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Flashcards in Trauma Deck (46)
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1

AMPLE history for trauma

Allergies, meds, pregnancy/PMH, last meal, events surrounding mechanism of injury

2

ABCDEF of trauma

Airway, breathing, circulation, disability, exposure/environmental control, Foley

3

What procedure is used if unable to intubate airway?

Cricothyroidotomy

4

What size is considered a large bore IV?

14 or 16 gauge

5

When should OGT (oral gastric tube) be placed rather than NGT?

When fx of cribriform is suspected

6

What is the "3 to 1" rule?

Rough estimate for how many liters of crystalloid are needed to replace one liter of lost fluid

7

Four types of hemorrhagic shock

8

How should type IV hemorrhagic shock be treated?

2 L saline followed by uncrossed (O negative) blood immediately. Death is imminent. 

9

What is FAST?

Focused abdominal sonogram for trauma. Looks at RUQ, LUQ, pelvis, and cardiac views. Most common area for blood to pool is the hepato-renal space (pouch of Morison). 

10

What are the five layers of the scalp?

Mneomonic is SCALP:

Skin, connective tissue, aponeurosis (galea), loose areaolar tissue, pericranium

11

Do you give abx ppx in simple scalp lacerations?

no

12

What CN runs along the edge of the tentorium cerebelli?

CN 3

13

Equation for cerebral perfusion pressure (CPP)

CPP = MAP - ICP 

14

What is Cushing reflex?

HTN and bradycardia in s/o increased ICP. The brain's effort to maintain CPP. 

15

Glasgow coma scale

16

What is severe vs. moderate vs. mild head injury according to the GCS?

Severe: 8 or less

Moderate: 9-13

Mild: 14-15 

17

Basilar skull fracture features

  • Sign of very signficant mechanism of injury
  • May have raccoon eyes, retruauricular ecchymoses (Battle's sign), otorrhea, rhinorrhea, hemotympanum, CN palsies

18

What is the ring test for CSF rhinorrhea?

Take a sample of blood from the epistaxis and place on filter paper. If CSF present, a large transparent ring will be seen encircling a clot of blood. 

19

Epidural hematoma

lens-shaped (convex) bleed; tearing of middle meningeal artery common. Classically have "lucid interval" and then go down hard 

20

Subdural hematoma

Concave bleed; better prognosis in elderly due to brain atrophy. Can be acute, subacute, or chronic. 

21

Management of severe head trauma

  • ABC's, intubation
  • Maintain adequate BP with fluids
  • Decrease ICP
    • Mannitol (osmotic diuretic to draw fluid out of brain)- can't use in hypotensive pt
    • Hyperventilation
    • Elevate head of bed
  • Consider seizure ppx with phenytoin. Tx seizures with lorazepam or diazepam and phenytoin
  • Ventriculostomy (burr hole) used to measure ICP 
  • Drain hematoma if present 

22

Anterior and posterior triangles of neck 

23

Three zones of the neck

24

How should you manage the airway of someone with laryngo-tracheal separation?

Tracheostomy

25

What type of injury can cause an anterior cord syndrome?

flexion injury 

26

What area of spine is most commonly injured? 

C spine

 

Thoracolumbar junction also fairly vulnerable

27

Indications for C-spine x-rays?

  • Tenderness along C-spine
  • Neuro deficit or altered sensorium
  • Good mechanism of injury
  • Distracting injury present 

28

What type of injury might cause central cord syndrome?

Hyperextension e.g. whiplash 

29

Atlanto-occipital dislocation

Results from severe traumatic flexion. Survival to hospital setting is rare. 

30

Jefferson fracture

C1 (atlas) burst fracture

  • Most common C1 fracture
  • Happens with axial loading, e.g. patient falls right on head, or something falls right on the patient's head