Flashcards in Trauma pt eval Deck (37):
Most common causes of Trauma Mortality?
CNS injury (1/2)
Exacerbating factors in Trauma Mortality? (3)
Low Glascow Coma rating
Immediate death from Trauma U result of? (4)
(death at scene)
Major body cavity
Early death from trauma U result of?
(w/i 4 hrs of injury)
CV or pulmonary collapse
Late death from trauma U result of?
(days to wks post)
Level I Trauma Center provides?
24 hr in-house surgeons + promptly available specialists
Level II Trauma Center provides?
Initiates definitive care
24 hr surgeon + specialty except for cardiac or microvascular surgery, dialysis
Level III Trauma Center provides?
Assessment, resuscitation, stabilization, intensive care
24 hr ER docs and general surgeons
Level IV Trauma Center provides?
Advanced traumatic life support prep for transfer
24 hr ED and labs
Level V Trauma Center provides?
Eval, stabilization, diagnostics, prep for transport
After hr protocols
ATLS includes? (4)
1) initial eval
Initial Eval of trauma includes? (4)
Identification of life-threat injury
Rapid organization of definitive care or transfer
Primary Eval must assess and address?
End-organs are? (4)
Airway management includes? (5)
1) Assess conscious pt (w/ question)
2) Protect airway/cervical spine of unconscious pt
3) Observe (signs of difficulty)
4) Inspect mouth/throat (obstacles)
5) Inspect/palp anterior neck
Tracheal Intubation used to?
Endotracheal tube passed b/w vocal cords,
Requires direct visualization of cords,
Tube tip placed 1/2 b/w clavicle and carnia (trach spit into bronchi)
insertion of tube thru incision in cricothyroid membrane
Breathing/Ventilation management includes? (6)
2) Chest wall inspection (asymm/paradox mvmt)
3) Auscultate (apices and axillae)
4) Palpate (crepitus/deformity)
5) CXR for unstable pt
6) r/o pneuom/hemothorax, tamponade
Treatment when signs of pneumothorax?
hypoTN, dyspnea, ipsilateral ↓ breath sounds
2nd ICS @ MCL
5th ICS @ MAL
immediately follows needle decomp
5th ICS, MAL
Vent treatment when unstable pt?
Circulation management includes? (5)
1) Palpate central pulses (carotid/femoral)
2) Observe for external hemorr
3) Place IV catheters
4) Blood typing
5) Determining exact BP not necessary
Arterial Hemorrhage management?
Venous hemorrhage management?
Tx for pts w/o central pulse?
Disability/Neuro management includes? (4)
1) Eval level of consciousness / Mental status
2) Pupil size, symm, light response
Exposure/Environment Control includes?
1) Visualize entire body
If pt is hemodynamically unstable, next step after primary survey?
Skip 2° survey
Send right to angio or major trauma center
2° Survey in trauma includes? (3)
Head to toe exam (fingers and tubes in every hole)
Detailed hx (of traumatic event and of pt's medical hx)
Common Misses in trauma:
Blunt abd trauma:
Penetrating abd trauma:
rectal or urethral
2° Survey: C-Spine management
Clear (no x-ray needed) if:
no distracting injury
If can't clear, do CT
*neg CT AND tenderness, still cannot clear
2° Survey: Tube considerations?
blood at meatus
mid face fractures
2° Survey: Abdomen?
Diagnostic Peritoneal Lavage
Most frequently injured organ w/ penetrating trauma?
Most frequently injured organ w/ blunt abd trauma in adults?
What vaccines recommended w/ loss of spleen?
Common result of splenectomy?