Truama

Question 1

RTA and free air

Answer 1

The DJ flexure is the commonest site of injury in deceleration accidents, followed by the terminal ileum. Repair of the former injury is often technically challenging.

Question 2

Damage to which area of the scalp has greatest risk of spread to CNS

Answer 2

Loose areoles Tissue

This area is most dangerous as infections can spread easily. The emissary veins that drain this area may allow sepsis to spread to the cranial cavity.

Question 3

Cushing reflex

Answer 3

Hypertension and bradycardia

Question 4

What percentage of pancreatic duct disruptions are due to penatrating trauma

Answer 4

70%

Question 5

Transfusion in major trauma

Answer 5

There is strong evidence to support the use of haemostatic transfusion in the setting of major haemorrhage due to trauma. This advocates the use of 1:1:1 ratios.

Question 6

End points for trauma transfusion

Answer 6

The typical therapeutic end points include:
• Hb: 8-10 g/di
• Platelets s1 100
• PT&APTT (INR) < 1.5
• Fibrinogen > 1.0 g/I
• Ca?+ > 1 mmol/i
• рн: 7.35-7.45
• BE: +/- 2
• T greater than 36°C

Question 7

Pancreatic trauma

Answer 7

Duct disruption - laparotomy
Distal - resect
Proximal - drains