Trauma

Question 1

Trauma
Primary Survey
1. Airway

Answer 1

Assess patency of airway, look
for obstruction (blood, emesis,
teeth, foreign body),
Ensure C-spine precautions
Airway management

Question 2

Trauma
Primary Survey
2. Breathing

Answer 2

Expose chest
Assess breathing
Auscultate for breath sounds
Rule out tension pneumothorax

Question 3

Trauma
Primary Survey
3. Circulation

Answer 3

Assess LOC
Signs of shock (HR, BP,
skin color, urine output, base deficit),
Sources of bleeding (external, chest,
abdomen, pelvis, femur)

Question 4

Trauma
Primary Survey
4. Disability

Answer 4

GCS assessment
Neurological evaluation including pupils

Question 5

Trauma
Primary Survey
5. Exposure/Environment

Answer 5

Fully expose and assess patient
Logroll patient to inspect for injuries, spinous tenderness and rectal exam for
high-riding prostate and tone
Keep patient warm to prevent hypothermia

Question 6

Trauma
Primary Survey
6. Adjuncts

Answer 6

eFAST Exam: subxiphoid pericardial window, perisplenic,pelvic/retrovesical, bilateral anterior lung
Portable X-ray: chest, pelvis, grossly deformed limbs
ECG: evaluate for dysrhythmias

Question 7

Trauma
Investigations
Trauma Triad of Death
Coagulopathy
Hypothermia
Acidosis

Answer 7

Bloodwork:
CBC
CMP
BUN/Cr
Glucose,
Lactate
INR/PTT
Fibrinogen
β-hCG
tox bloodwork
T+C
U/A

Question 8

Trauma
Management
General Resuscitation

Answer 8

Immediate hemorrhage control (Stop the Bleed)
Blood transfusion: balanced resuscitation to avoid dilutional coagulopathy
Tranexamic acid: 1g IV bolus then 1g IV over 8 hours
Consider permissive hypotension

Question 9

Trauma
Management
Head Trauma

Answer 9

Seizure management/prophylaxis
Treat suspected raised ICP
Neurosurgical intervention for severe head injury/bleeds

Question 10

Trauma
Management
Spinal Cord Trauma

Answer 10

Immobilization, treat neurogenic shock (goal MAP >85), consult spine service

Question 11

Trauma
Management
Chest Trauma

Answer 11

Airway management
Chest decompression
Resuscitative thoracotomy in
arrest, surgery for life-threatening injuries

Question 12

Trauma
Management
Abdominal Trauma

Answer 12

Laparotomy for hemodynamically unstable and hollow organ injuries

Question 13

Trauma
Management
Orthopedic Injuries

Answer 13

Reduce and immobilize when possible
Irrigate open fractures
Assess for neurovascular and skin compromise
Adequate analgesia, consult ortho

Question 14

Trauma
Investigations
Imaging

Answer 14

Imaging:
CT (selective vs. pan-scan) for stable
patients; unstable patients may require
emergent OR