Flashcards in Emergency Medicine Deck (30):
First priority in all trauma resuscitations.
secure Airway and ventilation
What is suspected if a trauma patient presents with hoarseness, subcutaneous emphysema, and a palpable neck fracture?
What is the next step in treating a trauma patient if intubation is unsuccessful?
What is the Mallampati Score?
Assesses the difficulty of intubation. Higher scores mean more difficult.
Scores are based on visibility into the patient's oral cavity while seated. Viewing only hard palate, vs being able to see soft palate or uvula account for the score.
What does a pulse oximeter measure?
Measures the amount of bound hemoglobin.
-not necessarily just oxygen bound to Hb
-DOES NOT measure ventilation
Airway management technique very useful for handling a bag-valve device.
-digits 3-5 grab the angle of the mandible and pull it forward while the thumb and 2nd digit hold the mask of the bag-valve over the patients airway.
How do you measure the correct size for an Oropharyngeal Airway?
Measure from the center of the mouth to the angle of the mandible.
What type of airway is preferred in a conscious patient?
How is a nasopharyngeal airway measured?
Measure from the nostril to the patient's earlobe
What is a definitive airway?
A tube present in the trachea with the cuff inflated, the tube connected to oxygen-assisted ventilation, and the airway secured in place.
What is RSI and when is it used?
Rapid Sequence Induction
-use of anesthetic and/or sedative medication in a patient that is awake or has an intact gag reflex in order to secure an airway
What are the 5 life threatening injuries identified on the primary survey?
1. Tension Pneumothorax
2. Open Pneumothorax
3. Flail Chest
4. Massive Hemothorax
5. Cardiac Tamponade
Tx for a patient that presents with unilateral absent breath sounds, tachypnea, cyanosis, and tracheal shift seen in the neck.
1. needle decompression 2nd intercostal space midclavicular line
2. chest tube placement 4th or 5th intercostal space ant. to mid-axillary line (only necessary for serious lung injury or penetrating wound that caused the pneumothorax)
Treatment for a patient that presents gasping for air, cyanotic, severehypotension, and a large stab wound in the upper thorax.
Sterile, air-tight dressing over the wound taped on 3 sides to act as a 1-way valve
Tx for a patient that presents with difficulty breathing, hypoxia, chest pain, and asymmetric rise and fall of the chest wall with respiration.
-oxygen to prevent hypoxia
-pain management if necessary
Tx for a patient that presents with absent breath sounds, mediastinal shift, and shock.
Massive Hemothorax (loss of greater than 1500cc in the thoracic cavity)
-chest tube placement
-send to surgery
What is Beck's Triad and what does it indicate?
3. Muffled Heart Sounds
Indicates Cardiac Tamponade
Tx for cardiac tamponade.
Most common cause of simple pneumothorax.
Lung laceration with air leakage into pleural space
Tx for simple pneumothorax
Chest tube placement in 4th or 5th intercostal space ant. to midaxillary line
Best treatment for hemothorax.
Large caliber chest tube
How does a pulmonary contusion present?
Similar to ARDS or other restrictive diseases. Patient will be in respiratory distress.
Tx for Pulmonary contusion.
PEEP: because it is acts like a restrictive disease that prevents the lungs from expanding, positive pressure helps prevent hypoxemia
Tx for a patient that presents with dysphagia, hoarseness, dyspnea, pain between the scapulae, mediastinal widening on CXR.
Traumatic Aortic Disruption
(most commonly occurs at ligamentum arteriosum after trauma)
Tx for a patient that presents with hemoptysis, fractured larynx and fractured 1st rib.
-secure airway and ventilate
-large tears require surgical intervention
What is suspected if a patient presents with gut contents coming out of a chest tube?
Tx for esophageal disruption.
Early surgical intervention w/ drainage of the pleural space
What is suspected if bowel sounds are heard in the lower chest along with hyperresonance to percussion?
Traumatic Diaphragmatic Injury
Tx for Diaphragmatic Injury.