced blood flow involves vasoconstriction of peripheral blood vessels, causing reduced blood
flow to the skin, resulting in paleness.
The other options are signs of decompensated shock
Deep wound in anterior thigh, 10 cm long, actively bleeding. How to control bleeding?
A - Direct pressure on the wound
B - Apply torniquet
C - Pressure on the femoral vessel above the wound
A. Direct pressure on the wound, if failed apply tourniquet
Male victim of gunshot to the thigh, he is pale and unconscious. BP 90/60 pulse 130. What is the next step in management?
A - Orotracheal intubation
B - Blood transfusion 2
C - Shift to OR
D - LR infusion
A. Unconscious, i.e., low GCS so intubate first as per ABC.
Trauma patient, hypotensive with Hb of 8. What to do?
A - IV normal saline.
B - Blood transfusion.
A.
Overall,
Hb levels criteria for blood transfusions are 2:
1- Hb below 7 for most patients.
2- Hb below 8 for patients with recent Mi. So, for this patient giving fluids is more appropriate.
Victim of RTA presents with facial and basal skull fractures. What is the first step in management?
A - Support the airway
B - Support the neck
A. ATLS Says that in the ABC, A: Securing airway and neck. But airway is more appropriate
Victim of RTA, stable everything is fine no clear fractures, suddenly deteriorates. What is the best way to secure airway?
A - Nasotracheal tube
B - Orotracheal tube
B. Orotracheal intubation is the preferred method of intubation in trauma patient unless
contraindications are there. Eg: Severe bleeding in the mouth, facial fractures etc..
Man after accident and resuscitation in a small hospital. You need to transfer to another
hospital after stabilization, it is 40 mins away. On x-ray you see fracture of 2 to 5 left ribs. No
pneumothorax. What will u do?
A - Intubate
B - Call the other hospital to inform the surgeon on call
C - Chest tube insertion
D – DPL
Answer: B
The patient has stable rib fractures without any pneumothorax mentioned. Intubation (Option A) is not indicated solely based on rib fractures, especially if the patient is stable and not experiencing respiratory distress.
Chest tube insertion (Option C) is not necessary in the absence of pneumothorax.
Diagnostic peritoneal lavage (DPL - Option D) is not relevant in this situation, as there is no indication of abdominal
injury or need for an exploratory procedure.
Patient RTA had a chest tube for a pneumothorax or hemothorax and had femoral fracture
Needed to transfer him to another hospital, suddenly while that he started to be hypotensive and tachycardic and his O2 drops What will you do?
a- continue transfer while doing nothing
b- intubate the patient
c-check the femoral fracture for bleeding
d- check chest tube for place and obstruction
Answer: D.
An improperly placed or obstructed chest tube can lead to tension pneumothorax or hemothorax, which can be life- threatening. Checking the chest tube for proper placement and any signs of obstruction is critical to address potential issues with lung expansion, drainage of air or fluid, and the subsequent impact on the patient’s hemodynamics and
oxygenation.
Burn patient, resuscitation done. Which of the following reflect good resuscitation?
A - Normalization of heart rate
B - Normalization of blood pressure
C - Urine out of 0.6ml/kg/h
D - Central venous pressure 12
Answer: C.
Assessing responses:
Burn pt = urine output
Tissue perfusion in sepsis = mixed venous O2
10 cm thigh wound with profuse bleeding. How to control it?
A - Apply pressure on wound
B - Apply pressure on femoral artery
Answer: A.
Direct pressure on the wound, if failed apply tourniquet.
Patient with stab wound to anterior neck. He is alert. Oxygen sat 82%. What to do?
A - Oxygen mask
B - Cricothyroidotomy
C - Endotracheal intubation
D – Tracheostomy
Answer: C
Risk of expanding hematoma, intubate.
Women had MVA. She has a tender abdomen and ecchymosis, but there’s no peritonitis signs. Her BP is fine. What is the next initial step?
A - IV crystalloid
B - FAST
C - Surgical exploration
A. IV fluid as per the ABC, then you can do CT as she is stable.
