Trauma Management (19) Flashcards
Dr. Thompson (42 cards)
What is involved in a primary survey of a trauma case?
- rapid assessment for life-threatening problems
- target critical organs by priority
- 2 minutes or less
What should you assess initially on a trauma patient?
- level of consciousness, attitude, behavior
- unusual activity
- unusual body or limb postures
What is the old method for initial assessment?
ABC
Airway
Breathing
Circulation
Neurologic
Wounds
What is apoptosis?
the natural process of old cells dying and being replaced by new ones
What is necrosis?
toxins, radiation, heat, trauma, lack of oxygen due to the interruption of blood flow
What do the ABCs have in common?
all pertain to red blood cells
How are red blood cells lost in trauma?
hemorrhage
compressible
non compressible
What is the new acronym for initial assessment?
M^2ARCH^2E
What are the Ms for M^2ARCH^2E?
massive hemorrhage and muzzle
What are the Hs for M^2ARCH^2E?
head injury and hypothermia
Name all of the M^2ARCH^2E
How do you deal with massive hemorrhage?
pressure!!!!
stop significant bleeding - [pressure, tourniquet, hemostatic dressings
What are the types of tourniquets?
C-A-TL Combat Application Tourniquet
SOF-T SPecial Operations Forces Tourniquet
What are the hemostatic bandages?
- combat gauze
- chitogauze
- hemcon
How do you assess the airway?
- check for patent airway: abnormal sounds, deformity
- restrain!
- reposition jaw, tongue, head/neck if needed
- clear airway of objects, blood
- listen for labored and noisy breathing
- feel the throat area and trachea in the front-center part of the neck
What is this assessing?
feeling for something blocking the airway
look for masses, wounds, swelling, or deformities that may cause airway obstruction
When you open the mouth to assess airway, what should you do?
examine the inside as far back into the throat area as possible to look for:
- masses
- foreign objects
- swelling
- deformities that may cause airway obstruction
What is the 2-finger sweep?
sweep vomit, blood clots, foreign objects from the mouth to clear the airway of obstructions
How do you remove?
pull tongue straight out between lower canine and gently pull bone up from chin to dislodge
How do you perform a tube tracheotomy?
make a transverse incision through the annular ligament between the 3rd and fourth (or fourth and fifth) tracheal cartilages
What should you not do during a tube tracheotomy?
do not extend the incision around more than half the circumference of the trachea
After incising the annular ligament, what is next?
facilitate tube placement by depressing the proximal cartilages with a hemostat
After depressing the proximal cartilages with a hemostat, what is next in a tube tracheotomy?
elevate the distal cartilages with an encircling suture
insert a tracheostomy tube that does not completely fill the lumen
What are the last steps to a tube tracheotomy?
appose the sternohyoid muscles, SQ tissue, and skin cranial and caudal to the tube
secure the tube by tying it with gauze or umbilical tape around the neck
