PRIMARY AND SECONDARY SURVEY OF A TRAUMA PATIENT Flashcards
(29 cards)
TCCC Primary Survey is as follows:
M - __________
A – __________
R – __________
C – __________
H – __________
M - Massive Hemorrhage
A – Airway
R – Respirations
C – Circulation
H – Head Injury and Hypothermia
Most casualties during combat are the result of __________ injuries, rather than the blunt trauma seen in the civilian setting.
penetrating
_________ should be used as a primary adjunct for massive or arterial bleeding until controlled by dressing or hemostatic agents
tourniquets
Internal Hemorrhage: If an operating room is not immediately available, abdominal or lower extremity hemorrhage can be reduced by what?
agents, wound packing, ligation, and clamping.
What Class of hemorrhage?
loss of up to 15 percent (about 750 mL)
-is tolerated well in healthy patients
Class I
What Class of hemorrhage?
15 to 30 percent (about 750 to 1500 mL)
-results in tachycardia and narrowed pulse pressure
Class II
What Class of hemorrhage?
30 percent (1500 mL)
-worsening hypotension, tachycardia, peripheral hypo perfusion, and decline in mental status
Class III
What Class of hemorrhage?
greater than 40 percent (2 Liters)
-the ability of the body to compensate has reached its limits and hemodynamic decompensation is imminent without effective resuscitation.
Class IV
In virtually all trauma casualties requiring urgent intubation, a ________ intubation technique should be used.
rapid- sequence
True/False
Attempts at intubation without optimal sedation and paralysis often result in failure
True
True/ False
A formal blood pressure measurement should be performed at the C in the MARCH algorithm
False
SHOULD NOT be performed
BP over palp
(1 Radial Pulse: pressure ≥ ___ mmHg
(2 Femoral Pulse: pressure ≥ ___ mmHg
(3 Carotid Pulse: pressure ≥ ___ mmHg
(1 Radial Pulse: pressure ≥ 80 mmHg
(2 Femoral Pulse: pressure ≥ 70 mmHg
(3 Carotid Pulse: pressure ≥ 60 mmHg
The sign of white or ashen, grey skin depicts what?
hypovolemia
When do you log roll the pt to check the back?
in the H of the MARCH
and when the pt is hemodynamically stable
At what part of the MARCH is thorax and neck palpated and interventions such as needle D or chest tube completed?
R
A GSC score of ≤ 8 indicates what?
severe head injury/coma
What is the AMPLE history
(1) Allergies
(2) Medications and nutritional supplements
(3) Past medical illnesses and injuries
(4) Last meal
(5) Events associated to the injury
_______ is a head-to-toe physical examination, to include a reassessment of vital signs
Secondary Survey
Clear evidence of intra-abdominal injury (peritonitis or evisceration) will lead to what surgery?
laparotomy
Basilar skull fractures are suggested by the presence of what signs?
bruising around the eyes(raccoon’s eyes) or behind the ears (Battle’s sign).
A mid-face fracture is present when a gloved finger placed into the mouth can move the ____
central incisors and palate
Any patient who is unconscious, has a neurologic deficit, or has an injury above the clavicles then you should treat them as if they have what kind of injury?
injury to the cervical spine until proven otherwise
What organ?
1) Most commonly injured organ in blunt trauma
2) Often associated with other injuries
3) Left lower rib pain may be indicative
4) Often can be managed non-operatively
Spleen
What organ?
1) Second most common solid organ injury
2 )Can be difficult to manage surgically
3 )Often associated with other abdominal injuries
Liver
