TARMS Flashcards
(39 cards)
Where is measured to fit a cervical collar?
Using finders from the patient’s trapezius to the point of the chin
What 3 factors can affect ventilation?
1) airway obstruction
2) CNS depression
3) Altered ventilatory mechanics (thoracic or cervical spinal cord function)
Describe the mnemonic for injuries that could compromise ventilation?
ATOM FC Airway obstruction Tension pneumothorax Open chest wound Massive haemothorax Flail chest Cardiac tamponade
Describe a mnemonic for assessing circulation and shock?
HEP B Hands (temp, sweating, cap refill) End organ perfusion (conscious level, urine output) Pulse (rate, quality) BP (hypotension - late sign)
Describe areas of blood loss ‘on the floor and 4 more’
External wounds Chest cavity Abdo cavity (includes retroperitoneal) Pelvic cavity Long-bone fractures
What can be given in IV in haemorrhage?
IV tanexamic acid
What things can contribute to secondary brain injury?
Inadaquete oxygenation, hypoperfusion, or hyperglycaemia
Describe the scoring system for eye opening in GCS
4 - spontanous
3 - to speech
2 - to pain
1 - none
Describe the scoring system of verbal response in GCS
5 - orientated 4 - confused 3 - inappropriate words 2 - sounds 1 - none
Describe the best motor response in GCS
6 - obeys commands 5 - localises to pain 4 - normal flexion 3 - abnormal flexion 2 - extension 1 - none
Describe ways of managing neurodisability
Optimising oxygenation Maintain cerebral perfusion (BP >90mmHg) avoid hypoglycaemia avoid pyrexia Definitive imaging and treatment
What BP is needed for ideal cerebral perfusion pressure?
BP > 90mmHg
What area of the spine is most commonly injured in trauma?
Cervical
How can you inspect the posterior of a patient in trauma?
log roll
Name 4 spinal cord syndromes
Central cord syndrome
anterior cord syndrome
brown-sequard syndrome
complete spinal cord syndrome
Describe some signs of spinal injury
Diaphragmatic breathing
Evidence of neurogenic shock
responds to pain only above the clavicle
priapism
flexed posture of upper limb or flacced areflexia
patient complains of loss of sensation or function
spinal tenderness, bruising or swelling on log roll
Discuss some early management of spinal cord injury
Optimise oxygenation Ensure good ventilation maintain spinal cord perfusion by avoiding hypotension maintain immobilisation document thorough spinal cord exam urinary catheterisation and NG tube definitive imaging early specialist advice
In which part of ABCDE assessment are pelvic fractures?
C - due to the possibility of massive blood loss
Why does hypothermia increase mortality from haemorrhagic shock?
It induces coagulopathy
Can you lose limbs in trauma?
Yes, neurovascular injury and cause limb loss through ischaemia
What are the uses of trauma scores?
Predict outcome Research Epidemiology Allocation of resource Triage tools
What are the limitations of trauma scores?
Complex and difficult to use in real time, many rely on delayed data
Name some commonly used trauma scores
Abbreviated injury scale
injury severity scale
revised trauma score
What is eFAST used for?
bedside ultrasound for patient’s in trauma
