Trauma #1 Flashcards Preview

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Flashcards in Trauma #1 Deck (19):
1

Radiological evidence of tracheal shift, early or late sign?

Early (down low)

2

Cyanosis and Hgb considerations

Cyanosis will not exist if Hgb is less than 5

3

Chest dart & tube lateral placement

Dart: 4th or 5th mid or anterior auxiliary line
Tube: 4th anterior

4

Positive pressure ventilation & pulmonary contusions

Aggressive PPV Can cause an air emboli

5

Hemothorax s/s

#1: hypovolemia shock
-can dump entire blood volume into chest
-blood loss enough to kill pt

ALOC
No midline tracheal shift
Flat neck veins
Little tension in chest.

6

Hemothorax treatment

Chest dart: minimal pressure relief
chest tube is ideal
Fluids!
Blood replacement
Intubated for ventilation failure.

7

Grunting equals

Auto-peep

8

Occlusive dressing considerations

Tape 3 sides initially
-placement t on end-exhalation

Tape 4th side only after chest tube placement.

9

Paradoxical movement in conscious pt

Pain stabilizes flail w/ muscle tension. Paradoxical movement only notable on NMBA's or unconscious pts.

10

Treatment of flail

Stabilize externally,
intubation w/ PEEP (stabilization from within)
Injured side down.
Confused lung beneath leak fluids: pulmonary edema. Limit fluids as able.
Opioids.

11

Signs of early cardiac tamponade

Sinus tachycardia, pulsus paradoxus

12

Pulsus paradoxus

Abnormally large decrease in in systolic pressure and pulse wave amplitude during inspiration
-normal fall is less than 10 mmHg
-when feeling a pulse, quality of pulse decreases on inspiration

13

Early tamponade treatment

Force fluids, anticipate progression

14

Late tamponade s/s

Severe hypotension, Becks triad

15

Becks triad

Muffled heart tones, JVD, Narrowed pulse pressure

16

Late tamponade treatment

Pericardiocentesis:
-set pt to 30% angle
-direct needle to inferior scapular margin,
-pull off 15-30 cc blood
-ectopy will be seen if needle hits heart (back needle out)

17

Cardiac tamponade causes what kind of failure. How do you normally treat this type of failure?

Diastolic failure
-heart is compressed and cannot open completely at contraction.
-loss of preload, ejection fraction fails

Treatment: force fluids in effort to increase preload

18

Aortic rupture s/s

Severe CP into back, mid scapular pain,
-dyspnea,
-HTN in upper extremities (flow to legs limited, diverted to arms)
-Harsh systolic murmur
-wide mediastinum on cxr

19

What causes gross abnormalities in BP readings between R/L arms in aortic rupture

Disruption between R/L subclavian arteries