Trauma Flashcards
(98 cards)
0
Q
Control of airway and external hemorrhage, immobilization and rapid transport of patient to nearest appropriate facility
A
Prehospital phase
1
Q
Period immediately following trauma in which rapid assessment, diagnosis assessment, diagnosis and stabilization must occur
A
Golden hour of trauma
2
Q
AMPLE history
A
Allergies Medication/Mechanism of injury Past medical history / Pregnancy Last meal Events surrounding the mechanism of injury
3
Q
Initial assessment and resuscitation of vital functions
A
Primary survey
4
Q
Prioritization based on ABCs of trauma care
A
Primary survey
5
Q
ABCs
A
Airway Breathing Circulation Disability Exposure Foley
6
Q
Airway and C spine
A
Assess patency
Jaw or chin lift
Clear foreign bodies
Insert oral or nasal airway
7
Q
Initially to open airway
A
Jaw or chin lift
8
Q
Obtunded or unconscious patients should be
A
Intubated
9
Q
Used when unstable to intubate airway
A
Cricothyroidotomy
10
Q
Breathing and ventilation
Ensure adequate ventilation and identify and treat injuries that may immediately impair ventilation
A
Tension pneumothorax
Flail chest and pulomonary contusion
Massive hemothorax
Open pneumothorax
11
Q
Blunt or penetrating injury of the lung
A
Tension pneumothorax
12
Q
Segment of the thoracic cage is separated from the rest of the chest wall
A
Flail chest
13
Q
Presence of blood in the pleural space
A
Massive hemothorax
14
Q
Associated with a chest wall defect
A
Open pneumothorax
15
Q
done to drain fluid, blood, or air from the space around the lungs
A
Thoracostomy
16
Q
Control of hemorrhage
A
Large bore IVs 14or16
Assess circulatory status
Direct pressure
Do nit clamo bleeding vessels with hemostats
17
Q
Glasgow coma scale other name
A
AVPU Alert Verbal Pain Unresponsive
18
Q
GCS score
Eye
Verbal
Motor
A
4
5
6
19
Q
GCS eye
A
4- open eyes spontaneously
3- to voice
2- to pain
1- unresponsive
20
Q
GCS verbal
A
5- oriented 4- confused 3- inappropriate words 2- inappropriate sounds 1- unresponsive
21
Q
GCS motor
A
6- obeys command 5- localizes painful stimuli 4- withrawal of painful stimuli 3- decorticate 2- decelabrate 1- no response
22
Q
Cimpletely undress the patient
Hook up monitors
A
Exposure
Environments
Extras
23
Q
Placement of urinary catheter is considered part of the
A
Resuscitative phase
24
Uinary output s replection of
Renal erfusion
| Volume status
25
Adequate urinary output
Adult- .5 cc/kg/hr
More than 1 - 1.0
Less than 1 - 2.0
26
Foley is contraindicated
Urethral transection
27
Perform before foley
Retrograde urethrogram
28
Signs of urethral transection
Blood at the meatus
High riding prostate
Scrotal hematoma
29
Reduce risk of aspiration by decompressing stomach
Nasogastric tube
30
Begins during the primary survey
| Life threatening injuries are tebded to as they are identified
Resuscitation
31
Fluid therapy should be initiated with 1 to 2 L of
Isotonic crystalloid solution
32
Example of isotonic crystalloid solution
LR lactated ringers
| NSS normal saline
33
Pediatric patients should recieve an IV
Bolus of 20 cc/kg
34
Trauma is the most common causes of death in persons aged
1-44 years old
35
____ leading cause of death in all individuals
4th
36
50% die from
Major vascular and neurologic injuries
37
30% die within the first few hours as a result of
Irreversible shock
| Intracranial hematomas
38
Trauma kn the philippines
5th leading cause of mortality
5x more common in males
Causes 8.5 of all deaths
39
Within seconds of injury
Peak 1
| Cannot be prevented
40
An hour or two after injury
Peak 2
41
Prompt intervention saves lives
Golden hour
42
Days after injury
Peak 3
43
Example of peak 1
Head injury
Heart injury
Aortic injury
44
Example of peak 2
Subdural and epidural injury
Hemo or pneumothorax
Organ rupture
Blood loss
45
Example of peak 3
Sepsis
| Multi organ failure
46
Assume cervical spine fracture in any patient with an injury aive the
Clavicle
47
Neurologic examination alone does not rule out a
Cervical spine injury
48
Must be visually examined
Seven cervical vertebre
49
Crosstable lateral cervical spine x ray or
Swimmer view
50
Airway patency does not assure
Adequate ventilation
51
Systolic pressure will be above 80 mmhg
Radial pulse
52
Systolic pressure will be aove 70 mmHg
Femoral pulse
53
Systolic pressure will be above 60 mmHg
Carotid pulse
54
Done on hypothenar eminence, thumb or toenail bed
Capillary blanch test
55
Color returns to normal within two seconds
Normovolemic patients
56
Phase 1
Primary survey
57
Life threatening conditions identified in the primary survey are constantly reassessed and management continued
Phase 2 resuscitation
58
designed to match the makeup of your intracellular fluid and are equal in osmotic pressure inside and outside your cells. This prevents any fluid shifting in and out of your cells
Isotonic electrolytes solution
59
Example isotonic
Lactated ringers- fluid of choice
Normal saline
Plasmalayte A
60
A solution that contains more dissolved particles (such as salt and other electrolytes) than is found in normal cells and blood.
Hypertonic solution
61
Example of hypertonic solution
Saline
| Dextrose
62
Rapidly expands plasma volume
Dextran
63
Raises intravascular volume
| Replaces body fluids
Normal saline
64
Raises intravascular volume
Reduces interstitial and intracellular edema
Promotes osmotic diuresis
Mannitol
65
Replace body fluids
Lactated
66
Provides additonal K and Ca
| Buffers acidosis
Ringers
67
Raises total body water
| Provides 200 calories/liter
D5 water
68
An acute infection, usually systemic, that overwhelms the body (toxic shock symdrome). Poisonous substances accumulate in bloodstream and blood pressure decreases, impairing blood flow to cells, tissues, and organs.
Septic shock
69
Injury or trauma to the nervous system (spinal cord, brain). Nerve impulse to blood vessels impaired, blood vessels remain dilated and blood pressure decreases
Neurogenic shock
70
Results from reaction to substance to which patient is hypersensitive or allergic (allergen extracts, bee sting, medication, food). Outpouring of histamine results in dilation of blood vessels throughout the body.
Anaphylactic shick
71
Shock caused by overwhelming emotional factors. Sudden dilation of blood vessels results in fainting because of lack of blood supply to the brain
Psychogenic shock
72
Trauma to the respiratory tract (trachea, lungs) that causes a reduction of oxygen and carbon dioxide exchange. Body cells cannot receive enough oxygen.
Respiratory shock
73
Body's homeostasis impaired; acid-base balance disturbed (diabetic coma or insulin shock); body fluids unbalanced
Metabolic shock
74
Myocardial Infarction with damage to heart muscle; heart unable to pump effectively. Inadequate cardiac output. Body cells do not receive enough oxygen.
Cardiogenic shock
75
Severe bleeding or loss of body fluid from trauma, burns, surgery, or dehydration from severe nausea and vomiting. Blood pressure decreases, thus blood flow is reduced to cells, tissue, and organs.
Hemorrhagic shock
76
neurotransmitter that helps control the brain's reward and pleasure centers. also helps regulate movement and emotional responses,
Dopamine
77
n. an inotropic sympathomimetic drug (a β1 agonist) used to increase the force of contraction of the ventricles and improve the heart output, for example in patients who have had a myocardial infarction or in cases of shock. It is given by intravenous infusion.
Dobutamine
78
has the function of preparing the body for ‘fright, flight, or fight’ and has widespread effects on circulation, the muscles, and sugar metabolism.
Epinephrine
79
antacid used to relieve heartburn and acid indigestion
Na Bicarbonate
80
Stimulates alpha beta and dopaminergic receptors
| Dose
Dopamine 2-10 mcg/kg/min
81
Dopamine has predominantly
Inotropic and chronotropic activit by direct beta stimulation
82
Stimulates release of endogenous noepinephrine
Dopamine
83
Symphatomimetic through beta receptor
| Drug of choice for myocardial support
Dobutamine
84
Give in patients in shock develop metabolic acidosis
Na bicarb
85
Effects of acidosis
Depresses myocardial contractility
| Decrease response to inotropic agents
86
Too much bicarbonate
```
Produce acidosis
Shifts o2 to left
Na overload
Elevated serum osmolarity
Hyopkalemia
Reduced ionized calcium
```
87
Comprehensive evaluation for detecting less obvious injuries not apparent during the primary survey
Secondary survey
88
Does not begin until the primary survey has been completed and the resuscitation phase has begun
Secondary survey
89
Evaluating the body by sections
Stethoscope used over each body cavity and major vessel
Palpate for bony defects
In depth evaluation
90
Secondary survey includes
Head to toe exam
History
Radiologic exam
Laboratory testing
91
History
```
About trauma scene
Inquire about the events
Allergies
Last meal
Surgical scars
```
92
Interrupt the exam to manage potentially life threatening injuries
Physical exam
93
Laboratory testing
```
Baseline blood count
Urinalysis
Electrolytes
Bleeding parameters
Blood type and cross match
```
94
Radiologic exam
Everything that hurts
Do not take precedence over treatment of life threatening conditions
Pero importante ang chest at cervical spine x ray
95
Patients less life threatening injuries are managed
Definitive care
96
In depth management of definitive care
Fracture stabilization
Necessary operative intervention
Stabilization of patient in preparation in transfer
97
Mortality can be grouped into
Immediate trauma death
Early trauma death
Late trauma death
