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Flashcards in Emergency/ Trauma Deck (47):
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a sudden illness or injury that is perceived to be a crisis threatening the physical or psychological well being of a person and continues until the condition is stabilized

emergency

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a nurse that evaluates the patient, to decide if they are stable enough to go home or if they need to be inpatient in facility

Psychiatric Nurse

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system of sorting  & classifying patients into priority levels according to illness or injury severity so that highest acuity patients get soonest evaluation, treatment, and prioritized resource utilization

triage

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the most important step in the ER

triage

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condition that condition must be treated immediately otherwise, life/limb/vision is threatened

emergent 

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condition that requires treatment quickly but an immediate threat to life dose not exist at the moment

urgent

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condition client that requires evaluation and possible treatment but time is not a critical factor

non-urgent

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Examples of Emergent Conditions

  • Chest pain with diaphoresis
  • Respiratory distress
  • Active hemorrhage
  • Unstable vital signs
  • Temperature of 103.5º F or greater

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Examples of Urgent Conditions

  • Severe abdominal pain
  • Renal colic  (kidney stones)
  • Displaced or multiple fractures
  • Complex or multiple soft tissue injuries
  • New-onset respiratory infection, especially pneumonia in older adults
    • Temperature of 101º to 103.4º F

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Examples of Non-urgent Conditions

  • Skin rash
  • Strains and sprains with good pulses
  • “Colds”
  • Simple fracture
  • Temperature less than 101º F degree

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Education materials & instructions must be at a _______ reading level.

6th grade

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Medical Examiner is present for:

  • Homicide/Suicide
  • Suspicious Deaths
  • Deaths caused by accidents
  • Death during/after surgery
  • Death associated with weapons
  • Death involving a crime
  • Stillbirths
  • Death related to drugs

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For Medical Examiner Case, leave all _________ in the body.

IV & tubes

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For Medical Examiner Case, place clothing in a _________.

paper bag

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type of nursing that encompasses the continuum of care from injury prevention and pre-hospital services, to acute care, rehabilitation, and, ultimately, community reintegration

Trauma Nursing

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Level of Trauma Center that is usually located in large teaching hospital systems in densely populated areas that provides full continuum of trauma care for all patients in every aspect of injury, from prevention through rehabilitation and offers professional and community education programs, conduct research, and participate in system planning.

Level I

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Level of Trauma Center located in community hospitals that provides care to most injured patients & advanced surgical care and plays a significant leadership role in injury management, education, prevention, and emergency preparedness planning and often transports patients to higher trauma center levels if patient needs exceed resource capabilities.

Level II

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Level of Trauma Center located in community hospitals that stabilizes patients with major injuries with orthopedic and general surgeons and often transports patients to higher trauma center levels if patient needs exceed resource capabilities.

Level III

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Level of Trauma Center located in rural and remote areas that provides advanced life support and transports to higher trauma center levels when able

Level IV

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In trauma, assess for DCAP, BLS and TIC = 

—Deformity

—Contusions

Abrasions

Punctures/Paradoxical movement

—Burns

Lacerations

Swelling

Tenderness

Instability

Crepitus

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Treatment for Crush Injury

  • Wrap amputated part in saline gauze
  • Do not clean or disinfect
  • X=Ray
  • Immerse in saline or saline & betadine
  • Prepare for surgery

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Primary Survey & Order of Approach for Trauma Patients

A-Airway/Cervical Spine

B-Breathing

C-Circulation

D-Disability

E-Exposure

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Secondary Survery for Trauma Patients

systemic head to toe assessment

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All trauma patients should receive ______.

oxygen!

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For trauma patient who is spontaneously breathing, give oxygen via __________.

100% Non Rebreather Mask

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For trauma patient who needs ventilation assistance, give oxygen via _______________.

Bag, Valve, Mask Ventilation

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To position for an open airway, you should use the __________ method.

jaw thrust

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Symptoms of Pneumothorax

  • —Decreased or absent breath sounds over the affected side
  • —Respiratory distress
  • —Hypotension
  • —Jugular vein distention
  • —Tracheal deviation (late symptom)

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Threats to Circulation (which all lead to shock)

  • cardiac arrest
  • myocardial dysfunction
  • hemorrhage

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Radial pulse is palpable at _____ mmHg systolic.

80

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Femoral pulse is palpable at _____ mmHg systolic.

70

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Carotid pulse is palpable at _____ mmHg systolic.

60

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By the time _________ occurs, compensatory mechanisms used by the body in an attempt to maintain vital signs in a shock state have been exhausted.

hypotension

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IV Access in a trauma should be at least ____ gauge in the _____.

16; AC

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In a trauma, resuscitation fluids are _______.

warmed

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During the "Disability" phase of trauma management, evaluate LOC for A.P.V.U.= 

  • A-Alert
  • V- responsive to Voice
  • P- responsive to Pain
  • U-Unresponsive

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Frequent Reassessment of LOC is needed in these situations:

  • —Metabolic abnormalities
  • —Hypoxia
  • —Neurologic injuries
  • —Drugs/alcohol

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Glasgow Coma Scale for Eye Opening:

spontaneously = 4

to speech = 3

to pain = 2

none = 1

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Glasgow Coma Scale for Verbal Response:

Orientated = 5

Confused = 4

Inappropriate = 3

Incomprehensible = 2

None = 1

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Glasgow Coma Scale for Motor Response

obeys commands = 6

localises to pain = 5

withdraws from pain = 4

flexion to pain = 3

extension to pain = 2

none = 1

 

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General causes of reduced LOC. Remember AEIOU-TIPS.

  • A  Alcohol
  • E  Epilepsy
  • I  Insulin
  • O  Overdose
  • U  Uremia
  • T  Trauma
  • I  Infection
  • P  Poisoning, Psychological
  • S  Sepsis  

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When cutting clothing, cut in the ______.

center

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body temperature < or = to 97º F

hypothermia

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Effects of Hypothermia

  • Vasoconstriction
    • Difficulty with venous & arterial assessment (blood draw)
  • Increased bleeding
  • Slowed drug metabolism

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For secondary assessment, remember A.M.P.L.E.

A – Allergies

M – Meds: Rx, OTC (used and not used)

P – Past medical/ surgical history

L – Last meal, Last menstrual period

E – Events preceding emergency and any care

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