Exam II Lecture 8 Poly Trauma Dayton Flashcards
(23 cards)
The trauma evaluation first begins when…
The evaluation begins when you first see the patient.
Checking neuro status, obvious injuries, stabilization/IV access or EMS/family story.
What does the primary survey cover?
ABCDE Airway Breathing Circulation Dissability Environmental contaminants.
What should falls and MVA be packaged with?
Package these patients with a C collar and back board.
A patient that is clammy with cold skin is showing signs of….
Shock!
No radial pulses is also a bad sign that the circulation to organs isnt sufficient.
What should the minimum systolic pressure to the radial pulse be?
At least 70 mmHg
What do you do if a patient isnt responding to IV?
Give them blood!
This is all to rule out shock after the administration of crystalloid fluid.
Describe hemorrhagic shock
Diminished tissue perfusion secondary to blood loss.
Class 1 shock
15% loss with normal vitals and slightly anxious.
Class 2 shock
15-30% mild tachy normal BP (Pulse pressure drops) RR increases and pt is anxious
Class 3 shock
30-40% pulse is >120 and the patient is hypotensive.
Less UOP but confused.
Class 4 shock
> 40%
Pt is obtunded, extremely tachycardic, cool and hypotensive.
What is the initial treatment for shock?
IV fluids
2 Liters in adults or
20mL/kg bolus for children.
If not responding to fluids use blood.
Kidneys are not making urine.
If the blood volume is low kidneys will stop making urine
Definitive treatment for hemorrhagic shock?
Surgery.
you need to stop the bleeding.
Should Dopamine or Doputamine be used in patients experiencing shock?
NO
Just makes the heart pump even faster/harder.
you need the volume.
At which Glascow Coma Scale level should the pt be intubated?
Intubate when the GCS is 8
Range is 3-15
Always assume an alcoholic under trauma has….
Head injury.
When should you get a head CT?
If loss of conciousness or neuro defecits
what about alcohol?
5% of head trauma also has,…
Cervical spine injury
What are the NEXUS five reasons to take the C-collar off?
No bony tenderness (bone only) No distracting injury (Open fx etc) No neuro deficits (push pull tracking) No cognitive dysfunction No intoxication
What age range requires pregnancy test?
8-80
What should you order if you cannot see C7 on X-ray?
Order a CT
When do people typically die from trauma?
the three peaks
At scene from large vessel or head/neck.
Shortly after arriving to the ER
In the ICU from head, overwhelming infections or clots.
