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Flashcards in Trauma Deck (18):
1

What problem do you address first in a trauma case

greatest threat to life

2

Age group with highest trauma rate

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

3

Why were trauma teams developed

to address early/immediate deaths as as possible.

4

When would you activate Full Trauma

- Airway distress or intubated
- RR 20 per min
- Circulation (Pulse > 120, SBP

5

Full vs Limited trauma

Limited is activating the ER team

6

Who comes to Full Trauma Team alert

- 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

Primary Survey in Trauma

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

What happens to everyone with GCS

Put in airway

9

Glascow Coma Scale

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

10

Limitations to GCS

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

11

2 most important vital signs in trauma

HR and BP

12

How to assess Neuro status

Talk to pt/ask questions and do physical exam
GCS

13

Adjuncts to primary survey

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

Secondary survey

Look at pt head to toe

15

Adjuncts to secondary survey

CTs
plain radiographs
blood tests

16

Endpoints of Resuscitation

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

17

What to include in trauma presentation to attending

ABC's first then Head to toe
- Give actual numbers for BP and HR!
- Never "stable"

18

Tertiary Exam

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