Approach to Trauma Flashcards by tcarlso 3

What are the general steps of ATLS?

ABCDEs
Log roll
X-ray and FAST
Secondary survey
Resuscitation and stabilization

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What are the hemodynamic effects of a tension pneumothorax?

Increases pressure in the thoracic cavity, thereby decreasing preload

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What is the needle used for a needle thoracostomy?

14-16 gauge

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Where is the appropriate site for a needle thoracostomy?

Midclavicular line in the second intercostal space, over the neurovascular bundle

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What is the size of the tube used in the placement of a chest tube?

36 french

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What SBP is needed to feel a radial pulse?

80 mmHg

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What SBP is needed to feel a femoral pulse?

60 mmHg

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What SBP is needed to feel a carotid pulse?

60 mmHg

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What is the relative HR for classes 1-4 of hemorrhagic shock?

1 = Normal-fast
2 = normal-fast
3. Fast
4. Fast

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What is the relative BP for classes 1-4 of hemorrhagic shock?

1= normal
2 = normal-low
3 = low
4 = low

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What is the percent blood loss for classes 1-4 of hemorrhagic shock?

1 = less than 15%
2 = 15-30%
3 = 30-40%
4 = 40%+

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What is the type of fluids given for classes 1-4 of hemorrhagic shock?

1 = NS
2 = NS
3 = NS+blood
4 = NS+blood

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What are the components of the AVPU scale?

Alert
Voice responsive
Pain responsive
Unresponsive

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What is assessed with the disability part of the ABCDEs?

Level of alertness (GSC)

Brief neuro function

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What sort of neuro exam should be done for the D part of the ABCDEs?

Wiggle toes, fingers,
Assess eyes
sensation in arms and legs
log roll and anal tone

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What are the components of the visual portion of the GSC scale?

4 = spontaneously
3 =  loud voice
2 = to pain
1 = none

What are the components of the verbal portion of the GSC scale?

5 = oriented
4 = confused
3 = Inapprop words
2 = Incomprehensible sounds
1 = no sounds

What are the components of the motor portion of the GSC scale?

6 = obeys commands
5 = Localizes to pain
4 = withdraws from pain
3= flexes
2= extends
1 =none

What are the standard x-rays to obtain in a trauma pt?

CXR and pelvis

What are the components of the secondary survey in the ATLS?

History (SAMPLE)

What are the components of the AMPLE mnemonic?

Allergies
Medications
Past history
Last meal 
Events

What are the major things to look for in the head part of the PE for ATLS?

Battle’s signs
Raccoon’s eyes
Hemotympanum

What are 0-5 grading for strength?

0 = paralyzed
1 = palable/visible contraction
2 = FROM with gravity eliminated
3 = FROM against gravity
4= FROM, but weak
5 = FROM, strong

What are the major things to look for in the neck part of the PE for ATLS?

Tracheal deviation, hematoma
SQ emphysema
Pulses

What are the components of the NEXUS criteria? (4)

- Alert, non-intoxicated - No midline TTP - No distracting injury - No sensory/motor deficit

What are the four general components of the PE for the chest in ATLS?

Inspect Palpate Percuss Auscultate

How will a tracheobronchial tree disruption present?

- SQ emphysema | - Lung fails to reinflate after chest tube placement

If a lung fails to inflate after a chest tube is placed, what should be suspected?

Tracheobronchial disruption

What happens to a pt with a pulmonary contusion after fluids are given? What is the treatment?

- Causes pulmonary edema | - Hold off on fluids and given oxygen

What is the presentation and treatment of a cardiac contusion?

EKG abnormalities | FIx them

How should a pelvic fracture be treated?

Sheets wrapped around and tightened. Pelvic binder.

What should be assess for in the perineum, rectum, and genital area in the ATLS secondary survey?

- Hematomas - Blood are the urethral meatus - Sphincter tone - High riding prostate

What should be assessed for in the arm/leg region of the ATLS secondary survey?

- Ensure neurovascularly intact | - Compartment syndrome

What are the labs, besides a type and cross, that should be obtained in a trauma pt?

``` CBC CMP ABG UA EKG EtOH ```