Primary and Secondary Survey Flashcards

1
Q

TCCC primary survey

A

Massive hemorrhage

Airway

Respirations

Circulation

Head injury and hypothermia

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2
Q

Used as a primary adjunct for massive or arterial bleeding until controlled by dressing or hemostatic agents

A

Tourniquet

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3
Q

In general, loss of up to ________ of circulating blood volume, is tolerated well in healthy patients.

A

15 percent (about 750 mL)

Class I hemorrhage

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4
Q

There is minimal or no tachycardic response, and changes in blood pressure usually do not occur. Without further bleeding, fluid replacement therapy is usually not needed.

A

Class I hemorrhage (15%)

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5
Q

Blood loss of ________ of total blood volume, generally results in tachycardia and narrowed pulse pressure.

A

15 to 30 percent (about 750 to 1500 mL)

Class II hemorrhage

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6
Q

There may be mild mental status changes. Provided the casualty had a normal RBC volume before hemorrhage, this degree of blood loss is tolerated without RBC replacement provided circulating volume is restored.

A

Class II hemorrhage (15-30%)

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7
Q

As blood loss increases beyond ____________ there is worsening hypotension, tachycardia, peripheral hypo perfusion, and
decline in mental status

A

30 percent (1500 mL)

Class III hemorrhage

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8
Q

At greater than ____________ the ability of the body to compensate has reached its limits and hemodynamic decompensation is imminent without effective resuscitation.

A

40 percent (2 Liters) blood loss

Class IV hemorrhage

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9
Q

Look, listen, and palpate from nose/mouth to trachea/bronchial tree

A

Airway

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10
Q

Should be part of the first response for a patient making inadequate respiratory effort.

A

Chin Lift/Jaw thrust maneuver simultaneously with in-line head and neck stabilization followed by insertion of an oral or nasal airway

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11
Q

Inspect to identify any abnormalities

Auscultate for presence or absences of breath sounds

A

Respirations

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12
Q

Intervention for tension penumothorax

A

Needle thoracostomy

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13
Q

Intervention for hemopneumothorax

A

Chest tube

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14
Q

Intervention for sucking chest wound

A

Occlusive dressing

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15
Q

Circulation is divided into two parts:

A

Hemodynamic Status

Hemorrhage Control

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16
Q

Evaluation of level of consciousness, skin color and presence and magnitude of peripheral pulses

A

Hemodynamic Status (Circulation)

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17
Q

Should not be used for measurement during the primary survey of circulation.

Rapidly obtain information by consciousness, pulse, skin color, and capillary refill time

A

Blood pressure measurement

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18
Q

Systolic pressure if radial pulse is felt

A

> 80 mmHg

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19
Q

Systolic pressure if femoral pulse is felt

A

> 70 mmHg

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20
Q

Systolic pressure if coratid pulse is felt

A

> 60 mmHg

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21
Q

Provides a rapid initial assessment of peripheral perfusion.

A

Skin Color and Cap Refill

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22
Q

Should be performed once the massive hemorrhage is controlled, airway is patent, breathing evaluated and the patient is stable hemodynamically

A

An abbreviated neurologic exam

23
Q

Abbreviated neuro exam should include:

A

Assessing the Level of Consciousness

Pupillary size and reactivity

Motor function

24
Q

Should be used to quantify the patient’s level of consciousness, ranging from a score of 3 (no response) to 15 (normal response on all measures)

A

Glasgow Coma Scale (GCS)

25
Q

A GSC score of ≤ __ indicates severe head injury/coma.

A

8

26
Q

HISTORY: A patient’s pertinent past medical history must be obtained. A useful mnemonic is the word:

A

AMPLE

  • Allergies
  • Medications
  • Past medical history
  • Last meal
  • Events associated with injury
27
Q

A head-to-toe physical examination, to include a reassessment of vital signs.

A

Secondary Survey

28
Q

Hemotympanum and/or disruption of the auditory canal on otoscopic exam are additional findings suggestive for:

A

Basilar Skull fracture

29
Q

CSF leaking from the ear is confirmatory for:

A

Basilar Skull fracture

30
Q

Presence of bruising around the eyes (raccoon’s eyes) or behind the ears (Battle’s sign)

A

Basilar Skull fracture

31
Q

A gloved finger placed into the mouth can move the central incisors and palate.

A

Mid-face fracture

32
Q

Malocclusion of the teeth is seen with either:

A

Mandibular or maxillary fractures

33
Q

Indicates a C-spine injury until proven otherwise

A

Any patient who is unconscious

Neurologic deficit

Injury above the clavicles

34
Q

In the absence of hypovolemia, neck vein distension can be suggestive of a:

A

Tension pneumothorax

Cardiac Tamponade

35
Q

Shortness of breath, pain, and tenderness to direct palpation or anterior posterior compression suggest:

A

Rib fractures

36
Q

Auscultation of distant heart sounds may be indicative of:

A

Cardiac tamponade

37
Q

Percussion of hypertympanic sounds may indicate:

A

Tension pneumothorax

38
Q

Any trauma patient in shock must have ________ injuries excluded
because these injuries are potentially dangerous.

A

Abdominal

39
Q

Most commonly injured organ in blunt trauma

Often associated with other injuries

Left lower rib pain may be indicative

Often can be managed non-operatively

A

Splenic injuries

40
Q

Second most common solid organ injury

Can be difficult to manage surgically

Often associated with other abdominal injuries

A

Liver injuries

41
Q

Small bowel and colon injuries result most often from:

A

Penetrating trauma

42
Q

Free fluid without solid organ injury is a ______ injury until proven
otherwise

A

hollow viscous

43
Q

The three basic regions of the abdomen are the peritoneal cavity with its:

A

Intrathoracic component

Retroperitoneum

Pelvic portion

44
Q

Diaphragm rises as high as the __ intercostal space

A

4th

45
Q

Extremities

Decreased or absent pulses suggest a:

A

Vascular injury

46
Q

Extremities

First sign of ischemia and should be aggressively evaluated.

A

Pain

47
Q

If there is any suspicion that a compartment syndrome is developing or exists, what should be performed?

A

Fasciotomy

48
Q

Extremities

For crush injuries, what must be considered?

A

Rhabdomyolysis

49
Q

For a patient with cardiac arrest, definitive care is:

A

Defibrillation with resultant normal rhythm

50
Q

Diabetic coma, definitive care is:

A

IV glucose until normal blood glucose levels returns.

51
Q

Casualties with obstructed airway, part of the definitive care are the:

A

Jaw thrust and assisted ventilation.

52
Q

Is comprised of evaluating circulation, airway and c-spine, breathing, disability (mental status), and environmental exposures.

A

Primary survey

53
Q

Includes a total evaluation of the patient injuries from head to toe

A

Secondary survey

54
Q

First thing you want to touch during the secondary survey

A

Skull and hair looking for blood