Trauma Flashcards
What is the priority in a trauma cardiac arrest
Reversing the reversible causes such as hypoxia, hypovalemia.
What can EMAS give for an open fracture?
Co-amoxiclav injection
What does co-amoxiclav do for open fractures?
Antibiotic that helps prevent the body from pathogens that cause bone infections
What does TXA do?
Works internally to help stabilise the clots that’s already been formed in the blood
What can you use for a stab wound to the leg?
Pack it and dress it, tourniquet
What is the first thing in a trauma primary survey?
Catastrophic haemhorrhage
What are you doing when you check catastrophic haemhorrhage ?
Visual check and sweeping the hollows and the back
If there is trauma and the airway needs opening what manouver is perfered
Jaw thrust over HTCL
In the primary survey what actions do we take in breathing?
15 litres oxygen in a non rebrether
Resps less than 10 bag
Quick ascultation - is there air entry
What could you start to consider at circulation in the primary survey?
TXA
What does SAMPLE stand for?
Symptoms
Allergies
Medications
Past medical history
Last meal
Events leading up
In a traumatic cardiac arrest what can help temporeally?
Bilateral chest needle decompression
In a traumatic cardiac arrest what are the exceptions when terminating CPR
Pregnancy, hypothermic patients and paeds
Define permissive hypotension
When a clinician allows a pts systolic blood pressure to fall lower than normal without intervention (fluids).
The blood pressure will avoid exsanguination (the action or process of losing blood) but is high enough to maintain perfusion.
What is the aim of permissive hypotension?
Maintain an adequete vasoconsriction, organ perfusion and prevent undesireed coagulopathy during initial fluid resuscitation. And to avoid disruption of an unstable clot by higher pressures and worsening bleeding
When shouldnt permissive hypotension be considered?
Controversey with blunt trauma as it can lead to poor outcomes as a result of tissue hypofunction
Bleeding and TBI - Blunt trauma dont give fluids unless bp is less than 90
Penetrating trauma and trauma of the trunk - dont give fluids less than 60
Define a diffuse brain injury:
When the energy is transfered over a large portion of the head such as concussion and dissuse axonal injury
Define a focial brain injury:
Smaller portion of the head, contuision or intercranial haemorrhage
What are the examples of an intercranial haemorrhage?
Subdural haemorrhage - under the dura layer
Extradural haemorrhage - Over the dura layer
Define secondary brain injury
This injury can occur from minutes to days following initial injury.
Hypotension - SBP < 90
SATS < 90 Percent
The skull is a rigid container that cannot accomodate bleeding or swelling
What are oxygen and glucose delivery controlled by?
Cerebral blood flow
When do you begin ventilations?
Signs of ineffective breathing or poor perfusion.
<10 resps adult and <30 for children
What are some indications for pre hospital EA (anaesthesia)?
Airway compromise
Failure of airway protection
Failure of ventilation or oxygenation
GCS<8
To facilitate safe transport (danger to themselves or the crew)
What are the contraindications for PHEA?
Known anaphylaxis
obvious physical deformity making intubation unsuccessful
croup or epoglottis
