Resuscitation

Question 1

What does AMPLE history consist of?

Answer 1

ALLERGIES
MEDICATIONS
PAST MEDICAL HX
LAST ATE
EVENTS LEADING UP TO PRESENTATION

Question 2

How might trauma lead to airway obstruction?

Answer 2

Loss of pharyngeal tone with posterior tongue displacement
Displaced facial fractures
Vomitus/Blood/Secretions
Soft tissue swelling / oedema/ inhalation burns
Direct laryngeal trauma

Question 3

What kind of breathing issues might chest trauma cause?

Answer 3

Tension pneumothorax
Flail chest/ pulmonary contusions
Massive haemothorax

Question 4

What are the differences between simple pneumothorax and tension pneumothorax?

Answer 4

Pneumothoraces can be classified as “simple” or “tension.” A simple pneumothorax is non-expanding. In a tension pneumothorax, a “one way valve” defect allows air into but not out of the pleural space. If left untreated, increasing pressure starts to collapse vascular structures within the mediastinum

In conventional pneumothorax, the heart is usually shifted toward the side of the thorax containing the most air, but in a tension pneumothorax the heart is shifted to the opposite side because of the increased pleural space pressure

Question 5

What are the ecg presentations of cardiac tamponade?

Answer 5

The ECG criteria of cardiac tamponade we adopted was as follows:

1) Low QRS voltage in a) the limb leads alone, b) in the precordial leads alone or, c) in all leads

2) PR segment depression

3) Electrical alternans (alternating QRS amplitude that is seen in any or all leads on an electrocardiogram (ECG) with no additional changes to the conduction pathways of the heart) - related to pericardial effusion

4) Sinus tachycardia.

Question 6

What are the most commonly injured organs from trauma in abdomen?

Answer 6

Liver or spleen

Question 7

What is the purpose of supplying red cell concentrates and fresh frozen plasma in resuscitation and what is the ideal ration of the two?

Answer 7

RCC = ensure better oxygen supply to tissues
FFP = for lack in plasma proteins like clotting factors

Ratio = 1:1

Question 8

What is permissive hypotension?

Question 9

How to distinguish epidural and subdural hemorrhage on imaging?

Answer 9

Epidural haemorrhage would produce a chunk of opacity, but subdural hemorrhage would present with opacity following sulci of brain

Question 10

Under what situations could you clear the C spine without a CT scan?

Answer 10

When there is no … following MINOR trauma

There is noposteriormidlinecervicaltenderness
There is no evidence of intoxication
The patient is alert and oriented to person, place, time, and event
There is no focal neurological deficit
There are no painful distracting injuries (e.g., long bone fracture)