Trauma And Burns Flashcards

1
Q

Axis of impact

A

Forward: well tolerated
Vertical: moderately tolerated
Lateral: poorly tolerated

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2
Q

MVA: Frontal Impact

A

Down and under
- Lower extremity and abdominal trauma
Up and over

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3
Q

MVA: Lateral impacts

A

Shearing forces

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4
Q

MVA: Rear impact

A

High likelihood for c-spine injury

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5
Q

Shock index

A

Heart Rate/Systolic BP

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6
Q

Critical Shock

A

SBP <100
HR > 100
HCT <32%
pH <7.25

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7
Q

Disseminated Intravascular Coagulation (DIC)

A

Abnormal coagulation
Continuous bleeding

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8
Q

Lethal Triad

A

Hypothermia
Acidosis
Coagulopathy
(Calcium now as well for lethal diamond”

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9
Q

TXA

A

Prevents plasmin from stabilizing the fibrin matrix
Must be given within 3 hours of injury

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10
Q

pH of Fluids

A

NSS (pH 5.5)
Lactated ringers (pH 6.5)

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11
Q

Ratio for blood products

A

1:1:1 ratio of PRBC:Plasma:platelets

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12
Q

Permissive hypotension

A

SBP minimum goal: 90-100 mmHg
-110 mmHg if associated CNS involvement

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13
Q

Transfusion reactions

A

Hemolytic
Fever, chills, flank pain
Febrile
Non-hemolytic
Managed with acetaminophen
TACO
Circulatory overload
TRALI
Acute lung injury, similar to ARDS

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14
Q

Aortic injury chest x-ray finding

A

*Widened mediastinum
Enlarged aortic knob

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15
Q

Treatment for Aortic injury

A

Anti-impulse
60-70 Bpm
SBP less than 100 mmHg

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16
Q

Blast injuries

A

Primary
-pressure injury
Secondary
-shrapnel
Tertiary
-Acceleration, deceleration
Quaternary
-Thermal injury
Quinary
-Thermal injury

17
Q

Monro-Kellie Doctrine

A

10% CSF
10% Blood
80% Brain

18
Q

Cushings triad

A

Increases ICP
-Hypertension
-Bradycardia
-Respiratory changes

19
Q

Secondary injury killers in TBI

A

Hypotension
Hypoxia
Hypercarbia

20
Q

Subarachnoid

A

Venous tears
-“Starfish” pattern on CT

21
Q

Subdural Hematoma

A

Slow, venous bleed
“Venous lakes” patterns
Results from higher magnitude forces
Increased risk with brain atrophy
-Alcoholics
-Elderly

22
Q

Anterior cord syndrome

A

Motor dysfunction
Preservation of pressure sensation
Retained proprioception

23
Q

Central Cord syndrome

A

“You can dance but you can’t clap”
Arm weakness
“Burning” hands
Legs less weak than arms

24
Q

Brown sequard syndrome

A

Contralateral
-Loss of pain
-loss of hot/cold sensation
Ipsilateral
-Loss of motor function
-loss of proprioception
-loss of light touch sensation

25
Q

Adult rule of 9’s

A

Head-9%
Chest-18%
Back-18%
Arms-9% (each)
Genital-1%
Legs-18% (each)

26
Q

Pediatric rule of 9

A

Head-18%
Anterior-18%
Back-18%
Arms-9%
Legs-14.5%

27
Q

Rule of palms

A

Patients palm-1%

28
Q

Prehospital Fluid administration for burn patients

A

Adults: 500mL/hr
Peds: 250mL/hr
Little peds: 125mL/hr

> 20%
Partial and full thickness burns only

29
Q

Census formula

A

Adults: 2mL/kg/%BSA
PEDS: 3mL/kg/%BSA
Under 30 kg: 4mL/kg/%BSA

30
Q

Urine output fluid resus

A

Adults: 0.5mL/kg/hr
Peds <30kg: 1mL/kg/hr
High voltage: 75-100 mL/hr until clear urine

31
Q

Most common dislocation

A

Hip

32
Q

Most common spontaneous recurrence

A

Anterior shoulder