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NB506 Trauma > Trauma Assessment and Managment > Flashcards

Trauma Assessment and Managment Flashcards

1
Q

Priorities in Scene Assessment

A
  • Danger
  • How many patients there are
  • Backup/additional recourses needed
  • Kinematics
  • Triage (dead dead or not)
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2
Q

Things that Effect Scene Safety

A
  • Chemicals/gas
  • Fire
  • Sharps on ground
  • Weapons/hostiles
  • Electricity
  • Traffic and weather conditions
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3
Q

Primary Survey

A

d anger
r esponse - AVPU

c atosrophic haemorrhage

A irway (c) - patent? open airway, maintain?, c spine considerations
B reathing - rate, effort, sound, colour, sats
C irculation - colour, other bleeding, pulses, CRT, BP
D isability - pupils and GCS
E xpose - completely expose for inuries, prevent hypothermia

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4
Q

Motor Response of GCS

A
  1. Obeys Command
  2. Localises to pain
  3. Withdraws from pain
  4. Flexion to pain
  5. Extension to pain
  6. No motor response
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5
Q

Verbal Response GCS

A
  1. Orientated
  2. Confused
  3. Inappropriate words
  4. Nonsensible sounds
  5. No verbal response
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6
Q

Eyes GCS

A
  1. Eyes open spontaneously
  2. Eyes open to speech
  3. Eyes open to pain
  4. Eyes not opening
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7
Q

Methods of External Haemmorhage Control (7)

A
  • Direct Pressure - pressure onto the bleeding site eg digital pressure
  • Indirect Pressure - not on site (needs to be practised with good A&P knowledge)
  • Wound Packing
  • Tourniquets
  • Haemostatic Dressing (celox) - prompts clotting (must be put into wound bed, don’t put into cavities as need definitive end point)
  • Elevation
  • Traction
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8
Q

Where are the 4 Spaces for Interal Haemorrhage?

A
  • Thoracic cavity
  • Abdomen
  • Pelvis - binding
  • Long bones - splinting
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9
Q

Secondary Survey (In Order)

A
  • ‘Smurf test’
  • Full set of obs
  • Access
  • Drugs/Fluids
  • History taking (AMPLE)
  • Pain management
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10
Q

What is an AMPLE History?

A

A llergies
M edications
P ast Medical history
L ast meal
E vents preceding injury

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11
Q

IPPA Assessment

A

Inspection - evaluate each region, observe for soft tissue injuries, deformities
Palpate - distension, pulses, crepitus, surgical emphysema, tenderness/pain
Percuss - chest injuries, hypo/hyperresonance
Auscultation - noisy breathing, equal air entry, adventitious sounds

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12
Q

List of Critical Patients

A
  • Inadequate or threatened airway
  • Impaired ventilation
  • Significant haemorrhage (external or suspected internal)
  • Abnormal neurological status
  • Penetrating trauma to the head, neck or torso
  • Amputation/near amputation
  • Trauma in presence of other significant findings
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13
Q

General Treatment Principles in Trauma

A
  • ‘treat as you go’ philosophy
  • Focus on life-threatening issues then rapid transfer
  • Limited on scene time to 10 minutes (if possible)
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14
Q

Fluid Resuscitation Procedure

A
  • Sodium chloride solution (with caution)
  • Two large bore cannulas (14-16 gauge)
  • En route procedures
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15
Q

When to give Fluids and When not to

A
  • if 90 or over NO fluids
  • If talking then NO fluids
  • Too much fluids being given will reduce clotting capabilities
  • Think permissible hypotension
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16
Q

Pain Releif Options and Cautions

A
  • Only done after primary survey
  • Use pain management ladder
  • IVP
  • Morphine - be cautious as it will cause vasodilation (drop of up to 10 systolic)
  • Entonox - careful of head/chest injuries
  • Penthrox
  • Ketamine (CCP)
  • Positional Relief eg splinting a mid shaft-femur fracture
17
Q

ATMIST Handover

A
  • A ge
  • T ime of incident/of arrival
  • M echanism of Injury
  • I njuries suspected/seen
  • S igns (obs)
  • T reatment given
18
Q

COMA

A

A good acronym for the second crew or second crewmate as useful tasks to do while another clinician is doing primary survey

C - clothes off
O - oxygen on (high flow)
M - monitoring
A - access

19
Q

What Looking for In Top to Toe: Scalp

A
  • Lacs to scalp can bleed a lot and will require a dressing
  • Boggy mass indicates head trauma and possible head injury
20
Q

What Looking for In Top to Toe: Face

A
  • Look for facial fractures
  • Battle sign and raccoon eyes are characteristic of facial fractures
  • Each classification creates different airway problems, sometimes due to haemorrhage where blood enters the airways or a fragment collapsing backwards into the pharynx
  • Look for any CSF leaking out of the ears (TBI)
21
Q

What Looking for In Top to Toe: Neck

A
  • Feel down bony structures of neck
  • Any penetrating trauma
  • Deviated trachea
22
Q

What Looking for In Top to Toe: Abdomen

A
  • See if distended/hard
  • Look for bruising and wounds
23
Q

What Looking for In Top to Toe: Pelvis

A
  • Does the pelvis shift and have little structure
  • Is it equal on both sides? can tell by positioning of iliac crest
24
Q

What Looking for In Top to Toe: Limbs

A
  • Feel for open or closed fractures
  • Any other bleeding wounds
  • Check gloves for blood systematically
  • Do pay attention to hands and feet to note any potential life changing injuries

NB506 Trauma (12 decks)

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