B6-072 Trauma

Question 1

primary survey ABCDE

Answer 1

A-airway
B- breathing
C- circulation, is it shock?
D- deficit deformity, neuro status
E- exposure: where all the injuries are

Question 2

most important part of secondary survey

Answer 2

reassessment

Question 3

what is considered a definitive airway?

Answer 3

tube in trachea

Question 4

what is an important consideration in trauma when establishing an airway?

Answer 4

C-spine stabilization

Question 5

paradoxical movement of the chest indicates

Answer 5

flail chest

Question 6

treatment for flail chest

Answer 6

positive pressure ventilation

Question 7

in field treatment for open pneumothorax

Answer 7

three sided dressing

Question 8

what is this?

Answer 8

tension pneumothorax

Question 9

what is this?

Answer 9

tension hemothorax

Question 10

treatment for pneum/hemothorax?

Answer 10

chest tube

Question 11

bubbling in the fluid chamber of a chest tube when the patient coughs/breathes deeply indicates

Answer 11

air leak

Question 12

Beck’s triad (hypotension, JVD, muffled heart sounds) indicates

Answer 12

pericardial tamponade

Question 13

establish […] IVs to resuscitate with blood

Answer 13

2 large bore

Question 14

most common cause of shock in trauma patient is

Answer 14

hemorrhage

Question 15

define massive blood loss

Answer 15

loss of entire blood volume over 24 hours OR
50% acute loss within minutes of injury

Question 16

define massive transfusion

Answer 16

> 10 unit PRBC OR
equivalent to blood volume has been given in 24 hours

Question 17

by the time changes in the blood pressure are occurring, what stage of shock is the patient in?

Answer 17

class 3- need blood

Question 18

triad of death

Answer 18

hemorrhage causing hypothermia, acidosis, coagulopathy

Question 19

GCS < 8 means the patient is

Answer 19

in a coma, may need intubation but check ABC first

Question 20

high spinal cord injury that affects the vagus nerve causes […] shock

Answer 20

neurogenic

Question 21

what two broken bones pose an immediate danger to the patient?

Answer 21

pelvis
femur

Question 22

the […] response of GCS is the most important predictor of outcome

Answer 22

motor

Question 23

hypotension
bardycardia
warm extremities

Answer 23

neurogenic shock

Question 24

treatment for neurogenic shock

Answer 24

volume resuscitation
vasopressors if needed

Question 25

what 4 spaces does a FAST exam look at?

Answer 25

hepatorenal perisplenic pelvis pericardial

Question 26

black space on FAST exam indicates

Answer 26

fluid (assumed to be blood until proven otherwise)

Question 27

why is it important to stabilize fractures?

Answer 27

diminishes blood loss

Question 28

open book pelvic fractures should receive a [...] to slow blood loss

Answer 28

binder

Question 29

abdominal injury is most often found on [...] survey

Answer 29

secondary

Question 30

thoracic injury is most often found on [...] survey

Answer 30

primary

Question 31

[...] percentage of abdominal injuries require surgery

Answer 31

high

Question 32

[...] percentage of thoracic injuries require surgery

Answer 32

low

Question 33

aortic bifurcation is at the level of

Answer 33

umbilicus

Question 34

any injury below the nipple line anteriorly and the scapulae posteriorly has potential for [...] injury

Answer 34

intraabdominal

Question 35

when perforated, "hallow" organs cause

Answer 35

contamination --> peritonitis

Question 36

what main structures are in the retroperitoneal cavity?

Answer 36

solid organs (kidney, pancreas) large vessels (aorta, vena cava)

Question 37

differential movement of fixed and non-fixed structures is caused by

Answer 37

deceleration injuries (MVC)

Question 38

treatment of extraperitoneal bladder rupture due to pelvic fx

Answer 38

Foley decompression

Question 39

treatment of intraperitoneal rupture with a full bladder

Answer 39

requires surgery b/c is leaking into abdomen

Question 40

"seat belt" sign can indicate injury to

Answer 40

bowel

Question 41

guarding rebound tenderness percussion guarding all sign of...

Answer 41

peritonitis

Question 42

small bowel injury many not show signs of [...] for several hours

Answer 42

peritonitis

Question 43

rolling a pregnant patient to the [...] will take pressure off the IVC

Answer 43

left

Question 44

patients in hemorrhagic shock should receive [...] and [...] before vasopressors

Answer 44

warm fluids blood products

Question 45

Glascow coma scale is part of [primary/secondary] survey

Answer 45

primary

Question 46

symptoms of massive hemothorax:

Answer 46

SOB tachycardia hypotension decreased breath sounds dullness to percussion flat neck veins

Question 47

symptoms of cardiac tamponade

Answer 47

muffled heart tones shock distended neck veins

Question 48

symptoms of neurogenic shock/spinal cord injuries

Answer 48

flaccid paralysis hypotension bradycardia

Question 49

best treatment for patient with blunt trauma that has a positive FAST exam

Answer 49

ex lap

Question 50

signs of tension pneumothorax

Answer 50

SOB diminished breath sounds tympany to percussion distended neck veins

Question 51

is chest xray necessary for diagnosis of pneumothorax?

Answer 51

no, can go ahead with chest tube

Question 52

laceration without active extravasation of contrast can be treated with

Answer 52

watchful waiting

Question 53

laceration with active extravasation of contrast in a patient that is hemodymically stable can be managed with

Answer 53

embolization

Question 54

laceration with active extravasation of contrast in a patient that is **not** hemodymically stable can be managed with

Answer 54

emergent laparatomy

Question 55

treatment for neurogenic shock

Answer 55

initial volume resuscitation followed by vasopressors as needed

Question 56

spinal cord injury low bp bradycardia

Answer 56

neurogenic shock