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Flashcards in Pestana- 1. Trauma Deck (183)
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1

How is an airway most commonly inserted?

Orotracheal intubation

2

How do you visualize the airway during an orotracheal intubation?

laryngoscope

3

If a patient has a c-spine injury and you cannot keep the head stable for orotracheal intubation, what is your other option?

Nasotracheal intubation over a fiber optic bronchoscope

4

What is a sign of major traumatic disruption of the tracheobronchial tree?

subcutaneous emphysema in the neck

5

What is required when securing an airway in a patient with subcutaneous emphysema in the neck?

fiberoptic bronchoscope

6

What is required if intubation cannot be done in the usual manner and time is limited?

cricothyroidotomy

7

At what age do you start feeling comfortable with doing a cricothyroidotomy?

12 (due to potential need for future laryngeal reconstruction)

8

List the clinical signs of shock.

-Low BP (

9

What are the typical causes of shock in trauma?

-Bleeding (hypovolemic/hemorrhagic)
-Pericardial tamponade
-Tension pneumothorax

10

In what type of shock is CVP (central venous pressure) low?

hypovolemic shock (bleeding)

11

How may you differentiate tension pneumothorax with pericardial tamponade?

Pericardial tamponade has NO respiratory distress where tension pneumothorax has severe respiratory distress

12

What are some other hints that your patient has tension pneumothorax?

-Unilateral absence of breath sounds
-Unilateral hyperresonance to percussion
-Mediastinum is shifted to opposite side

13

What is the routine volume replacement in the treatment of hemorrhagic shock?

-2L of Ringer lactate (without sugar)
-Blood (Packed RBCs)

14

When do you know to stop volume replacement in hemorrhagic shock?

-Urine output reaches 0.5-2 mL/kg/h
-CVP does NOT exceed 15mmHg

15

What is the preferred route of fluid resuscitation in the trauma setting?

2 peripheral IV lines, 16-gauge

16

What are the alternatives to the 2 peripheral IV lines in fluid resuscitation in the trauma setting?

-Percutaneous femoral vein catheter
-Saphenous vein cut-downs

17

What might you use to fluid resuscitate a child

Intraosseus cannulation of the proximal tibia

18

If the diagnosis of pericardial tamponade is not clear from clinical exam, what do you use to diagnose?

sonogram

19

How do you treat pericardial tamponade?

-Pericardiocentesis
-Tube
-Pericardial window
-Open thoracotomy

20

How do you manage tension pneumothorax?

Immediate big needle/IV catheter into affected pleural space

21

After inserting big needle or IV catheter into affected pleural space in a tension pneumothorax, what is the next step?

chest tube connected to underwater seal (inserted high in the anterior chest wall)

22

What is the CVP in cardiogenic shock?

high (see big, distended veins)

23

How do you treat cardiogenic shock?

circulatory support (DO NOT GIVE FLUIDS AND BLOOD)

24

In what 3 situations do you see vasomotor shock?

-Anaphylactic reactions
-High spinal cord transections
-High spinal anesthesia

25

What is the CVP in vasomotor shock?

low

26

What is the main therapy for vasomotor shock?

vasopressors

27

What do you do with a closed (no overlying wound) linear skull fracture?

leave it alone

28

What do you do with an open linear skull fracture?

wound closure

29

When do you go to the OR with a linear skull fracture?

if it is comminuted or depressed

30

What do you always get in a patient who had head trauma and goes unconscious?

CT scan