WEEK10-Major trauma

Question 1

whats the foundations of the major trauma primary survey

Answer 1

danger, ppe, pat, response, consent, catastrophic haemorrhage, c-spine, airway, breathing, circulation

Question 2

what is cat hem

Answer 2

extreme bleeding likely to cause death within minutes

Question 3

whats an adults circulating volume litres of blood

Answer 3

4.5-6 litres

Question 4

how can u evaluate how much bleeding a person has undergone

Answer 4

check the rate and volume of bleeding that you can see

Question 5

how can you tell if there’s an arterial bleed

Answer 5

can be recognised by spiriting thats rhythmic this will match the pulse rate

Question 6

what are the 2 types of haemorrhages

Answer 6

internal (blood loss beneath skin)
external (blood loss from traumatic wound)

Question 7

how do you conduct cat hem on the primary survey

Answer 7

assess for life threatening external bleeding

Question 8

whats the stepwise approach to extrenl bleeding managament

Answer 8

direct pressure, indirect pressure pressure dressing, hemostatic gauze, torniquet

Question 9

whats the indications for pressure dressing

Answer 9

mild to moderate bleeding

Question 10

whats the indications and how do you conduct hemostatic gauze

Answer 10

bleeding thats uncontrolled by any sort of pressure

pack into the wound until bleeding has stopped

Question 11

contraindications of haemostatic gauze

Answer 11

must not be used in eyes or mouth

Question 12

why do guidelies state you shoudlnt use haemostatics on non-compressible wounds

Answer 12

because wounds to non- compressible wounds like the chest and abdomen cant be controlled through direct pressure.

Question 13

indications and how to conduct a tourniquet

Answer 13

bleeding that uncontrollable

apply 2-3cms above the site of bleeding. twist until the bleeding stops. ensure its secured

Question 14

whats the saying if the c-spine

Answer 14

c3,4 and 5 keep you alive!

Question 15

what is the c-spine

Answer 15

cervical spine is made of 8 vertebrae with multiple nerves running within

the nerves help conduct signals from brain to body.
fractured vertebral bodies can lead to severe spinal cord injuries

Question 16

what does c-spine immobilisation ensure

Answer 16

that no secondary spinal cord injuries occur and performing manual in-line spinal immobilisation ASAP

Question 17

what is c0spine immobilisation

Answer 17

manual in-line spinal immobilisation is when someone physically supports the patients head and neck to prevent it from moving

one conducted do not move unless c-spine injury has been completely ruled out.

Question 18

can you conduct head tilt chin lift with c-spine injury if not why

Answer 18

no because can’t move neck if c-spine injury is present

Question 19

what are the guidelines for who and when to conduct c-spine immobilisation

Answer 19

any patient that has drugs or alcohol
if they are confused or have reduced gcs
any history of spinal injuries
a high mechanism of injury (falling of a horse)

Question 20

indications of a non-occlusive dressing

Answer 20

if patient has evidence of a penetrating chest wound then the rusell chest seal should be applied

Question 21

do you give 100% oxygen for major trauma

Answer 21

yes in every patient, including people with copd

should be given 15 litres of oxygen regardless of the spo2 reading

Question 22

whats blood on the floor and 4 more

Answer 22

helps detect internl bleeding.
the 4 cavities to check are:
chest
abdomen
pelvis (hips)
long bones (legs)

Question 23

what do you check for during blood on the floor, 4 more

Answer 23

chest-bruising, flailed segments
abdomen- palpating rigid and observation of bruising or external marks
pelvis- don’t move. just look and base on mechanism of injury
long bones- assess for injuries that could cause blood loss like a mid femur fracture

Question 24

indications and contraindications of a pelvis binder

Answer 24

pelvis holds 4-6 litres of blood therefore must intervene asap

pelvic binder is sued for suspected pelvic bleeding caused by unstable pelvic fractures. or any mechanism of injury that might have caused structural damage

dont conduct if theres an impaled object through the pelvis

Question 25

how do you conduct a pelvis binder

Answer 25

expose pelvis
open binder and place under legs and use a see-saw motion to move upwards
palpate the greater trochanter and place centre of binder on this site
apply tension and secure

Question 26

indications and contraindications of a traction splint

Answer 26

femur fracture can loose up to 1,.5 litres of blood (30%)

use a traction splint on a suspected id shaft femur fracture open/closed

dont conduct if theres fractures to ankle/foot or partial amputation/avulsion with bone separation. also fracture’s to knee tib/fib

Question 27

how to conduct a traction splint

Answer 27

measure pole against good leg
expose leg
place blue thigh strap over patient and attach the metal pole
place foot into heel strap and attach to pole
apply yellow knee strap (just above or below knee)
apply traction y pulling red tab on ankle strap
secure by applying red and green strap

Question 28

what is hypvolemic shock

Answer 28

inadequate organ perfusion caused by loss of intravascular volume

characteristic= bleeding
blood loss of up to 1L-1.5L required before classic signs appear (like anxiety, abnormal behaviour, tachycardia)

Question 29

whats the shock triggered by

Answer 29

critical drop in circulating blood volume. massive loss in red blood cells intensifies the tissue hypoxia

Question 30

what are the 4 key stages of blood loss

Answer 30

stage 1: volume loss= up to 15% of total blood (750ml)
heart rate= normal or minimally elevated
usually no change in blood pressure, pulse, respiratory
patient= pale and anxious

stage 2: volume loss= from 15% to 30% of total blood volume (750-1500ml)
heart rate/respiratory rate= elevated
pulse pressure becomes narrow (diastolic increases)

stage 3: volume loss= from 30% to 40% of total blood volume (1500-2000ml)
heart and respiratory rate= are significantly elevated and capillary refill is delayed
patient= is extremely pale, cold, and sweaty
significant drop in blood pressure and confusion

stage 4: volume loss is +40%
hypotension and narrow blood pressure (less than 25 mmHg between systolic/diastolic)
tachycardia (+120 bpm) cap refill= delayed/absent
likely to have reduced LOC and mental state increasingly down

Question 31

what are the specific numbers for hypovolemic shock stages 1-4

Answer 31

stage 1:
blood loss= 750ml (15%)
bpm= up to 100
blood pressure= normal
RR= 14-20
urine output= more than 30ml per hour
cns symptoms= normal

stage 2:
blood loss= 750-1500ml (15-30%)
bpm= above 100
blood pressure= decreased
RR= 20-30
urine output= 20 to 30ml per hour
cns symptoms= anxious

stage 3:
blood loss= 1500-2000ml (30-40%)
bpm= above 120
blood pressure= decreased
RR= 30-40
urine output= 5-15ml per hour
cns symptoms= confused

stage 4:
blood loss= above 2000ml (40%+)
bpm= above 140
blood pressure= decreased
RR= above 35
urine output= none
cns symptoms= lethargic