Triage and Trauma Flashcards
What are some classical signs of shock?
Tachycardia, Prolonged CRT, Elevated lactate, pale mm, tachypnea, low SPO2
What is the order of priority in Triage?
Respiratory System Cardiovascular System Neurological System Abdominal Organs Musculoskeletal System Integumentary System
What are two things you need to check in the respiratory system in trauma?
Airway - ET or Tracheostomy
Breathing
Three most common respiratory injuries?
Pulmonary contusions (bruises)
Pneumothorax
Rib fractures
Radiographs are indicated if you have a thoracic trauma case, How do pulmonary contusions show up on a radiograph?
Appears as an infiltrate, no anatomical pattern, may take up to 12 hours to show pathology radiographically. So if they are clinical and nothing else explains it - its probably a pulmonary contusion
If you can’t radiograph a suspected pneumothorax, what else can you do that is diagnostic and therapeutic?
Thoracocentesis of both sides of the chest
What is the biggest obstacle to treatment of rib fractures in trauma cases?
Pain inhibits breathing but they need to be hemodynamically stable before being given analgesics
If a dog with rib fractures comes in with shock, what is the first step?
Fluid resuscitation 1/4 shock dose before analgesia
What type of fluid do you give for a shock patient with pulmonary contusions?
To avoid pulmonary edema: Isotonic crystalloids but use 1/2 shock dose and you can bolus colloids or hypertonic saline if needed
Shock dose protocol for internally hemorrhaging patients?
Do 1/4 shock dose with isotonic fluids over 30 mins, monitor bp and stop when it is stable at 90 bp
What type of neurological problem do you need to immediately immobilize the patient?
Spinal cord injuries
What are some signs that there may be abdominal injuries in a patient?
Perioneal penetration Unexplained shock Organ evisceration Free gas on rads Bacteria or debris on abdominal tap
What is the preferred means of confirming abdominal injury with trauma patients?
Abdominocentesis
What does it mean if the tap fluid pcv is greater than the peripheral pcv?
Laceration and internal hemorrhage is likely. Medical management has lower morbidity and mortality than surgery.
How can you determine if you have a uroabdomen with out the use of a radiograph?
Abdominocentesis and the pcv is lower than peripheral blood. You place this fluid on an AZOSTIX and compare BUN to peripheral blood. Easy uroabdomen diagnosis.
What type of fractures can result in 25% blood loss?
Femoral and Pelvic fractures. These may need blood transfusions and surgery to stop the bleeding. But definitive fracture repair is usually delayed until patient is stable (1 - 5 days)
What is one key to successful traumas?
Reassessing our trauma patients continually, things can change very quickly.
