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Critical Care <3 > Trauma > Flashcards

Trauma Flashcards

(47 cards)

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1
Q

What is the first hour of emergent care called and what does it involve?

A

Golden hour
focuses on rapid assessment, resuscitation, and treatment of life threatening injuries

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2
Q

Who are part of the trauma team?

A

EMS
Trauma surgeon
emergency physician
anesthesiologist
trauma nurse leader
trauma resuscitation nurse
scribe
pharmacist
RT
lab
radiology
physician specialist

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3
Q

who is the overall team leader?

A

Trauma surgeon

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4
Q

What does a primary survey involve?

A

most crucial assessment tool within 1-2 minutes
used to identify life threatening injuries accurately, establish priorities and provide interventions

uses ABCDEFG mnemonic

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5
Q

What does the mnemonic ABCDEFG stand for?

A

Airway
Breathing
Circulation
Disability (neuro)
Exposure
Full set of vitals and family
Get resuscitation adjuncts

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6
Q

What does secondary survey involve?

A

initiated after resuscitation

Head to toe assessment
assess each region of body for any missed injuries

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7
Q

Secondary survey
MIST acronym

A

Mechanism of injury
Injuries sustained
Signs and symptoms in the field
Treatment in the field

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8
Q

Secondary survey SAMPLE acronym

A

Symptoms
Allergies
Medications
Past medical history
Last oral intake
Events and environmental factors

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9
Q

what are the three elements that are considered the trauma triad of death?

A

Hypothermia
hypotension
acidosis

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10
Q

ABCDEFG: Airway assessment

A

stridor
central cyanosis
nasal flaring
trauma to face or mouth
inability to speak

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11
Q

ABCDEFG: Breathing assessment

A

asymmetrical chest movement
open chest wounds
dyspnea
low or high resp rate

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12
Q

ABCDEFG: Circulation assessment

A

presence of pulses
weak, thready
pallor
MAP < 65
obvious hemorrhaging

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13
Q

ABCDEFG: Disability assessment

A

Neuro status
GCS < 13
posturing
lack of sensations

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14
Q

What is FAST ultrasound?

A

provides rapid means of diagnosing accumulation of blood or free fluid in peritoneal cavity or pericardial sac

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15
Q

What is E-FAST?

A

ultrasound that diagnoses accumulation of blood but also extends to chest injuries like hemothorax and pneumothorax

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16
Q

What do you need to monitor during fluid resuscitation?

A

Urine output (0.5 mL/kg/hr)
LOC
HR
BP
Pulse pressure
Labs
MAP

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17
Q

What can happen with excessive fluid resuscitation?

A

Dilutional coagulopathy
third spacing
Edema
abdominal compartment syndrome
ARDS
AKI
MODS

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18
Q

What is TEG?

A

thromboelastography
evaluates whole blood coagulation and identifies coagulopathy

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19
Q

What is the purpose of exposing the patient?

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A

full body visualization

20
Q

Interventions to prevent prolonged hypothermia?

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A

warmed IV fluids
warm the room
warm blankets
cover patients head

21
Q

Classic signs of cardiac tamponade?

Study These Flashcards
A

Beck’s triad: hypotension, muffled or distant heart sounds, elevated venous pressure/distended neck veins

22
Q

What are some possible ECG presentations for cardiac tamponade?

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A

PVCs, A-fib, bundle branch block, or ST segment changes

23
Q

What should you anticipate as the treatment for cardiac tamponade and what equipment should you obtain?

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A

pericardiocentesis
obtain equipment for emergency thoracotomy in case arrest occurs

24
Q

How does the patient with a pneumothorax present?

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A

resp distress
tachypnea
tachycardia
diminished breath sounds
and chest pain

25
What are the interventions for pneumothorax?
provide oxygen anticipate chest tube
26
What is a tension pneumothorax and how does it differ from a normal pneumothorax?
TP is always severe and fatal air enters the pleural cavity with no escape and air accumulates with each breath causing mediastinal shift and collapse
27
What is a pulmonary contusion?
bruising to lung tissue causing inflammation and edema
28
what is the presentation of a pulmonary contusion?
worsening dyspnea ineffective cough hypoxia chest wall abrasions chest pain
29
Nursing interventions for pulmonary contusion?
anticipate mechanical ventilation supplemental oxygen pain relief IV narcotics
30
What are the three levels of triage?
emergent, urgent, and delayed
31
What is the emergency severity index?
Tool used to categorize patients based on their needs
32
Explain the tiers of the emergency severity index
1.) Resuscitation, immediately dying 2.) High risk 3.) two or more resources need 4.) one resource needed 5.) no resources needed
33
What is flail chest?
Occurs when three or more ribs are broken in at least two places stability of chest wall is disturbed
34
How does flail chest impact overall health?
Pain altered gas exchange permanent chest wall deformity
35
Expected manifestations of flail chest
severe pain tachypnea shallow breaths splinting abnormal rise of chest retractions
36
Diagnostics for flail chest
chest x ray lab hemodynamics ABGs
37
What is compartment syndrome?
increased pressure within muscle compressing nerves, blood vessels which can lead to necrosis
38
What are the Six P's?
Pain pressure pallor pulses paresthesia paralysis
39
What can you expect in the assessment of a patient with suspected compartment syndrome?
increased pain no relief from analgesia pain with extension of first digit
40
What can you anticipate as the treatment for compartment syndrome?
fasciotomy
41
what is rhabdomyolysis and what are the interventions?
muscle damage aggressive fluid resuscitation to flush out myoglobin and prevent aki
42
What do you do if there is no drainage from a chest tube?
Check for kinks or clots assess placement verify suction check for air leaks
43
What do you do if there is continuous bubbling in water seal chamber?
check connection from patient to drainage system could mean an air leak assess the patient
44
What do you do if the chest tube gets disloged?
apply a sterile occlusive dressing over insertion site put tube in sterile water
45
What do you do if chest tube become clogged?
gently milk the tube
46
What do you do if the chest tube system is not bubbling at all?
check suction source assess water seal assess patient
47
When should you report to the provider on the drainage amount from chest tube?
more than 200 mL per hour

Critical Care <3 (16 decks)

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