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othopaedics > ATLS principles > Flashcards

ATLS principles Flashcards

1
Q

ABCDE means

A 
airways and cervical spine protection
breathing and ventilation
circulation with haemorrhage control
disability (glucose)
exposure and environmental control
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2
Q

what to do for A 5 steps

A 
assess airway
stabilise neck
open airway with jaw thrust
clear obstructions (suction)
give 100% oxygen
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3
Q

what to do for B 5 steps

A 
Inspection 
palpate: central trachea, expansion
percussion dull for blood, resonant for air
auscultation
obs-spo2, pulse, bp
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4
Q

signs of obstructed airways

A

hoarseness
stridor
snoring
no noise

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5
Q

breathing management for ATLS

A

high flow o2 trauma mask-50L

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6
Q

what is a insufficient respiratory rate

A

<10 breaths per minute

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7
Q

specific breathing injuries to be aware of for breathing 2

A

c2 fracture- common in hyperflexion injuries- can cause a pneumothorax
pneumothorax

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8
Q

3 types of pneumothorax

A

tension
open
closed

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9
Q

what is a tension pneumothorax

A

internal one way valve so air flowing in builds up in pleural space

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10
Q

signs of a tension pneumothroax 6

A 
mediastinum shift
engorged neck veins
reduced lung expansion
deviation trachea
increased percussion 
decreased breath sounds
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11
Q

management of a tension pneumothorax and location

A

needle decompression in 2nd intercostal space mid clavicular
definitive chest drain

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12
Q

what is a open pneumothorax

A

sucking chest wound
external one way valve with air coming in
air pressure same as outside-tear doesnt act as a valve

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13
Q

management open pneumothorax

A

three sided occlusive dressing

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14
Q

what is a closed pneumothorax

A

air has got in and then closed

so pressure is < then the atmosphric pressure

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15
Q

what is flail chest

A

when 2 or more ribs are fractured in 2 or more places- ie complete separated
cant contribute to lung expansion

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16
Q

signs of flail chest

A

indrawing on inspiration

moving out on expiration

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17
Q

circulation assessment steps 3

A

circulatory compromise signs: pale, hr, bp, pulses
obvious sources
IV access establish x2

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18
Q

fluid resus components 3 and how much

A

fluid bolus (10-20ml/kg)-1l crystalloid
Blood products
Tranexamic acid 1gIV

19
Q

3 blood products and their ratio

A

red blood cells
fresh frozen plasma
platelets
1;1;1

20
Q

responses to fluids 3

A

responsive
transient: goes up/down
non-responsive

21
Q

what is permissive hypotension and what bp aiming for

A

restrictive fluid therapy so that don’t quite reach normal BP
only to achieve radial pulse/ bp of 80-90 systolic

22
Q

pelvic fracture management

A

pelvic binder as can lose all of circulating volume

23
Q

normal blood volume l

A

5l

24
Q

what is the definition of a massive haemothorax and the signs

A

> 1500ml of blood in pleural cavity
dull on percussion
respiratory compromise
large volume loss

25
Q

management of a massive haemothorax

A

chest drain and surgery

26
Q

what is cardiac tamponade

A

fluid in the pericardium sac

27
Q

what is Beck’s triad of cardiac tamponade

A

hypotension: decrease SV
jugular venous distension: increase heart pressure
muffled heart sounds

28
Q

management of cardiac tamponade

A

pericardiocentesis under ultrasound guidance

29
Q

what is shock

A

end organ dysfunction
low blood pressure
inadequate o2 available

30
Q

what organs are prone to shock 4

A

brain
renal
cardiac
GI

31
Q

lethal triad of shock measurements

A
  1. acidosis pH <7.25, base excess <5 and lactate >2.5
  2. hypothermia <35
  3. coagulopathy platelets <120 inr >1.5
32
Q

2 types of shock

A

haemorrhagic and non-haemorrhagic

33
Q

types of haemorrhagic shock 5

A 
intrathoracic
intraperitoneal
retroperitoneal
thigh compartment
floor
34
Q

types of non-haemorrhagic shock 5

A 
cardiogenic
tension pneumothorax
neurogenic- spinal cord injury and BP
septic: vasodilatory
anaphylaxis
35
Q

class I shock measurements and management

A 
blood loss <15%
pulse <100
BP N
urine <30
crystalloid replace
36
Q

class II shock

A 
blood loss 15-30%
pulse 100-120
BP N
urine 20-30
crystalloid replace
37
Q

class III shock

A 
blood loss 30-40%
pulse 120-140
BP low
urine 5-15
crystalloid and blood
38
Q

class IV shock

A 
>40 blood loss
pulse >140
bp low
negative urine
crystalloid and blood
39
Q

normal circulating volume

A

70mlx kg

40
Q

3 GCS components

A

eye opening
verbal response
motor response

41
Q

what is the AVPU scale

A

alert, verbal, pain or unresponsive

42
Q

disability components

A

GCS or AVPU
pupils constriction
blood glucose

43
Q

2 steps after abc

A

secondary survey- full on exam with leg roll

tertiary survey

othopaedics (21 decks)

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