Week 1 Trauma Care Flashcards
What are osteoclasts?
It is a cell that removes bone
What are osteoblasts?
It is a cell that develops bone
What are osteocytes?
It is a cell within the developed bone
What does ICP stand for?
Increased intracranial pressure
What is a hematoma?
Bruises
What is RICE?
Rest, Ice, Compression and Elevation
What are the three main components of the skull?
Brain tissue, blood and cerebrospinal fluid
What is the primary injury in ICP?
It is injury which happens at the time of the accident
What is a secondary injury in ICP?
It is the resulting hypoxia, ischaemia, hypotension, oedema or increased ICP that results in injury to three main components
What is intracranial pressure ?
It is the hydrostatic force measured in the brain CSF compartment
What is the Monro-Kellie doctrine?
It is the principle that states that a change in blood, brain or CSF volume results in reciprocal changes in one or both of the other two components.
Does the Monro-Kellie doctrine apply to people with open skulls?
Nope
What are the three types of cerebral oedema?
Vasogenic, cytotoxic, and interstitial
What are some signs of increased ICP?
LOC, change in vital signs, ocular signs such as large pupil, decrease in motor function, headache, and vomiting
What are some diagnostic studies for ICP?
Health Hx, physical exam, vital signs, neurological assessment, ICP measurements, X-rays, ECG, Laboratory studies
How high should the bed be raised for suspected ICP?
30 degrees
What is some medication management of ICP?
Osmotic fluids, hypertonic saline, corticosteroids,
What are some types of head injuries?
Scalp lacerations, skull fractures,
What is a craniotomy?
Removal of bone flap
What is a brain abscess?
Accumulation of pus within the brain tissue
What is meningitis?
It is acute inflammation of the meningeal tissue surrounding the brain and the spinal cord
What are the 6 Ps of compartment syndrome?
Paraesthesia (numbness and tingling).
Pain distal to the injury that is not relieved by opioid analgesics and pain on passive stretch of muscle travelling through the compartment.
Pressure increases in the compartment.
Pallor, coolness and loss of normal colour of the extremity.
Paralysis or loss of function.
Pulselessness or diminished/absent peripheral pulses.
What are the complications of post-traumatic injury?
Shock, multiple organ dysfunction, critical bleeding, hypermetabolism, hyperglycaemia, compartment syndrome, malnutrition, infection, delayed wound healing, pain, anxiety, delirium, sleep disturbances, PTSD,
What is compartment syndrome?
It is increased pressure in a certain compartment
Who is at a higher risk of trauma?
Children, people over the age of 55, and Men
What are the different types of trauma?
Non-penetrating, penetrating (low and high velocity), Thermal, other (electrical and poisoning)
What is the thorax?
The main bit of the body like chest to belly
What are some common causes of thoracic injuries?
Seatbelt injury, crush injury and penetrating injury
What are the areas of concern for anatomical damage?
Heart, lungs, great vessels and airways
How to assess thoracic injuries?
Inspection, auscultations, percussion, palpation, X-ray, ultrasound, ct, MRI
What does CT stand for?
Computed tomography
What does MRI stand for?
Magnetic resonance imaging
Whare are some common thoracic injuries?
pneumo/haemothorax, tension pneumothorax, rib factures including flail chest, sternal fracture, spinal injury, myocardial/pericardial injury, ruptured aorta, oesophageal injury, tracheal injury and ruptured diaphragm
What is a pneumo/haemothorax?
It is air or blood in the plural space
What is the plural space?
the part that sits between the lung and rib
What are some consequences of pneumo/haemothorax?
The lung can no longer expand to breath properly
What is a treatment for pneumo/haemothorax?
intercostal catheter and underwater sealed drain
What does sbd stand for in terms of intercostal catheters and underwater sealed drainages?
Swinging, bubbling and drainage
Whare are some possible intra abdomincal trauma?
Sepsis, damage to the great vessels (abdominal aorta and femoral vessels, retroperitoneal haematoma, pelvic fractures, renal, spleen and liver injury
What are some assessments for abdominal injuries?
Inspection, auscultation, percussion, palpation, x-ray, ultra fast scan, CT and MRI
What is an ultra Fast scan?
It is a rapid, non-invasive sonograph to detect intra-abdominal or pericardial-free fluid
What is a flail chest?
Where the rib is broken in 2 places and the rib is failing around
What is stage 1 in bone healing?
Haematoma forms
What is stage 2 in bone healing?
Granulation
What is stage 3 in bone healing?
Callus formation
What is stage 4 in bone healing?
Ossification
What is stage 5 in bone healing?
Remodelling
What are Cushing triad symptoms?
Hypertension, bradycardia and decreased respiratory effort
What is Cushing triad?
When the cerebellum is pushed out of the top of the spine
What is a sign of a comminuted/depressed fracture?
Raccoon eyes
What is a sign of a basilar fracture?
Battle sign which is bruising behind ear that has a high risk of CSF leak
What is the midline shift?
When the brain is swelling on one side, pushing the other side
What are some nursing strategies we can use to prevent spikes in ICP?
Positioning at 30 degrees, keep them warm, antiemetics, not too much fluid, quiet room, cluster care
What is intracranial hypertension refractory?
It is when there is a recurrent increase of intracranial pressure above 20-22 mmHg for sustained period of time despite other therapies being given
What is a normal ICP range for adults?
10-15 mm Hg
What medication is given in hyperosmolar therapy?
mannitol and hypertonic saline
What medication is given in hyperosmolar therapy?
mannitol and hypertonic saline
