Flashcards in Trauma Deck (37):
Most Dangerous GSW
RIFLE- highest velocity/most important dynamic variable then Trajectory, then MASS
Pulse-most important-lose pulse everything goes else goes to shit
Pulse distall to the injury? No pulse-manipulate/rotate to regain pulse
with a pulse- splint in place
severe blunt forced to chest, difficulty breathing-BIG S/S-diminished/absent LS
pos-hypotension, JVD, Trake Deviation to opposite side of injury (don't rely on this sign as its a late sign)
All the same thing-
Decompress 2nd intercostal space superior to the 3rd rib mid clavicular or 5-6 intercostal space mid axillary
Cushings Triad (3 elements)
HYPERTENSION-with widening pulse pressures- systolic & diastolic get further apart
Direct injury from blunt trauma-ie getting hit in the head with a bat
Injury behind the initial blunt trauma- being slammed up against a wall after explosion
Worst bleed:buildup of blood occurs between the dura mater (the tough outer membrane of the central nervous system) and the skull
Layers of the Head
Skin, Periosteum, Bone, Dura Mater, Arachnoid, Pia Mater
Slowest onset, headache that gets progressively worse, slow venous bleed
confused ALOC, n/V, photophobia, Repetitive Questioning(Dead Giveaway), need eval to make sure
Pneumatic Anti S.G. Indications/Contra
Indication Abdominal Bleed or pelvic fracture stabilization. Contra-impaled object to abdomen or chest, 3rd trimester (ABSOLUTE)
or suspect cardiogenic shock or P.E.
Primary Blast Injury
Primary-Hollow organs-initial blast, collapses hollow organs
Secondary Blast Injury
Shrapnel and fling objects
Tertiary Blast Injury
Injury from being thrown or hitting the ground and wall or objects
Rule of Nines and Palms, Parkland Formula
When do you use a dry sterile dressing?
Large % burns use a dry sterile. Usually over 25% BSA
First 8 Hours?
BSA burned % x KG x 4mL /2 gives you the first 8 hours. Divide that by 8 will give you the first hour. Don't divide the original number by 2 and you get the first 24 hours
1st degree - sunburn
Partial Thickness Burn
2nd degree- the moment blisters form its a 2nd degree
Full Thickness Burn
3rd degree burns
Brown Sequard Syndrome
Incomplete spinal cord lesion often in the cervical region. Ipsilateral-deficits occur on the same side as the injury. Hemispherical. Contralateral loss of pain, and temperature sensation.
Burn Worries and Order of oh Shit!
Any break in cervical cord region...
expect respiratory compromise
marks beginning of the Thorasic Region. Bony bone sticking out on back of neck above shoulders
Leforte Fracture I
Just below the nose and affects the pallete. Most dangerous because of airway implications.
Le Forte fracture II
Top of the nose with a downward arch ending in the mouth
Le Forte Fracture III
Top of the nose and extends around eyes ending in the jaw area by the ear
Rhabdomyalisis -breakdown of the muscle fibers cause a release of myoglobin into blood stream causing metabolic acidosis aka lactic acid buildup causing an THROMBIS of EMBOLIS, TX is sodium bicarb.
if a pt has a 360 degree circumferential burn blister put pressure on muscles and tissue. Definitive TX is a FASHIOTEMY by a DR ONLY. My TX is PUHA
WHEN TO C-SPINE
Any patient with a loss of conciousness, and of head, neck or back pain