Trauma #1 Flashcards Preview

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Flashcards in Trauma #1 Deck (19)
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1
Q

Radiological evidence of tracheal shift, early or late sign?

A

Early (down low)

2
Q

Cyanosis and Hgb considerations

A

Cyanosis will not exist if Hgb is less than 5

3
Q

Chest dart & tube lateral placement

A

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

4
Q

Positive pressure ventilation & pulmonary contusions

A

Aggressive PPV Can cause an air emboli

5
Q

Hemothorax s/s

A

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
Q

Hemothorax treatment

A
Chest dart: minimal pressure relief
chest tube is ideal
Fluids!
Blood replacement
Intubated for ventilation failure.
7
Q

Grunting equals

A

Auto-peep

8
Q

Occlusive dressing considerations

A

Tape 3 sides initially
-placement t on end-exhalation

Tape 4th side only after chest tube placement.

9
Q

Paradoxical movement in conscious pt

A

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

10
Q

Treatment of flail

A

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

11
Q

Signs of early cardiac tamponade

A

Sinus tachycardia, pulsus paradoxus

12
Q

Pulsus paradoxus

A

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
Q

Early tamponade treatment

A

Force fluids, anticipate progression

14
Q

Late tamponade s/s

A

Severe hypotension, Becks triad

15
Q

Becks triad

A

Muffled heart tones, JVD, Narrowed pulse pressure

16
Q

Late tamponade treatment

A

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
Q

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

A

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
Q

Aortic rupture s/s

A

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
Q

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

A

Disruption between R/L subclavian arteries