Flashcards in Trauma #3 Deck (23):
Blast injuries: Secondary
Victim being struck by projectiles from blast force
-penetrating or blunt
Blast injuries: Tertiary
Victim impacting the ground to another object
CO production in burn setting
Any incomplete combustion
-complete combustion is rare
Cyanide production in burn setting
Incomplete petroleum combustion
Adult UO goal I'm burn pt
30-50 ml or 0.5 ml/kg/hr
Pediatric UO goal for burn patients
Babies: 2 ml/kg/hr
Kids: 1 ml/kg/hr
When are Parkland formula or consensus formulas implemented during burn resuscitation?
Once desired UO are achieved
1/2 over 1st 8 hours
1/2 in 16 hours
Burn mortality %
Age + BSA (2nd&3rd degree) = mortality %
-add 20% if respiratory involvement.
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
Legs: (front) 9 (back) 9
Pediatric rule of 9's
Trunk: 18, back: 18
Only chemical burn with which you should neutralize
-copious amounts of fluid,
-10% calcium Gluconate infiltrated into tissues
Alkali metal burns
React with water
Sweep off and irrigate with cooking oils (absorbs heat)
Acid chemical burns
Most acids cannot penetrate deep into tissues
Cause coagulate necrosis (self limiting)
Acids denature cellular proteins and cause cellular coagulation
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 .
-Secondary to electrical burns.
-large intramuscular protein which stores O2 (slow twitching muscle)
-can result in ATN and renal failure
-tx with fluids to maintain UO to 100 ml/hr, osmotic diuresis, bicarbonate solution.
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
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
Triage immediate criteria
Respirations: abnormal rate, WOB, distress
Perfusion: central cap refill >2 seconds
-penetrating trunk trauma
Triage delayed criteria
Respirations: normal pattern or agonal
Perfusion: central cap refill normal
Mentation: Alert and oriented x3
How much time should be spent with each patient in a triage situation?