Trauma #3 Flashcards Preview

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Flashcards in Trauma #3 Deck (23):
1

Blast injuries: Secondary

Victim being struck by projectiles from blast force
-penetrating or blunt

2

Blast injuries: Tertiary

Victim impacting the ground to another object

3

CO production in burn setting

Any incomplete combustion
-complete combustion is rare

4

Cyanide production in burn setting

Incomplete petroleum combustion
-especially carpet

5

Adult UO goal I'm burn pt

30-50 ml or 0.5 ml/kg/hr

6

Pediatric UO goal for burn patients

Babies: 2 ml/kg/hr
Kids: 1 ml/kg/hr

7

When are Parkland formula or consensus formulas implemented during burn resuscitation?

Once desired UO are achieved

8

Parkland formula

4 ml/kg/%BSA
1/2 over 1st 8 hours
1/2 in 16 hours

9

Consensus formula

2-4 ml/kg/%BSA

10

Burn mortality %

Age + BSA (2nd&3rd degree) = mortality %
-add 20% if respiratory involvement.

11

Adult Rule Of 9's

Head: (front) 4.5 (back) 4.5
Torso: (front) 18 (back w/ buttocks) 18
Arms: (front) 4.5 (back) 4.5
Groin: 1
Legs: (front) 9 (back) 9

12

Pediatric rule of 9's

Head: 18%
Trunk: 18, back: 18
Arms: 9
Groin: 1
Legs: 13.5

13

Only chemical burn with which you should neutralize

Hydrofluoric acid.
-copious amounts of fluid,
-10% calcium Gluconate infiltrated into tissues

14

Alkali metal burns

React with water
Sweep off and irrigate with cooking oils (absorbs heat)

15

Acid chemical burns

Most acids cannot penetrate deep into tissues
Cause coagulate necrosis (self limiting)
Acids denature cellular proteins and cause cellular coagulation

16

Alkali chemical burns

-Dissolve protein and collagen causing dehydration and saponification (Turning into soap).
-tend to cause more damage and severe burns
-they'll keep working as long as they are given elements to react with .

17

Myoglobinuria

-Secondary to electrical burns.
-large intramuscular protein which stores O2 (slow twitching muscle)
-clogs kidneys
-can result in ATN and renal failure
-tx with fluids to maintain UO to 100 ml/hr, osmotic diuresis, bicarbonate solution.

18

Why is a bicarbonate soln administered to myoglobinuria?

Causes proteins to become less polar
Diffused easier into glomerier structures
Diffuses into urine, urine becomes more polarized.
Proteins cannot escape urine

19

Categorizations of triage tags

Green: walking wounded: level III: priority 3
Yellow: delayed: level II: priority 2
Red: immediate: level I: priority 1
Black: Dead: Priority 0

20

Triage immediate criteria

Respirations: abnormal rate, WOB, distress
Perfusion: central cap refill >2 seconds
Mentation: ALOC
Also:
-penetrating trunk trauma
-injured rescuers

21

Triage delayed criteria

Respirations: normal pattern or agonal
Perfusion: central cap refill normal
Mentation: Alert and oriented x3

22

How much time should be spent with each patient in a triage situation?

15-30 seconds

23

Blast injuries Primary injuries

Injuries due to primary blast,
Air containing organs (lungs, bladder, stomach, ears)