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Flashcards in trauma Deck (33):
1

All patients with blunt trauma require cervical spine immobilization

Yes

2

most common indication for intubation

altered mental status

3

What is the indication of emergent tracheostomy

laryngotracheal separation or laryngeal fractures

4

Treatment of flail chest with underlying pulmonary contusion

require presumptive intubation and mechanical ventilation

5

treatment of tension pneumothorax

CTT

6

treatment of open pneumothorax

closure of pneumothorax and CTT

7

What is the direction of insertion of a CTT

directed superiorly and posteriorly
36F Chest tube

8

where is the incision of a CTT

4th - 5th ICS MAL

9

pressure of carotid pulse

60 mmHG

10

pressure of femoral pulse

70 mmHg

11

pressure of radial pulse

80 mmHg

12

Definition of massive hemothorax

1. >1500 ml blood loss
2. 1/3 of blood volume in pediatrics

13

what is the incision on emergency department thoracotomy

left anterolateral thoracotomy

14

Indication of emergency department thoracotomy

1. witnessed penetrating trauma with < 15 mins of prehospital CPR
2. witnessed blunt trauma with < 5 mins of prehospital cpr

Persistent severe post injury hypotension BP <60 mmHg
3. cardiac tamponade
4. hemorrhage
5. air embolism

15

Layers of the body passed by CTT

1. skin
2. suuperficial fascia
3. serratus anterior
4. external intercostal
5. internal intercostal
6. innermost intercostals
7. endothoracic fascia
7. parietal pleura

16

What is the most common cause of cardiogenic shock in a trauma patient

tension pneumothorax

17

Areas in the body in performing physical exam that needs special attention

1. axilla
2. back
3. perineum

18

The big three radiographs in BLUNT trauma

1. lateral cervical spine
2. chest
3. pelvic

19

Radiograph for truncal gunshot wound

1. anteroposterior and lateral chest and abdomen

20

Target INR and PTT of trauma patients

INR < 1.5
PTT < 45 seconds

21

What are the zones of the neck?

zone 1 - up to the level of cricoid
zone 2 - cricoid up to the angle of mandible
zone 3 - above the mandible

22

What is the 5 plain radiograph views of the cervical spine

1. lateral
2. anteroposterior
3. transoral odontoid
4. bilateral oblique views

23

Treatment of penetrating neck injury that is asymptomatic

zone I
-CT scan neck and chest, CTA esophagogram, bronchoscopy
zone II
a.transcervical GSW - like zone 1
b. all others - observe
zone III
-observe

24

Treatment of penetrating neck injury that is symptomatic, stable

zone I
-CT scan neck and chest, CTA esophagogram, bronchoscopy
zone II
a. operative exploration
zone III
-angiography - Interventional radiography embolization

25

Treatment of GSW/Stab wound in the abdomen of stable patient

A. GSW
1. Anterior abdomen - explore lap
2. RUQ, tangential, back or flank - CT scan

B. Stab wound
1. back, flank - CT scan
2. AASW + LWE - DPL, CT or Serial Exam

26

Positive Result of DPL

1. WBC > 500 ml
2. Amylase > 19
3. ALP > 2
4. Bilirubin >0.01

5. RBC
a. AASW > 100,000
b. Thoraco abdominal >10,000

if between 1,000 - 10,000 do laparoscopy or thoracoscopy

27

Areas of FAST

1. subxiphoid
2. morison's pouch/ hepatorenal recess
3. LUQ/ perisplenic
4. pelvis

>250 ml blood

28

What age is cricothyroidotoy is contraindicated

< 8 years old can cause subglottic stenosis

29

What is the immediate management of air embolism

Trendelenberg position to trap air in the left ventricle

30

What is the blood loss of a rib fracture

100 to 200 ml

31

What is the blood loss of a pelvic fracture

>1000 ml

32

What is the blood loss of a tibial fracture

300 to 500 ml

33

What is the blood loss of a femur fracture

800 to 1000 ml