Week 2 Flashcards

1
Q

What is the definition of trauma?

A
  • injury to living tissue caused by extrinsic forces
  • a disordered psychic or behavioural state resulting from severe mental or emotional stress or physical injury
  • an agent, force or mechanism that causes trauma
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2
Q

What is the definition of an injury?

A

physical damage that results when a human body is suddenly subjected to energy that exceed the threshold of physiological tolerance.

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3
Q

what are some consequences of injuries and violence?

A

physical injuries
mental consequences
behavioural changes
HIV, STD’s, unwanted pregnancies

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4
Q

what are the leading causes of deaths trending from 2012 - 2030?

A

Road traffic injuries increasing
Suicide will decrease
Falls going to increase

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5
Q

Who is more at risk at road traffic, suicide and homicide from men and women?

A

Men

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6
Q

what are the largest causes of death for people aged 15-29 globally?

A
  1. road traffic

2. suicide

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7
Q

What is the WHO plan for road safety?

A
  1. prehospital care system
    2 - Hospital trauma care systems
    3 - early rehabilitation and support to trauma patients and those bereaved
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8
Q

what categorises major trauma in the state trauma system?

A
  • death after injury
  • admission to ICU for more than 24 hours, requiring period of assisted ventilation
  • serious injury to two or more body systems
  • urgent surgery to intracranial, intrathoracic or intraabdominal injury
  • fixation for pelvic or spinal fractures
  • paediatric trauma for all children up to 16 years old
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9
Q

What hospitals are vicotiras major trauma centres?

A
  • the alfred
  • the royal melbourne
  • the royal childrens
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10
Q

what are the pre hospital vital signs for major trauma?

A
Adult:
HR <60 - >120
RR <10 - >30
BP <90
Spo2 <90%
GCS <13
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11
Q

What are the actual TCG value?

A
Adult:
HR <60 - >120
RR <10 - >30
BP <90
Spo2 <90%
>16 :GCS <13
<16: GCS <15
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12
Q

What are the emergent injury types for the TCGs?

A

Blunt injuries:

  • serious injury to a single body region
  • significant injuries involving more than one body region

Specific injuries:

  • Limb amputation or limb threatening injury
  • spinal cord injury or spinal fracture
  • burns >20%
  • respiratory tract burns
  • High voltage burns
  • Serious crush injury
  • major compound fracture or open dislocation
  • Fracture to 2 or more long bones
  • Fractured pelvis

Crush Limb amputation Open dislocation Burns Blunt injury Spinal cord LIGHTING

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13
Q

What are the potential mechanisms in the TCGS?

A
Motor/cyclist impact >30kph
High speed MVA >60kph
Pedestrian impact
Ejection from vehicle
Prolonged extrication
Fall from height >3
Struck on head >3m
Explosion

+ age <12 >55
Preggers or
significant co-morbidity

3, 3, 30, 30, 60, P, E, E

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14
Q

what are the barriers to adequate pain management?

A

Caregiver’s belief
Characteristics of pain management
System barriers

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15
Q

What is the dose of paracetamol for paeds?

A

15mg/kg

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16
Q

What is the fentanyl IN dose for paeds?

A
small child (10-17kg) = 25mcg IN
medium child (18 - 39kg) = 25-50mcg IN

Repeat dose every 5 - 10 minutes
Consult after 3 doses

17
Q

What are the contraindications of paracetemol?

A
  1. hypersensitivity
  2. <1 month
  3. administered already in last 4 hrs
  4. intake in last 24hrs exceeds 4g or 60mg/kg (paeds)
  5. chest pain in suspected ACS
18
Q

What is the presentation of paracetemol?

A

500mg tablet

120mg in 5ml liquid (24mg/ml)

19
Q

What is the presentation of methxyflurane?

A

3mL glass ampule

20
Q

What are the contras for methoxy?

A
  1. renal disease
  2. concurrent use of tetracycline antibiotics
  3. total dose of 6mL in last 24 hrs
  4. Malignant hyperthermia history
  5. muscular dystrophy
21
Q

what are the side effects of methoxy?

A

drowsiness
decrease in BP
Bradycardia
exceeding max dose may lead to renal toxicity

22
Q

What are the side effects of paracetemol?

A

hypersensitivity reactions

haematological reactions

23
Q

What is the presentation of Morphine?

A

10mg in 1mL

24
Q

What are the contraindications of morphine?

A
  • renal disease/failure
  • hypersensitivity
  • late second stage labour
25
Q

What are the side effects of morphine?

A

CNS effects:

  • drowsiness
  • respiratory depression
  • euphoria
  • nausea, vomiting
  • addiction

Cardiovascular:

  • Hypotension
  • bradycardia
26
Q

What is the presentation of fentanyl?

A

100mcg in 2Ml

150mcg in cartridge

27
Q

What are the contraindications for fentanyl

A
  • hypersensitivity

- late second stage labour

28
Q

What are the side effects of fentanyl?

A

resp depression
apnoea
rigidity of diaphragm
bradycardia

29
Q

What is the presentation of Ketamine?

A

200mg in 2mL

30
Q

What are the contraindications for ketamine?

A

hypersensitivity

sever hypertension >180

31
Q

What are the side effects of ketamine?

A

Cardiovascular:
increase BP and HR

CNS:
resp depression or apnoea
emergence reactions
enhanced skeletal tone
- nausea and vomiting

Ocular:
Diplopia (double vision
Nystagmus (eye twitching)

Other:
Lacrimation
Hypersalivation