Week 2 Trauma

Question 1

purpose of triage

Answer 1

categorizes patients based on:
(1) need for immediate care
(2) facilitate patient flow & avoid congestion
(3) initial assessment & history documentation

Question 2

P0

Answer 2

dead on arrival

Question 3

P1

Answer 3

critically ill

Question 4

P2

Answer 4

Major emergency

Question 5

P3

Answer 5

Minor emergency

Question 6

P1 patients

Answer 6

CVS / imminent collapse & needs immediate medical attention

Question 7

P2 patients

Answer 7

stable upon initial examination but patient unable to walk / in distress whose condition needs urgent but not immediate medical attention

Question 8

P3 patients

Answer 8

able to walk with mild / moderate symptoms that need early treatment

Question 9

Paramedic role

Answer 9

stabilize patient for txfr to hospital & provide details w/ initial assessment of patient

Question 10

importance of trauma radiography

Answer 10

• faster decision making
• fast, accurate & non-invasive diagnosis
• possibly higher cost
• leads to incidental findings

Question 11

diff types of trauma

Answer 11

1) blunt / non-penetrating
2) penetrating
3) thermal

Question 12

what is the issue with blunt trauma

Answer 12

extent of injuries are less obvious = more difficult to diagnose

Question 13

Trauma team role

Answer 13

1) identify & treat injuries
2) resuscitate patient
3) stabilize vital signs
4) determine extent of other injuries
5) prepare & transport patient to hospital

Question 14

ATLS

Answer 14

advanced trauma life support

Question 15

what is ATLS

Answer 15

framework to assess & treat patients with injuries & look for diagnosis

Question 16

what does ATLS aim to minimize

Answer 16

mortality & morbidity

Question 17

who can perform ATLS

Answer 17

only clinicians

Question 18

what is the earliest part of primary survey

Answer 18

mechanism of injury

Question 19

what do clinicians do for mechanism of injury

Answer 19

determine probability of serious injury, identify injuries & treatment plan

helps raise suspicion of other injuries which need further investigation

Question 20

ABCD of primary survey

Answer 20

Airway w/ spinal control
Breathing
Circulation
Disability

Question 21

when does secondary survey take place

Answer 21

after primary survey completed, resuscitation in progress, patient is hemodynamically stable

Question 22

what is tertiary survey

Answer 22

used to identify injuries within 24 hours of injury/admission

Question 23

what happens during tertiary survey

Answer 23

primary & secondary surveys repeated w/ all lab & imaging data reviewed

reduces missed injuries

done when patient moved out of resuscitation bay

Question 24

what is important in trauma

Answer 24

speed

Question 25

how should patients on spinal nursing be treated

Answer 25

use adaptive techniques with minimal movement of patient

if need to move, use log roll method to turn while maintaining spine alignment

Question 26

what views should you take for injuries

Answer 26

orthogonal views via horizontal beam / adaptive techniques / beam angulation

Question 27

what views should you take for FB

Answer 27

tangential views to demonstrate FB but reduce exposure settings

Question 28

purposes of imaging

Answer 28

scout
complement physical assessment findings
post initial treatment
pre admission

Question 29

factors influencing choice of imaging

Answer 29

• patient condition
• tissue / area exposed
• radiation exposure
• cost
• availability of modalities
• implants

Question 30

presence of air within pleural cavity

Answer 30

pneumothorax

Question 31

presence of air within mediastinum

Answer 31

pneumomediastinum

Question 32

presence of air within peritoneal cavity

Answer 32

pneumoperitoneum

Question 33

what are periprosthetic #

Answer 33

that occur in association with orthopedic implants

Question 34

what should imaging never interfere with

Answer 34

resuscitation or delay interventions

Question 35

when is reduction done

Answer 35

restore # / dislocation to correct alignment maintained by casts

Question 36

what are the main types of volvulus

Answer 36

sigmoid & caecal volvulus

Question 37

what is the danger of volvulus

Answer 37

part of colon twists on its mesentery & cuts off blood supply = bowel perforation & necrosis

Question 38

SBO small bowel dilation diameter

Answer 38

> 3 cm; paucity of colorectal gas

Question 39

LBO colonic dilation diameter & cecum diameter

Answer 39

> 6 cm; > 9 cm; relative paucity of rectal gas & proximal colonic faecal burden