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4th year Block 3 > Trauma > Flashcards

Trauma Flashcards

1
Q

Types of obstructed airway

A 
Sudden (FB) 
Progressive (anaphylaxis)
Partial (tumour) 
Complete 
Transient 
Recurrent (anaphylaxis)
Permanent (tumour)
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2
Q

Signs of a partially obstructed airway

A 
Agitation 
Coughing/choking
Snoring 
Gurgling 
Stridor 
Tracheal tug 
Abdominal movement 
Use of accessory muscles 
Cyanosis
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3
Q

Major sign in completely obstructed airway

A

SILENCE

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4
Q

What are the accessory muscles of breathing

A

Intercostals and

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5
Q

What is a Le-fort fracture

A

Midface fracture - can displace downwards and backwards impinging on the posterior pharyngeal wall causing airway obstruction - need to manually reduce

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6
Q

Presentation of laryngeal trauma

A 
Neck pain/tenderness 
Hoarseness 
Subcutaneous emphysema 
Haemoptysis 
Dysphagia
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7
Q

When might you see laryngeal trauma

A

More common in older population when cartilage becomes calcified
often associated with injuries to the oesophagus. carotid artery and jugular vein (need reviewed by ENT)

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8
Q

List 7 methods of relieving airway obstruction

A
  1. Jaw thrust/chin lift (head tilt)
  2. Suction
  3. Oropharyngeal airway
  4. Nasopharyngeal airway
  5. Laryngeal mask airway
  6. Endotracheal tube
  7. Surgical airway (cricothyroidotomy)
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9
Q

Define shock

A

State of inadequate tissue perfusion and tissue oxygenation as a result of a deficiency in the circulation

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10
Q

name the 4 categories of shock

A

Distributive
Cardiogenic
Obstructive
Hypovolaemic

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11
Q

Give the BP equation

A

BP = CO (HRxSV) x SVR (normal vascular tone determined by sympathetic innervation)

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12
Q

Septic is an example of which kind of shock

A

Distributive

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13
Q

SIRS = 2 of…

A

RR >20 bpm
WCC <4 or >12
HR > 90 bpm
Temp: fever >38 or <36

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14
Q

What happens in septic shock

A

Massive vasodilation (reduction in systemic vascular resistance) so become hypotensive

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15
Q

Anaphylaxis is an example of which kind of shock

A

Distributive

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16
Q

Treatment of anaphylactic shock

A 
Fluids 
Adrenaline 
Chlorphenamine 
Steroids 
Anaesthetist for airway management
17
Q

What is neurogenic shock

A

a kind of distributive shock - massive vasodilatation and loss of sympathetic vascular tone.
Can be caused by high cervical cord injuries

18
Q

Causes of cardiogenic shock

A

Acute MI - large infarction or papillary muscle rupture

Other conditions - septic shock, myocarditis, arrythmias, drugs (betablocker overdose), myocardial contusion

19
Q

Describe cardiogenic shock

A

due to pump failure - loss of cardiac output

20
Q

Causes of obstructive shock

A

Tension pneumothorax - mediastinal shift affects preload and afterload
Cardiac tamponade - accumulation of fluid in paricardial space resulting in reduced ventricular filling

21
Q

Becks triad of cardiac tamponade

A

Increased JVP
Hypotension
Diminished heart sounds

22
Q

Causes of hypovolaemic shock

A

DRY system
haemorrhage
sepsis
Diarrhoea and vomiting

23
Q

Where might the blood be in hypovolaemic shock

A

1 on the floor and 4 more
revealed on the floor at the scene
concealed - chest, peritoneal, long bones, retroperitoneum (will show bruising of flanks)

24
Q

Wound types

A

Abrasion (superficial, blunt tangential force)
Contusion (blunt, subcut blood)
Laceration (blunt, full thickness)
Incision (sharp, full thickness)

25
Q

What foreign bodies are visible on ultrasound but not on Xray

A

Wood or plastic

Glass and metal can be seen on X ray

26
Q

what is secondary closure

A

closure by secondary intention - heals from the bottom up

(not appropriate if expose vital structures or if mobile area as scar may restrict movement

27
Q

when might you use delayed primary closure

A

close in 24-28 hours - too swollen initially or there is concern about infection

28
Q

methods of closure

A

steristrips
tissue adhesive
sutures
staples

29
Q

How long must sutures remain for the

1) Face and hands
2) Scalp
3) Trunk and limbs

A

1) 5 days
2) 7 days
3) 10-14 days

30
Q

What may need to consider with fight bites

A 
Infection 
Fracture 
Foreign body 
Hep B cover 
Secondary closure 
Antibiotic cover

4th year Block 3 (1 decks)

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