Trauma Flashcards
What should scene time be limited to in cases of significant trauma?
10 min or less
What is the Modified Shock Index?
Heart rate / MAP
How do you calculate MAP?
[(DBP x 2) + SBP] / 3
What is the guideline for fluid therapy in observed or suspected hemorrhagic shock?
Adult - limited crystalloids as needed until restoration of distal pules, improved mental status and/or permissive hypotension levels reached (70 to 90 systolic), with exception of severe TBI which SBP should be maintained at > 90SBP
Pediatric - 10 mL/kg for volume expansion, repeat as needed until restoration of distal pules, improved mental status and/or permissive hypotension levels reached (70 + (2x age in years)), with exception of severe TBI which SBP should be maintained at > 70 + (2x age in years) SBP
Should you use wet dressings on burn patients? Why or why not?
No, burn patients are prone to hypothermia
What is the guideline for fluid therapy in burn patients?
Adult - 500 mL/hr
Pediatric
Age < 5 - 125 mL/hr
Age 5 to 13 - 250 mL/hr
Age ≥ 14 - 500 mL/hr
When would an occlusive dressing be used?
Sucking chest wound, penetrating abdominal trauma, penetrating neck wounds
What are possible signs/symptoms of tension pneumothorax?
SOB, dyspnea, acute chest pain, tachycardia, AMS, decreased/absent breaths sounds, tracheal deviation
What level should a pelvic sling be placed at?
Trochanters
What dislocations can you reduce w/o neurovascular compromise?
Patella, digits, shoulder (anterior)
What nerve do you want to be sure to check prior to reducing a shoulder dislocation and where is it?
Axillary, outer aspect of shoulder
What are ways to control bleeding?
Direct pressure, tourniquet, hemostatic agent, pelvic binder, wound packing (junctional injuries), pressure dressing
What are the indications for cervical spine restriction?
Impaired judgement/cannot focus on exam
Barrier to evaluate (e.g. language)
Pt >65 or <5
Midline tenderness, step-offs, or deformities
Neurologic deficits or complaints
If cervical spine restriction is indicated, what findings require full SMR?
Obvious motor or sensory deficit
Pt is not alert/oriented, unreliable, agitated, uncooperative, etc.
What VS do we want to maintain in TBIs?
SpO2 95-98%
Eucapnia (EtCO2 35-40)
Normotension (>90 SBP adults or 70+(2x age in years) for peds)
BGL not hypoglycemic
