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-MSK Diseases > 12. Multiply Injured Patient > Flashcards

12. Multiply Injured Patient Flashcards

1
Q

What percentage of deaths due to trauma are potentially avoidable?

A

Up to 30%

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2
Q

What can be done to improve the deaths which could be avoided?

A
  1. Improve pre-hospital care
  2. Use Advanced Trauma Life Support (ATLS) principles
  3. Integration of Trauma Services
  4. Invest in Rehabilitatiion
  5. Clinical Audit and Research
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3
Q

When should Trauma management start?

A

From the Time of Injury:

  1. Golden Hour
  2. Platinum 10 minutes
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4
Q

What information should be conveyed, pre-hospital arrival?

A
  1. Time of Injury
  2. Mechanism of Injury
  3. Speed / Forces involved
  4. Ejection / Pedestrian
  5. Likely Serious Injuries
  6. Vital Signs
  7. Interventions Carried Out
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5
Q

What is a trauma team made up of?

A
  1. Emergency Department
  2. Anaesthetics
  3. Radiology
  4. Intensive Care Unit
  5. Surgical Specialties
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6
Q

What is the Primary Assessment Survey, in Trauma Assessment?

A

ABC:

Detects and Treats immediate threat to life

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7
Q

What does the ABC approach include?

A 
Airway with C-Spine Control
Breathing with O2
Circulation with Haemorrhage Control
Disability
Expose and Environment
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8
Q

What is assessed in “Airway with C-Spine Control”?

A
  1. Noises - Speech; Gurgling; Stridor

2. Visual - Swelling / Deformity; Vomit / Blood / Debris

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9
Q

How is “Airway with C-Spine Control” managed?

A
  1. Manoeuvers
  2. Suction
  3. Adjuncts
  4. Advanced Procedures
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10
Q

What is assessed in “Breathing with O2”?

A
  1. Look - Work of Breathing / Expansion . Effort
  2. Feel - Palpate / Percussion
  3. Auscultate
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11
Q

What is Clinically Assessed in “Circulation”?

A
  1. Heart Rate / Palpable Radial Pulse
  2. Blood Pressure / Pulse Pressure Narrows
  3. CRT
  4. Urine Output
  5. Confusion
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12
Q

What is Blood Test Results are Assessed in “Circulation”?

A
  1. Haemoglobin Levels

2. Serum Lactate

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13
Q

What is Imaging Results are Assessed in “Circulation”?

A
  1. Ultrasound

2. CT

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14
Q

What are the most common 5 sites for Blood Loss?

A
  1. Chest
  2. Abdomen
  3. Pelvis
  4. Long Bones
  5. Floor
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15
Q

What is considered when assessing “Circulation”?

A

Haemorrhage Control

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16
Q

What is considered in Volume Replacement in “Circulation”?

A
  1. I.V. Access vs I.O. Access
  2. Type of Volume
  3. Amount of Fluid
  4. Massive Transfusion Protocols
17
Q

What needs to be monitored as Volume Replacement is being performed?

A
  1. Vital Signs
  2. Urine Output
  3. Lactate
18
Q

What is the “Legal Triad” of Volume Replacement?

A
  1. Coagulopathy
  2. Acidosis
  3. Hypothermia
19
Q

What is assessed in “Disability”?

A
  1. Alert, Voice, Pain, Unconscious (AVPU)
  2. Glasgow Coma Score
  3. Pupils
  4. Tone and Reflexes
20
Q

What is included in “Expose and Environment”?

A
  1. Expose to allow a full examination

2. The cover to keep warm

21
Q

What does “DEFG” often stand for, in this setting?

A

Don’t Ever Forget Glucose

22
Q

What Bedside tests are often done in Trauma cases?

A
  1. ECG
  2. Arterial Blood Gas
  3. Urine Dipstick
23
Q

What investigations are done very quickly, once the patient arrives in the Hospital Setting?

A
  1. X-Ray / CT Scan - C-Spine, Chest, Pelvis

2. Ultrasound - Pneumothorax

24
Q

What is included in the Secondary Survey?

A

Meticulous Head to Toe examination to identify all injuries and plan management

25
Q

What are the options for Transfer and Further Management?

A
  1. Theatre - Operative Management
  2. Interventional Radiology - Control of Bleeding
  3. Intensive Care Unit - ICP monitoring, Ventillation, Continued Resuscitation

-MSK Diseases (43 decks)

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