Trauma Flashcards
primary survey involves
A Airway & C-spine protection B Breathing & Ventilation C Circulation w/ Hemorrhage control D Disability/Neurologic status E Exposure/Environmental control
how to monitor breathing
Inspect for symmetrical chest movements. Auscultate for breath sounds bilaterally. Palpate the trachea for deviation and the chest wall for fractures or emphysema
segment of the rib cage breaks under extreme stress and becomes detached from the rest of the chestwall and moves independently
flail chest
where to do a needle decompression
2nd ICP MCL
universal blood
O-
any hypotensive trauma pt think
hemorrhagic shock
GCS EYE
4-opens spontaneously
3-opens to speech
2-open to pain
1-none
GCS VERBAL
5-oriented 4-confused 3-inappropriate 2-incomprehensible/mumbling 1-none
GCS MOTOR
6-obeys commands 5-moves to pain 4-moves away from pain 3-abnormal flexion 2-abnormal extension (decerebrate) 1-none
two parts of an organ accelerate or decelerate at different rates.
shear
what vessels can be injured in the scalp?
middle meningeal artery or dural sinus
CSF leak
Raccoon Eyes
Battle’s Sign
basilar skull fracture
how to tx closed, uncomplicated skull fx
Symptomatic management
Observation for 2-3 days
No need for Antibiotics
how to tx basilar skull fx
Single dose antibiotic prophylaxis
Do not pack nose or ears to stop CSF leaking (danger of meningitis)
Put patient in semi-sitting position
ICP range
10 mm Hg = Normal
>20 mm Hg = Abnormal
>40 mm Hg = Severe
epidural hematoma
Blood btw skull & dura
Classic: Tear of middle meningeal artery
subdural hematoma
Tears to bridging vessels of cerebral cortex
Rapid surgical evacuation recommended, especially if > 5 mm shift of midline
how to dx SAH
blood in CSF
diffuse axonal injury
CT may initially be normal
seen in high velocity impact
No gross pathology. Transient LOC. CT Scan is normal
concussion
Bruising of brain surface underneath a fracture or at under-surface of frontal & temporal lobes, due to shearing forces Seen on CT scan
contusion
Tearing of brain substance. Seen on CT Scan
laceration
localized in glial cells, myelin sheaths & intercellular spaces. May cause ICP
**May not be seen initially on CT scan.
brain edema
severe brain injury GCS score
moderare
mild
3-8
9-12
13-15
