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EMERGENCY MEDICINE > ADVANCED TRAUMA LIFE SUPPORT > Flashcards

ADVANCED TRAUMA LIFE SUPPORT Flashcards

1
Q

initial assessment and management of trauma patient
epidemiology

________ is the major cause of long term morbidity and mortality in developing nations

A

road traffic accidents

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2
Q

most trauma deaths occur immediately or in the _________ hour

A

1st hour

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3
Q

trauma systems development (LEVEL)

highest level of care, leaders in research, clinical care and education

A

level 1

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4
Q

trauma systems development (LEVEL)

provides definitive care in wide range of complex traumatic patients

A

Level 2

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5
Q

trauma systems development (LEVEL)

provides initial stabilization and treatment. may care for uncomplicated trauma patients

A

Level 3

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6
Q

trauma systems development (LEVEL)

provides initial stabilization and transfers all trauma patients for definitive care

A

Level 4

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7
Q

MECHANISM OF ENERGY

types of blunt trauma
_______ forces ( there are 3)

C-S-O

A

compression forces
shear forces
overpressure partial tear

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8
Q

BASICS OF TRAUMA ASSESSMENT

designed to identify injuries that are immediately life threatening and treat them as they are identified

A

Primary survey

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9
Q

TOPIC: AIRWAY INTERVENTIONS

Definitive airway of choice

A

video laryngoscopes

explanation:
visualize glottic opening using a monitor/screen
prevents movement of head and neck, specially in trauma patients

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10
Q

TOPIC: BREATHING AND VENTILATION

LIFE THREATENING INJURIES

most life threatening
air trapping in the pleural space between the lung and chest wall
sufficient pressure builds up and pressure to compress lungs and shift the mediastinum contralaterally

A

tension pneumothorax

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11
Q

TOPIC: BREATHING AND VENTILATION

LIFE THREATENING INJURIES
Tension Pneumothorax

_________ is definitive management
5th intercostal space, anterior axillary line

A

tube thoracostomy

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12
Q

TOPIC: BREATHING AND VENTILATION

LIFE THREATENING INJURIES

described as blood collecting in the pleural space and is common after penetrating and blunt chest trauma

A

Hemothorax

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13
Q

TOPIC: BREATHING AND VENTILATION

LIFE THREATENING INJURIES

described as blunt trauma involving area 1 inch from the Carina

A

Tracheobronchial Injury

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14
Q

TOPIC: BREATHING AND VENTILATION

LIFE THREATENING INJURIES

described as direct injury to the chest resulting in an unstable segment of the chest wall that moves separately from remainder of thoracic cage

A

Flail Chest

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15
Q

TOPIC: BREATHING AND VENTILATION

LIFE THREATENING INJURIES

described as Sucking chest wound
large defect of chest wall

A

Open Pneumothorax

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16
Q

TOPIC: BREATHING AND VENTILATION

LIFE THREATENING INJURIES
Open Pneumothorax

lifesaving procedure
midclavicular line

A

needle thoracostomy

17
Q

TOPIC: CIRCULATION

impaired tissue perfusion
tissue oxygenation is inadequate to meet metabolic demand
blood transfusion together with early surgical intervention is key for prevention

A

Shock

18
Q

TOPIC: CIRCULATION
Clinical signs of shock

Arterial Hypotension <____
Radial Pulse - SBP > ____
Femoral pulse - SBP >____
Carotid pulse - SBP >____

A

120, 90, 80, 60 RESPECTIVELY

19
Q

TOPIC: CIRCULATION
TYPE OF SHOCK

Assume ________ shock in all trauma patients UNTIL proven otherwise

results from external or internal bleeding

A

Hemorrhagic

20
Q

TOPIC: CIRCULATION
TYPE OF SHOCK

cardiac tamponade
tension pneumothorax

A

Obstructive

21
Q

TOPIC: CIRCULATION
TYPE OF SHOCK

secondary to spinal cord injury

A

Neurogenic

22
Q

TOPIC: CIRCULATION
SITUATIONS UNDER CIRCULATION

used in combination with damage control surgery

control hemorrhage rapidly and prevent coagulopathy by minimizing crystalloid use and transfusing early using relatively high ratios of plasma and platelets to RBCs

A

damage control resuscitation

23
Q

TOPIC: CIRCULATION
SITUATIONS UNDER CIRCULATION

an approach that targets early fluid resuscitation onto to a SBP or greater than 70 mmHg

beneficial to patients with hemorrhagic shock due to torso injuries from gunshot or stab wounds

A

delayed fluid resuscitation/ controlled hypotension

24
Q

TOPIC: CIRCULATION
SITUATIONS UNDER CIRCULATION

for trauma patients that is unlikely to be controlled quickly or adequately -> IMMEDIATE transfusion of blood products in 1:1:1 ratio of PRBCs, fresh frozen plasma FFP, and platelets

A

severe ongoing hemmorhage

25
Q

TOPIC: CIRCULATION
SITUATIONS UNDER CIRCULATION

pericardium or sac around heart fills with blood due to penetrating or blunt injury to chest

MENTION BECK’S TRIAD
D, H, M

A

Cardiac tamponade

BECK’S TRIAD
distended jugular veins
hypotension
muffled heart sounds

26
Q

TOPIC: CIRCULATION
SITUATIONS UNDER CIRCULATION

Invasive procedure must be done ultrasound-guided
puncture skin 1-2 cm inferior to xiphoid process
45/45/45 degree angle

A

pericardiocentesis

27
Q

TOPIC: CIRCULATION
SITUATIONS UNDER CIRCULATION

CARE FOR TRAUMA PATIENT WITH CARDIAC ARREST

CPR
B
P
V

A

CPR
Bilateral Tube Thoracostomy
Pericardiocentesis
Volume resuscitation

28
Q

TOPIC: DISABILITY

Baseline neurologic exam
described with dilated pupil - suggests transtentorial herniation on ipsilateral side

A

pupillary exam

29
Q

TOPIC: SECONDARY SURVEY

signs
injury extends from clavicle to the pelvic area
rule out: neck, blunt chest wall, blunt abdominal and pelvic injuries

FAST ultrasound

A

Seatbelt sign

30
Q

TOPIC: FAST EXAM

4 views of abdomen to look for fluid
R
S
L
B

A

RUQ/Morrison’s pouch
Sub-xiphoid
LUQ
Bladder

31
Q

TOPIC: FAST EXAM
4 views of abdomen to look for fluid

Trauma ultrasound- fluid = black
most dependent portion of the abdomen during trauma
(+) blood will be between in kidney and liver

A

RUQ/Morrison’s pouch

32
Q

TOPIC: FAST EXAM
4 views of abdomen to look for fluid

E FAST Ultrasound
done in cardiopulmonary resuscitation in non-trauma patients

A

Sub-xiphoid

33
Q

TOPIC: FAST EXAM
4 views of abdomen to look for fluid

View between the spleen and kidney
another dependent place where fluid collects
Diaphragm can also be seen

A

Left Upper Quadrant

34
Q

TOPIC: FAST EXAM
4 views of abdomen to look for fluid

evaluates for fluid in the pouch of douglas (posterior to bladder)
dependent potential space

A

Bladder view

EMERGENCY MEDICINE (8 decks)

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