trauma trigger COPY USE THIS ONE

Question 1

mannitol is used for what

Answer 1

increased ICP

Question 2

open fx abx

Answer 2

rocephin

Question 3

ruptured abdominal viscus abx

Answer 3

unasyn or zosyn

Question 4

vaginal/rectal lacerations ABX

Answer 4

unasyn or zosyn

Question 5

why can children <6 mo old have respiratory failure with midface trauma?

Answer 5

they are obligate nasal breathers

Question 6

Initial approach to trauma patient acronym

Answer 6

S - s/s
A - allergies
M - medications
P - past medical hx
L - last oral intake
E - events leading up to presentation

Question 7

what is given to a trauma patient with hypotension

Answer 7

1 L NS bolus and 1L blood products

Question 8

If a child presents with blunt force trauma to the abdomen and you suspect they are bleeding out into their abdomen, what would you expect their vitals to look like?

Answer 8

normal BP with tachycardia

(this is supposed to be compensated shock from hemorrhage)

Question 9

what injury are infants/neonates at a higher risk for in trauma than other populations?

Answer 9

significant intracranial injury

Question 10

there are lower incidences of vertebral fractures in what population? why?

Answer 10

pediatric population

increased flexibility = decreased vertebral fractures

Question 11

intrathoracic injury without external signs of trauma are present in who? why?

Answer 11

peds, becuase chest wall is more compliant and not as protetive

Question 12

are rib fractures common in peds? why/why not? what might they suggest?

Answer 12

NO

sign of child abuse in the absence of a traumatic event. Especially if broken ribs are posterior. Ribs have increased compliance in pediatric patients, so unlikely to break w/o large force.

Question 13

indications for CT for abdominal and GU trauma

Answer 13

suspicious MOI
tenderness on exam (wtf? just from hannahs quizlet idk)
seat belt sign
distention
vomiting
>50 RBC on UA in blunt trauma

Question 14

what might an anterior ring pelvic fracture indicate

Answer 14

urethral or bladder injury

Question 15

what are s/s of impending brain herniation? what would you want to maintain during this time?

Answer 15

severe HA w vomiting
HTN w brady/tachycardia
papilledema
(from UTD, dont come at me)

maintain a PaCO2 of 30-35

Question 16

what should be obtained in almost every geriatric (65+ via google) head injury and C spine injury

Answer 16

CT brain - head injury
CT c spine - c spine injury

“liberal use of CT head” - HB quizlet

Question 17

what is the workup for a geriatric pt with abdominal trauma

Answer 17

stable = CT
untable or + FAST = OR

Question 18

MCC injury in geriatric population?

Answer 18

falls

Question 19

what complication is common in the geriatric population that should make you cautious of fluid rescucitation

Answer 19

fluid overload

Question 20

how much fluid volume can you lose before shock s/s are present

Answer 20

up to 30-35%

Question 21

why are pregnant patients at higher risk for hemorrhage during trauma

Answer 21

uterus displaces other organs so increased risk with any penetrating upper abdominal injury

Question 22

MCC of abdominal hemorrhage

Answer 22

spleen (im assuming rupture)

Question 23

MCC of pregnancy complications

Answer 23

prreterm labor and abruption of placenta

Question 24

who are coup-countercoup injuries more common in

Answer 24

elderly due to atrophy

Question 25

what is the difference between tx of fractures of the skull (lets say isolated and linear) that are depressed vs nondepressed

Answer 25

depressed - admission w neurosurgery consult and abx nondepressed - none

Question 26

what is a hemothorax? how would you DX and Tx it?

Answer 26

* blood in the pleural cavity * DX: FAST exam and CXR * Tx: thoracostomy

Question 27

How would you diagnose and tx a pneumothorax?

Answer 27

Dx: auscultate, CXR, eFAST, CT Tx: if small (<1.0cm and confined to upper chest) then none. if large = thoracostomy

Question 28

what type of rupture is an epidural hematoma vs a subdural hematoma

Answer 28

epidural = arterial (bleeds out FAST!!!!) subdural = venous

Question 29

LOC followed by lucidity followed by more LOC is associated with what ? what else might you find on exam?

Answer 29

epidural hematoma may see fixed & dilated pupil on side of lesion

Question 30

CT shows a biconvex lense in the temporal aspect of the skull

Answer 30

epidural hematoma

Question 31

brian atrophy puts pts at increased risk of what conditions

Answer 31

subdural hematoma and coup-countercoup injuries

Question 32

CT shows hyperdense lesion that crosses suture lines

Answer 32

subdural hematoma CT

Question 33

what should you keep MAP above in head trauma

Answer 33

80

Question 34

what would you give to a pt who is seizing after a head injury

Answer 34

IV lorazepam and fosphophenytoin

Question 35

what are the disposition plans for patients w head injury? (home criteria, ED criteria, Admit criteria)

Answer 35

* home w reliable caretaker - GCS 15 w normal CT and norm serial neuro exams * ED - GCS of 14 w normal CT * Admit - anyone w abnormal CT or GCS <14

Question 36

what is the NEXUS Criteria for C spine imaging

Answer 36

- AMS - midline cervical tenderness or step off - intoxication - neuro deficits - severe distracting injury

Question 37

when can you clinically clear C spine

Answer 37

- negative NEXUS scan - ROM greater than 45 degrees BIL w no pain

Question 38

if a patient has a cervical spine injury, what should you scan

Answer 38

the entire spine

Question 39

when can you clinically clear thoracic and lumbar spine

Answer 39

* negative NEXUS * assess sensation in all extremities * assess motor fxn in all extremities

Question 40

what is contained in the 2nd zone of the neck

Answer 40

mid carotid/vertebral arteries, jugular veins, esophagus, c spine larynx, and trachea. cricoid cartilage to angle of mandible

Question 41

what types of traumas do bowel injuries typically present with? How might a different type of trauma cause bowel injury?

Answer 41

typical - penetrating trauma different - decelerating trauma that causes mesenteric tear or blow out injury of the antimesenteric border.

Question 42

what type of trauma are duodenal injuries most associated with

Answer 42

high speed vertical or horizontal deceleration

Question 43

what type of trauma are pancreatic injuries most assocaited with

Answer 43

rapid deceleration or crush injuries

Question 44

tx of humerus fx

Answer 44

sling, splint, analgesia

Question 45

management of olecranon fx

Answer 45

long arm posterior splint w ortho fu

Question 46

management of radial head fx

Answer 46

sling and fu w ortho

Question 47

management of forearm fx

Answer 47

* nondisplaced - sugartong splint and ortho f/u * displaced: reduce and ortho f/u

Question 48

what are s/s of a hip fracture and how do you treat it

Answer 48

* grain pain and shortening of the affected leg * immobilize, pain control, inline traction, monitor for blood loss, ORIF

Question 49

manmagement of femoral shaft fractures

Answer 49

ORIF

Question 50

how fast does CPK rise post muscle injury? when does it peak

Answer 50

2-12 hours 1-3 days peak