Week 6 Flashcards
(24 cards)
What are we assessing for disability?
- disability
- Assess conscious level = AVPU or GCS
- Pupillary response
What are we assessing for in exposure and environment?
we need to expose our pt and look for: -needle marks -wounds -abrasions -anything else For environment we would be assessing the pt's temp control
The Glasgow Coma Scale is used to assess the level of consciousness. This is separated into 3 parts what are they?
- eye opening = 4
- verbal response =5
- motor response = 6
List the responses for eye opening and there values.
4= spontaneous-pt opens eye's spontaneously 3= to voice - pt opens eyes to command 2 = to pain stimulus = pinch trapezius muscle 1= no response
List the responses for verbal response and their numerical values.
5= orientated - pt can give name, address and day of week 4= confused - pt knows name but less likely to know day of week 3= inappropriate words- inconsistent answers, profanity, repeats same words over and over 2= incomprehensible sounds -may have to be intubated. 1= no response
List the responses for motor response and their numerical values.
6 = obeys commands - obeys complex commands
5= localises pain - pt localizes source of pain
4= withdraw pain = pt knows there is pain but can’t localize it
3=abnormal flexion (decorticate)
2= abnormal extension= decerebrate
1= no response
What does decorticate posturing indicate?
Indicates that there may be damage to areas including the cerebral hemispheres, the internal capsule, and the thalamus
-it is an ominous sign of severe brain damage, and may also indicate lesion(s) in the lower brainstem.
What does decerebrate posture indicate?
Indicates that there are lesions or compression in the midbrain lesions in the cerebellum
If it is a progression from decorticate to decerebrate posturing is often indicative of tonsil are brain herniation.
List what we would be assessing for in a primary survey of a pt who has presented with trauma.
- Airway + c-spine
- Breathing
- circulation and haemorrhage control
- disability
- exposure
- Fahrenheit
- prevention of further compromise or complications
What are we doing on a secondary survey?
- head to toe assessment
- finger and tubes in every hole
what are we doing on a tertiary survey of the pt?
- identifying injuries that have not yet been detected
- full head to toe assessment
- assessing the initial response to treatment and plan assessment and management strategies for future care.
what is the golden hour?
it is the belief that trauma pt’s have better outcomes if provided definitive care within 60 minutes of injury
What does FAST mneumonic stand for and what is it used for?
Focused Assessment with Sonography for Trauma
- used as part of secondary assessment
- used to determine if free fluid is present in the abdominal cavity
what is hypothermia?
a core temperature that is below 35*C
what is coagulopathy?
it is a term used for a group of conditions in which there is a problem with the process of blood clotting
what is a flail chest?
it is when fractures to 2 or more ribs occur in 2 or more places
what is a pneumothorax?
an accumulation of air in the pleural space
what is the management for a pt with chest trauma?
- pt positioning = early mobilisation is vital to prevent complications
- pain relief - IV opioids or NSAID
- surgical intervention if required
- chest drain - monitoring and management
- ventilatory support - airway and breathing management
- allied health interventions - physio, OT
what pt management are should we performing on a pt with abdominal therapy?
- monitoring for deterioration is essential
- pain management
- vital sign monitoring
- post op care = discuss feeding and bowel care to avoid adverse events
Clinical manifestations of penetrating trauma can be divided into 2 broad types. What are they?
- Conspicious = the penetrating article is grossly visible
- Inconspicious = the penetrating article is not immediately visible and may only become apparent during the systematic trauma assessment
what is the trauma triad?
when a critically ill pt can experience hypothermia, acidosis and coagulopathy.
List 2 types of trauma
- blunt
- penetrating
What does RIPPA stand for in the primary survey?
It is used in the breathing category and stands for: R-respiration rate I-inspection P-palpitation P-percussion A-auscultation
List some potentially life threatening chest injuries.
- airway obstructions
- tension pneumothorax
- massive haemothorax
- cardiac temponade
- flail chest
- open pneumothorax
