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Flashcards in Trauma Deck (18)
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1
Q

What problem do you address first in a trauma case

A

greatest threat to life

2
Q

Age group with highest trauma rate

A

Young adults in late adolescence/early 20s (Males > females)

3
Q

Why were trauma teams developed

A

to address early/immediate deaths as as possible.

4
Q

When would you activate Full Trauma

A
  • Airway distress or intubated
  • RR 20 per min
  • Circulation (Pulse > 120, SBP
5
Q

Full vs Limited trauma

A

Limited is activating the ER team

6
Q

Who comes to Full Trauma Team alert

A
  • ED/MD doc at head
  • Trauma surgeon
  • 2 RNs
  • resp therapy (2)
  • ED Tech
  • Pharmacy (pediatric alerts only, sometimes adults)
  • Runners for blood bank
  • Fluid RN
  • OR Charge nurse
  • Recorder- typically ICU nurse
  • Charge RN
7
Q

Primary Survey in Trauma

A

C-ABCDE

  • Catastrophic hemorrhage control
  • Airway (and cervical spine control where appropriate)
  • Breathing and Ventilation (with O2 where available)
  • Circulation and Hemorrhage control
  • Disability or Neuro deficit
  • Extremity/Environment/Exposure

Meds/Allergies/ Past fam hx not important right now

8
Q

What happens to everyone with GCS

A

Put in airway

9
Q

Glascow Coma Scale

A

3-5 point scale
Best observed response
Modified for children
= 8 is a “coma” and requires intubation for airway protection

10
Q

Limitations to GCS

A

Peds
Motor deficits- well quantified but deficits not given priority
EtOH, Intoxication, language barriers

11
Q

2 most important vital signs in trauma

A

HR and BP

12
Q

How to assess Neuro status

A

Talk to pt/ask questions and do physical exam

GCS

13
Q

Adjuncts to primary survey

A
Chest Xray (tension pneumo, 
Pelvis Xray (fractures)
FAST exam (fluid; can also check for pneumothorax if no chest xray)
Diagnostic peritoneal lavage--not really done anymore
14
Q

Secondary survey

A

Look at pt head to toe

15
Q

Adjuncts to secondary survey

A

CTs
plain radiographs
blood tests

16
Q

Endpoints of Resuscitation

A
  • HR
  • Urine output
  • BP
  • Organ specific indicator of perfusion
  • Global indicators of perfusion (Lactic acid, base, CO, oxygen delivery and consumption)
17
Q

What to include in trauma presentation to attending

A

ABC’s first then Head to toe

  • Give actual numbers for BP and HR!
  • Never “stable”
18
Q

Tertiary Exam

A
  • Done 12-24 hours later
  • Reassess basically everything including review of all xrays
  • Rate of delayed dx as high as 10%