Trauma Study Guide

Question 1

Define Trauma:

Answer 1

Trauma is defined as a severe injury or damage to the body caused by an accident or violence

Question 2

What are some causes of traumatic events?

Answer 2

Blunt, penetrating, explosive, and thermal forces are common causes of traumatic injuries

Question 3

What type of equipment is most commonly utilized for trauma radiography, especially in the ER?

Answer 3

mobile radiography

Question 4

What types of devices may need to be utilized to obtain images in trauma situations?

Answer 4

portables, mobile fluoroscopy units, or C arms. immobilization devices.

Question 5

What are the primary responsibilities of the RT (R )?

Answer 5

Perform quality diagnostic imaging procedures, practice ethical radiation protection, and provide patient care

Question 6

What are examples of status changes in a trauma patient?

Answer 6

Cool clammy skin-shock
Excessive sweating- shock
Slurred speech- head injury, stroke, drug or ethanol influence
Agitation or confusion-head injury, drug or ethanol influence
vomiting w/o abdomen complaints-head injury, hyperglycemia, drug, or ethanol overdose
loss of consciousness- shock, head injury, hyperglycemia

Question 7

How would you assess status changes and how do you react to them when they occur?

Answer 7

Visual inspection and verbal questioning enable the radiographer to determine whether the status of the pt changes during the procedure. –Depending what the severity of the change is you need to report it to the physician. Always chart things

Question 8

Speed, Accuracy and Quality are important. Define each of these

Answer 8

Speed-efficiency in producing quality images in the shortest possible time
Accuracy- optimum image quality/minimum repeats
Quality-quality cannot be sacrificed for speed. Do not use patient condition as an excuse for poor quality images

Question 9

Be able to assess a given situation and describe how you would obtain the images. You may have to review prior lessons!!!

Answer 9

page 33

Question 10

Why should you practice standard precautions?

Answer 10

you’ll be exposed to bodily fluids in the ER

Question 11

What is the rule of thumb when it comes to immobilization devices that are on the patient when they get to your department?

Answer 11

do not remove immobilization devices without physician’s orders

Question 12

How do you communicate with trauma patients? What if they are unconscious?

Answer 12

Talk to your patient. Explain hat you’re doing to reduce anxiety. Be reassuring with your body language and make eye contact. If unconscious don’t assume they cannot hear you.

Question 13

What do you do if you have a patient with a gunshot wound?

Answer 13

mark entrance and exit wound

Question 14

What type of exposure time is good for trauma cases? Why?

Answer 14

use short exposure times to eliminate possibility of imaging motion

Question 15

What type of exposure time is good for trauma cases? Why?

Answer 15

If you change your protocol for whatever reason.. Such as doing images or replacing an image with another

Question 16

a. You hear a page overhead to come to Trauma 1. Once you get to the ER the ER Doctor tells you that you have a multiple patient MVA on the way and there are at least 3 people. One adult and two children. The paramedics are concerned about head injuries on the 2 patients that were in the front seat. The one in the back seems to be okay, but is a younger child (18 months old) so they cannot get him to do anything but cry. The doctor has ordered AP chests on all 3 people. AP/Lateral Skulls on the 2 in the front seat. AP/Lateral C-spine on the 2 in the front seat. Explain how you will complete the exams on the patients, upon arrival:
Patient 1: 36 years old, on a back board, wearing a C-collar

Patient 2: 8 years old, on a back board, wearing a C-collar

Patient 3: 18 months old, carry patient, no immobilization devices

Answer 16

Patient 1: 36 years old, on a back board, wearing a C-collar
AP chest place IR under backboard angle tube caudal however much is necessary, take on inspiration.
AP skull- do AP axial angle tube caudal 30
AP cspine- ir underboard 15-20 cepallic. Lateral do cross table
Patient 2: 8 years old, on a back board, wearing a C-collar
Same positioning as the first but lower techniques and shield gonads
Patient 3: 18 months old, carry patient, no immobilization devices
have another worker hold the pt arms out of the way or use a blanket to immobilize. Use a small IR and low technique

Question 17

b. A patient fell off of his roof while working. He landed on his feet in a pile of rubble. He has drove his self to the ER and is having severe foot pain especially in the heel region. The doctor orders a foot series bilateral and a calcaneous. You get started doing the calcaneous and he cannot flex his foot all the way, how are you going to get the image?

Answer 17

angle to compensate for the lack of angle on the foot

Question 18

What other modalities might be used in trauma situations?

Answer 18

CT, mobile radiography, mobile fluoroscopy, statscan systems

Question 19

What type of positioning aids might help a radiographer in a trauma situation?

Answer 19

Sponges, sandbags, and the creative use of tape

Question 20

Which of the following would absorb more radiation and therefore require higher technical factors, internal bleeding or bowel obstruction?

Answer 20

internal bleeding

Question 21

When localizing a foreign object you should mark what 2 point?

Answer 21

entrance and exit

Question 22

What types of things can you do to maintain radiation protection during trauma radiography?

Answer 22

close collimation
gonad shielding
lead aprons for all personnel
exposure factors that minimize pt dose
announcement of impending exposure

Question 23

Study table 13-1!!! Be able to describe what symptoms you will see with shock, head injury, drug /alcohol influence, airway compromise, Circulatory compromise, spinal cord/nerve damage, hip fracture, and internal bleeding from a pelvic fracture/organ laceration.

Answer 23

PG 29
shock- cool skin, excessive sweating, increased drowsiness, loss of consciousness, thirst
head injury-slurred speech, agitation or confusion, vomiting w/o abdominal complaint, increase drowsiness, loss of consciousness, seizures
drug/alcohol- slurred speech, agitation or confusion, vomiting
airway compromise- pale or bluish skin
circulatory compromise-bluish nail beds
spinal cord/nerve damage- complaints of tingling or numbness, unable to move area, or not able to feel your touch
hip fx- extreme eversion of the foot
internal bleeding-increasing abdominal distension and firmness to palpation

Question 24

What is hypovolemic/hemorrhagic shock?

Answer 24

A medical condition in which there are abnormally low levels of blood plasma in the body such that the body cannot properly maintain blood pressure, cardiac output of blood, and normal amounts of fluid in the tissues. Most common type is shock.

Question 25

What is vasovagal reaction?

Answer 25

Vasovagal attack, situational syncope, and vasovagal syncope. It is a reflex of the involuntary nervous system or a normal physiologic response to emotional stress. Patients may complain of nausea, feeling flushed (warm), and feeling light headed. They may appear pale before they lose consciousness for several seconds.

Question 26

You should never assume the patient cannot what?

Answer 26

hear

Question 27

shock

Answer 27

cool skin, excessive sweating, increased drowsiness, loss of consciousness, thirst

Question 28

head injury

Answer 28

slurred speech, agitation or confusion, vomiting w/o abdominal complaint, increase drowsiness, loss of consciousness, seizures

Question 29

drug/alcohol-

Answer 29

slurred speech, agitation or confusion, vomiting

Question 30

airway compromise-

Answer 30

pale or bluish skin

Question 31

circulatory compromise-

Answer 31

bluish nail beds

Question 32

internal bleeding from pelvic fracture or organ laceration

Answer 32

increasing abdominal distension and firmness to palpation

Question 33

hip fracture

Answer 33

extreme eversion of the foot

Question 34

spinal cord/nerve damage

Answer 34

complaints of tingling or numbness, unable to move area, or not able to feel your touch