Module 1

Question 1

Acceleration and Deceleration Injuries

Answer 1

Shearing
Compression
Rebound

Question 2

Shearing Injuries

Answer 2

Shearing forces cause liver heart and other organs to pull away or fold around ligaments or muscle

Question 3

Compression Injuries

Answer 3

ie: head hits dash board

Question 4

Rebound Injuries

Answer 4

Occur due to recoil following deceleration

Includes spinal # and contra coup injuries to the brain

Question 5

What must you always ask about with any injury/ Trauma

Answer 5

Pre incident
Incident
Post incident
Targeted history taking

ie. were you dizzy before you fell

Question 6

Cauitation

Answer 6

When the body is hit by something there is a transfer of energy that knocks the organs out of place

Can be permanent or temporary (depending on the amount of force and elasticity of tissues involved)

Question 7

Permanent Cauitation

Answer 7

tract or hole through tissue that remains after the energy is removed

Question 8

Exit wounds

Answer 8

larger then entry wounds

The structures and debris that the bullet collects as it passes through are forced out the exit wound

Question 9

Trauma assessment (C)

Answer 9

CPR

Hemorrhage

Question 10

Trauma assessment A

Answer 10

Look
-swelling
-facial trauma
-look in the mouth (broken teeth etc.)
-chest rise and fall
-LOC
Listen
-air movement
-Stridor
Feel
-air movement

clarity of speech
signs of obstruction
AVPU
CSpine

Question 11

Trauma assessment B

Answer 11

Look

• WOB
• Symetry (flail segment?)
• Rise and fall
• Skin colour
• Tracheal deviation
• Depth
• Quality
• Rate

Listen
-Lungs to bases

Feel
-SubQ emphysema

Question 12

Trauma assessment C

Answer 12

Skin: colour, temp, moisture
cap refill
pulses:quality ,rate, rhythm
chest pain?
signs of bleed
FAST
POCUS
pelvic stability

Question 13

Trauma assessment D

Answer 13

Gluc
Barriers (pain and nausea)
Doctor/specialists
AVPU
Pupils
GCS
cincinnati stroke scale

Question 14

Trauma assessment E

Answer 14

Assess for further injuries

Question 15

Silver half hour

Answer 15

Used for infants/Peds

Question 16

Silver half hour

Answer 16

Used for infants/Peds

Question 17

Trauma triad of death (list the 3 parts)

Answer 17

Coagulopathy
Acidosis
Hypothermia

Question 18

Trauma

Answer 18

Injury to tissues resulting from the transfer of energy

Question 19

Blunt trauma

Answer 19

Skin remains intact
more serious -extent of injury is hard to see
more wide spread injury

Question 20

Penetrating trauma

Answer 20

skin surface is broken

Question 21

List the accelerating and decelerating forces

Answer 21

Shearing injuries
Compression injuries
Rebound injuries

Question 22

Essential information to gather from scene/paramedics

Answer 22

speed
seatbelt
airbags
LOC
Intrusion
Deaths at scene
EBL (arterial vs Venous)
MOI

Question 23

Trauma interventions A

Answer 23

Intubate early
BVM
suction 
Jaw thrust (or chin lift for C-Spine)
C-spine/SMR
Sx airways- needle cric, sx cric, tracheostomy's

Question 24

Trauma interventions B

Answer 24

Oxygen
Assist with breaths (BVM)/vent
pulse oximeter
Resposition if safe
BiPAP or CPAP
Chest tube
needle thoracostomy

Question 25

Trauma interventions C

Answer 25

``` Pericardial needle aspiration cardiac monitor Pelvic binder IV fluids RL/Plasmalyte (avoid NS) 1-2L Blood 1:1:1 TXA IV/IO 12 lead ECG ```

Question 26

Trauma interventions D

Answer 26

CT scan Decrease ICP control pain and nausea

Question 27

Trauma interventions E/F

Answer 27

``` Family presence rewarm cut off wet clothes behr hugger blankets etc. ```

Question 28

Trauma triad of death HYPOTHERMIA

Answer 28

Core Temp <35 vasoconstriction causes a lack of perfusion to cells (blood is shunted to core organs)- leads to acidosis The clotting cascade is temperature-dependent Oxygen dissociation curve shifts left (LOVE oxygen)

Question 29

Trauma triad of death ACIDOSIS

Answer 29

Build up of lactic acid d/t poor perfusion (anaerobic metabolism)

Question 30

Trauma triad of death HYPOTHERMIA INTERVENTIONS

Answer 30

``` Active rewarming warm fluids warm blankets warm CBI warm thoracic lavage ```

Question 31

Trauma triad of death COAGULOPATHY

Answer 31

bleeding out loosing clotting factors INR >1.5 Inability to clot Inflamatory response causes us to lose clotting factors which causes DIC Hypothermia inhibits ability to clot Acidosis (<7.3) inhibits ability to clot

Question 32

Trauma triad of death ACIDOSIS INTERVENTIONS

Answer 32

Improve oxygenation and perfusion give oxygen Give fluids (RL or blood) find cause of acidosis

Question 33

Complications with CSpine collars

Answer 33

Impaired venous drainage from head pain skin breakdown Airway compromise (SUCTION)

Question 34

Flail Chest

Answer 34

3 or more ribs broken in 2 or more places (segments)

Question 35

Flail Chest Interventions

Answer 35

Immediate intubation | Saline bags on injury

Question 36

Tension Pneumo Signs and symptoms

Answer 36

Early signs - SOB - Decreased sats - Decreased TV Late signs - Altered LOC - Tracheal deviation - hypoxic arrest

Question 37

Tension Pneumo Signs and symptoms

Answer 37

Early signs - SOB - Decreased sats - Decreased TV Late signs - Altered LOC - Tracheal deviation - hypoxic arrest

Question 38

Fluid resuscitation in trauma

Answer 38

RL or plasmalyte not NS because it can lead to acidosis | Blood products 1:1:1 FFP, Platlets and PRB then 1g calcium gluconate

Question 39

Chest drainage systems should be clamped when?

Answer 39

to much blood loss- clamping it can cause a tamponade which will apply pressure and slow bleed

Question 40

Worst type of brain bleed

Answer 40

epidural (arterial bleed)

Question 41

Signs of Increased ICP

Answer 41

Uneven pupils | Cushings triad

Question 42

Cushings triad

Answer 42

Widening pulse pressure irregular resps bradycardia

Question 43

Cushings triad

Answer 43

Widening pulse pressure irregular resps bradycardia

Question 44

Cushings triad

Answer 44

Widening pulse pressure irregular resps bradycardia

Question 45

Secondary assessment LMNOP

Answer 45

``` Labs Monitor Nasogastric tube Oxygen Pain ```

Question 46

Trauma triad of death COAGULOPATHY INTERVENTIONS

Answer 46

Blood products 1:1:1 | WARM pt