Trauma Flashcards
(75 cards)
1
Q
Order of spider straps
A
- Shoulders
- Feet
- Above Knee
- Pelvis
- Armpits
2
Q
When two holes in chest, how is oclusive dressing applied?
A
Vented seal is higher than non-vented
3
Q
Who gets cel-x (special wound packing)
A
Hypothermia and blood thinners
i.e., cold and old
4
Q
Muscle injury from overstretching or overexertion
A
Strain
5
Q
Obstructive shock
A
Due to something that is limiting function - tamponade, tension pneumo, pulmonary embolism
6
Q
Distributive shock
A
w/o loss of fluids but with floppy wide blood vessels: neurogenic, septic, anaphylactic - shock
7
Q
Cardiogenic shock
A
Due to damage to heart - problematic rhythms, MCI, trauma to heart (contusion)
8
Q
Hypovolemic shock
A
Due to the loss of fluid - hemorrhage, loss of plasma, loss of body fluids
9
Q
Trauma triad
A
Hypothermia, coagulopathy, acidosis
10
Q
Coagulopathy happens…
A
Below 95 degrees, above 1.5 INR
11
Q
End tidal above ?? means the kidneys are perfused
A
20
12
Q
MAP formula and hypoperfusion MAP #
A
MAP is DBP + 1/3 PP
Hypoperfusion MAP<60
13
Q
Drugs NR considers for unconscious patient w\o known reason
A
Thiamine, D50 and Naloxone
14
Q
Open fracture and shortness of breath
A
Lead to pulmonary embolism
Especially tib-fib, FAT embolism that can reach lungs. s/s shortness of breath
15
Q
Compartment syndrome following supracondylar fracture. Distal humorous, close to the elbow; common, especially PED
A
Volkmann contracture
16
Q
Blast injuries impact
A
- Primary - blast wave itself
- Secondary - missiles propelled
- Tertiary - impact w/another object
- Quaternary - collateral: burns, crush injuries, toxic inhalation
- Quinary - long term damage
Related injury - arterial air embolism from alveolar disruption
17
Q
Bleeding that is life threatening
A
Exsanguination
18
Q
Another term for swelling (edema)
A
Erythema
19
Q
Term for a bruise w/ black and blue marks
A
Ecchymosis (e cha mosis)
20
Q
Collection of blood under the skin. Blue discoloration
A
Hematoma
21
Q
The four phases of shock
A
- Initial - hypoxia, anaerobic cell respiration. Tachypnea
- Compensatory - (MAP above 60 means cells are still perfused)
- Progressive/uncompensated - MAP below 60. Organs are compromised.
- Refractory - Vital organs have failed, imminent death.
22
Q
The fracture is at an angle to the shaft
A
Oblique fracture
23
Q
The fracture is perpendicular to shaft
A
Transverse fracture
24
Q
Growth plate in bone - fracture there can cause growth problems
A
Epiphyseal plate
25
Shifting of the joint without a full dislocation. Unlike dislocations, allows for normal, albeit painful motion.
Subluxation (sab lak say shen)
26
Falling on locked knees. Can result in tearing of the ligaments of the pelvis, symphysis pubis, and sacrum.
Vertical shear injury
27
Alveolar collapse, prevents ventilation
Atelectasis (a te LEK ta ses)
28
Air under the skin ("snap, crackle, pop") suggest lung or airway injury
Subcutaneous emphysema
29
Mid section of the thoracic cavity; contains the heart and main blood vessels. Inflammation of
Mediastinum and mediastinitis
30
Flail chest is
TWO or more consecutive ribs must also be fractured in TWO or more places
31
Rib fractures concerns
* Aortic injury
* Tracheobronchial injury
* Pneumothorax (look for subcutaneous emphysema)
9-11 be suspicious of abdominal injuries
32
Can be auscultated when lung collapses (pneumothorax)
Hyperresonance
33
s/s of pulsus paradoxes
Drop of 10 mmHg during inspiration; we can feel radial pulse on expiration but not inspiration
34
Common between tension pneumo and simple pneumo
Shortness of breath, absent/diminished sounds on impacted side
35
Difference between tension pneumo and simple pneumo
Tachycardia and hypotension due to intrathoracic pressure causing decreased venous return to the heart.
36
Signs of tension pneumothorax
Absence of breath sounds on affected side, unequal chest rises, pulsus paradoxes, tachycardia and progression to vfib, JVD, narrow pulse pressure and tracheal deviation
37
Space between the visceral and parietal pleura of the lungs
Pleural cavity. One for each lung. Lubricated. Each space can hold up to 3000ml (exsanguination)
38
Massive hemothorax defined
More than 1500ml of blood in the pleural space (about 25% of adult blood volume).
39
When air leaks into the mediastinum
Pneumomediastinum (aka mediastinal emphysema)
40
s/s = Frequent PVCs in trauma patient. Shortness of breath, chest pain, cardiac dysrhythmias
Myocardial contusion
41
Beck's triad (pericardial tamponade)
1. Hypotension (bcs pressure limits preload)
2. Muffled heart sounds (Fluid makes it harder to hear)
3. Jugular venous distension (backup of blood in superior vena cava or heart)
Also, tachycardia and narrowing pulse pressure.
42
Treatment for pericardial tamponade - Prehospital and in hospital
Prehospital attempt to increase preload through fluids. In hospital - pericardiocentesis
43
Common between cardiac tamponade in tension pneumo
Right ventricle and vena cava compressed on inspiration - preload leading to lower BP
44
Different between cardiac tamponade in tension pneumo
w/TP no lung sound on one side; air hunger
45
Common to pulmonary contusion and pulmonary embolus
V/Q mismatch. i.e., ventilation normal but low pso2 & high end tidal
46
Aortic dissection, disruption , rupture s/s
Tearing pain behind sternum or in scapula; sign of shock; hematoma can lead to hoarseness or difficulty swallowing; harsh murmur as blood passes the injury site; Blood flow may be interrupted to extremities leading to pulse difference between left/right, upper/lower
Treatment: supportive, fluids
47
Concussion impact on memory
Transient retrograde amnesia (retrograde means before the event)
48
TBI Hematoma shapes
Subdural - crescent / banana shape (narrow)
Epidural lemon/round shape and bigger. More severe, only 1-2% of TBI
49
ETCO2 and head injury
“Targeted Ventilatory Management”
* Maintain 35-40 if NO signs of herniation.
* If herniation, 30-35.
* Never allow the ETCO2 to drop below 25 mmHg (increased mortality)
50
Signs of ICP
GCS drop of 2 or more, from 9
Pupillary changes
Cushing triad
Hyperpyrexia
51
Exceptionally high body temp due to ICP or infection
Hyperpyrexia
52
Cushing triad, (ICP sign)
1. Widening pulse pressure;
2. Bradycardia;
3. Chaine Stokes/abnormal breathing
53
Medications that decrease cerebral edema and ICP
Mannitol (Osmitrol), furosemide (Lasix)
54
Epidural hematoma s/s
Often lose consciousness initially; regain consciousness for a while; and then fall unconscious when ICP at critical levels.
55
Head injury w/rapid onset of s/s: significant headache, mimic meningitis, Cushing reflex.
Subarachnoid hemorrhage
56
Injury separating facial bones from skull
Le Fort III
57
This injury disconnects the axons in the spinal cord to the brain.
Diffuse axonal injury
58
Results from hyperextension of the cervical spine. Loss of function in upper extremities.
Central cord syndrome
59
Fracture with s/s of battle sign, raccoon eyes, a positive halo test.
Basal skull fracture
60
Lesion in the spinal cord causing weakness or paralysis on one side and a loss of sensation on the opposite side.
Brown-Sequard syndrome (BSS)
61
Flexion injury with s/s motor and sensory loss inferior to the injury.
Anterior cord syndrome
62
Extension injury leading to decreased sensation to light touch and proprioception.
Posterior cord syndrome
63
Body's ability to sense its position, movement, and orientation in space.
Proprioception, aka kinesthesia
64
Double vision
Diplopia
65
Neurological, ability to move both eyes in the same direction.
Conjugate gaze
66
4 Layers of skin
1. Epidermis - part of it is dead cells that continuously shed
2. Dermis - nerve, vessels, sweat, hair
3. Subcutaneous tissue - insulates, protects and stores fat
4. Deep fascia - thick, dense
Below them tendons connect muscles to the skeleton
67
Surgical procedure to treat full-thickness circumferential burns.
Escharotomy (es ke RA tami)
68
Most significant systemic response to burns
Hypovolemic shock due to (a) Fluid loss through damaged skin, (b) Volume shifts of fluids across body.
69
Injury to skeletal muscle and involves leakage of large quantities of toxic intracellular contents into plasma (potassium).
Rhabdomyolysis (rabdo ma YA la sis)
70
Emergency procedure to decompress compartment syndrome
Fasciotomy
71
Collected blood in abdominal cavity
Hemoperitoneum
72
Referred pain to left shoulder
Kehr sign
73
Hypothermia temp
Body temperature has decreased to 35°C (95°F) or less
74
Fragile bones
Osteoporosis
75
s/s Blood clots, Bruising, mottling of the skin, Drop in blood pressure, Bleeding from many sites in the body
Disseminated intravascular coagulation, or DIC
