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Complex Care > Trauma > Flashcards

Flashcards in Trauma Deck (31):
1

Level 2 trauma care

Same as level one except does not participate in education and research

2

Level 3 trauma care

Stabilize and transfer

3

Level 4 trauma care

Resuscitate and stabilize and arrange for transfer

4

First peak of death

Instantaneous death on the spot
Only help is prevention and teaching

5

Second peak of death

The golden hour
What happens in trauma bay to rapidly determine injuries that could cause death
First hour of emergent care
Rapid fluid resuscitation important

6

Third peak of death

Death due to SIRS, sepsis, ARDS, ICP, MODS

7

Fluid resuscitation in trauma

60-80ml/kg/hr massive
20-30ml/kg/hr normal
Make sure you get weight immediately
Base off if BP and map
Changes in hgb, k+, and Na+
Third spacing

8

Intraosseous access

Infiltration risk look for signs and symptoms of infection
Infiltration fluid dependently below needle

9

Minor trauma

Single system injury
No threat to life or limb

10

Major trauma

Multiple system injuries

11

Blunt trauma- most common mechanism of injury

Shearing and crush injuries
MVCs, falls, sports related injuries, fragmentation and rupture

12

Level one trauma care

Regional resource center
Providers immediately available
Participate on research and education
Trauma bay and at least 2 ORs
Comprehensive trauma care

13

Penetrating trauma

Implement of foreign objects
Exit wounds can be bigger and more severe than entrance wounds

14

Blast trauma

Primarily associated with burn
More difficult to manage
More systemic response
More end organ damage
Compartment syndrome

15

Primary survey- emergency care phases

Very quick 1-2 mins
ABCDE
Airway
Breathing
Circulation
Disability
Expose patient

16

Secondary survey- emergency care phase

Full assessment
History and full head to toe assessment
Give comfort measures

17

Resuscitation phase

Begins prehospital to stabilization
Key component fluid resuscitation
Establish airway patency
Maintain effective breathing
Maintain circulation
Diagnostic testing
Assessment of neurological disabilities
Exposure and environment considerations

18

Establish airway patency

Open airway
Jaw thrust/ chin lift
Suction
Oro/nasopharyngeal airway
Endotracheal intubation
Laryngeal mask airway
Cricothyrotomy

19

Maintain effective breathing

Effective positioning
Frequent/ongoing assesment, impaired gas exchange?
Paradoxical movement of the chest?
Tracheal shift?

20

Maintain circulation

Hypolvolenia most common cause of circulatory collapse
Apply pressure
Replace circulatory volume
Early rapid surgical intervention
Assesment?

21

Diagnostic testing

X ray
FAST- focus assesment with sonography for trauma
CT scan
12 lead ECG
Continuous ECG

22

Adequacy of resuscitation

Sublingual capnometry- partial pressure of CO2
Near infrared spectroscopy- tiny needle in Palm of thumb that measures oxygen saturation state of tissue

23

Fluid resuscitation

2 large bore IV rapid
IO line or central venous line
Pulmonary artery catheter?
Ongoing assesment

24

Fluid resuscitation complications

Dilation all coagulopathy
Third spacing

25

Assesment of neurological disabilities

TBI
Primary head injuries/ blunt trauma to head
Spinal cord injuries
Assess LOC complete sensory and neurological exam, spinal immobilization

26

Passive external rewarming strategy

Remove wet clothes
Normal blankets

27

Active external rewarming strategy

Warming blankets
Convection blankets
Warming lights

28

Active internal rewarming strategies

Warmed IV fluids

29

Thoracic injuries/lung

Decreased or uneven breath sounds
Dullness on percussion
Possible chest tube
Rib fractures most common- give morphine to help breathe better
Flail chest- paradoxical chest movement
Open pneumothorax- apply dressing right away and tape on 3 sides

30

Abdominal injury

Liver most commonly injured after blunt or penetrating trauma
Greys turner sign- ecchymosis in flank area=bleeding in abdominal cavity, splenic injuries
Cullen sign- bruising in c shape around umbilicus

31

Disruption of pelvic structure

Pelvic stabilization
Bruising in perineum
High mortality rate