Trauma Flashcards

1
Q

S/S of Tension Pneumothorax

A

Tracheal Shift (Late on external exam, early on radiographic)
Decreased / Absent lung sounds
JVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Treatment of Tension Pneumothorax

A
Needle thoracostomy (2nd ICS mid-axillary, 4th-5th Mid-axillary)
Tube thoracostomy (5th ICS Anterior Axillary)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

S/S of Hemothorax

A

Midline Trachea
Decreased / Absent breath sounds
Hypovolemic shock
Flat neck veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Treatment of Hemothorax

A

Tube thoracostomy (5th ICS Anterior Axillary)
Crystalloid / Blood replacement
Intubate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

S/S Open Pneumothorax

A

Sucking chest wound
Respiratory distress
Tachypnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatment of Open Pneumothorax

A

Occlusive dressing upon end exhalation

Taped 3 sides until chest tube placement, then 4th

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

S/S Flail Chest

A

Paradoxical movement
Respiratory distress
Chest pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Treatment of Flail Chest

A

Attempt to stabilize flail chest segment
Injured side down
Limit fluids if available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

S/S Early Cardiac Tamponade

A
Pulsus Paradoxus (Quality of pulse changes with respirations)
Sinus Tachycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Treatment of Early Cardiac Tamponade

A
Force Fluids (Increase preload)
Anticipate Tamponade progression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

S/S Late Cardiac Tamponade

A

Beck’s Triad (Muffled heart tones, JVD, Narrowed Pulse Pressure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Treatment of Late Cardiac Tamponade

A

Pericardiocentesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

S/S Aortic Rupture

A

Harsh systolic murmur
CXR findings of widened mediastinum
Chest / mid-scapular pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Treatment of Aortic Rupture

A

If caval or liver laceration suspected, establish IV access above and below diaphragm
Rapid transport to surgeon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

S/S Diaphragmatic Rupture

A

Bowel sounds in chest

Scaphoid abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment of Diaphragmatic Rupture

A

NG/OG
NPO
Intubate / PPV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

S/S of Tracheobronchial Disruption

A

Continuous air leak or persistent pneumothorax
Rapidly progressing subcutaneous emphysema
Pneumomediastinum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Treatment of Tracheobronchial Disruption

A

Supportive

Consider mainstem intubation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

S/S of Esophageal Perforation

A

Hematemesis
Dysphagia
Dyspnea
Shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Treatment of Esophageal Perforation

A

NG/OG
Antibiotics
Antiemetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Newton’s 1st law

A

Object in motion remains in motion, object at rest stays at rest, unless an outside force acts upon it.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Newton’s 2nd law

A

F=MA (Force = Mass x Acceleration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Newton’s 3rd law

A

Every action has an equal and opposite reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Head-on Collison:

Up and Over pattern

A

Head, neck, chest, pelvis injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Head-on Collison:

Down and Under pattern

A

Knee’s, femur, pelvis, lower back, chest, facial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Rear-end Collision injuries

A

T12-L1 back injuries
C2 fracture of neck
Evaluate for 2nd impact injury patterns (hitting steering wheel)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

T-bone or lateral Collison injuries

A

Look for injuries secondary to loose objects or other people in vehicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Motorcycle Head-on injuries

A

Up and Over

femur, head, neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Motorcycle Slide / Side injuries

A

Femur, Pelvic, Tib/Fib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Rollover Collisions

A

Causes the most lethal injuries of all collisions.

Axial loading, multiple injury patterns

31
Q

Trauma Management : Airway indications

A

Conscious ability to swallow
Oxygenation or Ventilation failure (Sao2 <60, Co2 >55, Ph <7.2)
Expected clinical course

32
Q

Trauma Management : Circulation

A

Assess cardiac output (HR more important than BP)
Think Tamponade
Assess bleeding

33
Q

Blood pressure won’t fall until EBL is ___.

A

> 30-40%

34
Q

Managing Increasing ICP

A

Watch for herniation (Posturing, Pupil changes)
Raise HOB 30*
Hyperventilate to 30-35 ETCO2
Sedation, NMBA, Diuretics

35
Q

Farming accident considerations

A

Delayed arrival of medical care and extrication
Tractors are heavier than autos
Tractors are prone to rollovers
End-over-end rollovers have a greater potential of entrapment
Higher potential for Hazmat involvement

36
Q

Falls occur primarily in adults and children ___.

A

Under 5

37
Q

Children fall and impact ____.

A

On their head

38
Q

Adult’s “lover leap”

A

Lands on feet then falls backwards on butt and hands.
Feet, leg, hip fx.
Axial loading on lumbar / cervical
Colles fx of wrists

39
Q

Impalement / stab wound considerations

A

Area of body
Blade length
Angle of penetration

40
Q

Firearm wound considerations

A
Type (caliber, handgun, long gun)
Distance from weapon
Bullet construction (FMJ, hollow point)
41
Q

Primary blast injuries

A

Initial air blast causing damage to hollow organs

42
Q

Secondary blast injuries

A

Projectiles / shrapnel from blast force

43
Q

Tertiary blast injuries

A

Impacts ground or other object

44
Q

Parkland burn formula

A

4ml/kg/BSA%
Give 1/2 over 1st 8 hours, 1/2 over next 16 hours
Don’t calculate 1st degree burns

45
Q

Always assume Carbon Monoxide poisoning in ____.

A

Fires in confined spaces

46
Q

Consider ___ with fires of carpets and plastics.

A

Cyanide poisoning

47
Q

Consensus burn formula

A

2-4ml/kg/BSA%

48
Q

Burn Mortality percentage

A

Age + BSA % (add 20% if Resp involvement)

49
Q

Hydrofluoric acid treatment

A

Copious water

Infiltrate tissue with 10% Calcium Gluconate

50
Q

Alkali metal burns (Na, K+) treatment

A

Reacts with water

Absorb heat with oil

51
Q

Acid burns

A

Most cause Coagulative necrosis and can’t penetrate deep into tissues. They denature cellular proteins and cause cellular coagulation.

52
Q

Alkali burns

A

Dissolve protein and collagen causing dehydration and Saponification (turns fat into soap). Tend to cause more severe burns.

53
Q

Two-step Hazmat Decon Process

A

Usually at a fast break scenario
Remove all clothing or jewelry from body
Wash and rinse patient with soap and water
Reposition out of runoff and rewash and rinse

54
Q

Myoglobinuria is often a problem due to ____.

A

Massive muscle damage

55
Q

Electrical injuries result in ____ and _____.

A

Acute Tubular Necrosis

Renal failure

56
Q

Electrical injury treatment

A

Maintain urine output of a minimum of 100 ml/hr
Osmotic diuretics
Alkalinize urine with Bicarb solution

57
Q

Start Triage Assessment

A

Respirations
Perfusion
Mentation

58
Q

Start Triage Quick Rules

A

15-30 second assessment per patient
Apneic patients can have airway repositioned once
Check cap refill at core

59
Q

In START Triage, all penetrating trunk injuries are classified as?

A

Immediate

60
Q

In START Triage, all rescuers injured on scene are classified as?

A

Immediate

61
Q

Crystalloid to blood replacement ratio

A

3:1

62
Q

Initial fluid resuscitation should be with?

A

Isotonic crystalloid (0.9% NS or LR)

63
Q

Fluid resuscitation should have a MAP goal of?

A

80-90 mmHg

64
Q

Poor urine output in trauma is indicative of ___ failure.

A

Pre-renal

65
Q

Humoral blood loss

A

750 ml

66
Q

Blood loss femur

A

1500 ml

67
Q

Complications of crush injuries

A

Compartment syndrome
DIC
Renal failure
Hyperkalemia

68
Q

S/S of Larynx fracture

A

Subcutaneous emphysema

Flattened cricothyroid prominence

69
Q

At room temperature, an amputated part is viable for reimplantation for approximately how many hours?

A

4-6 hours

70
Q

With proper cooling measures, an amputated part is viable for reimplantation for approximately how many hours?

A

Up to 18

71
Q

Spontaneous recurrence is common in what dislocation?

A

Anterior shoulder

72
Q

The most common musculoskeletal dislocation is?

A

Hip

73
Q

Leading cause of death in trauma victims is?

A

Head injury

74
Q

Massive Hemothorax is defined as ___ of blood.

A

> 1500ml or 1/3 patient’s blood volume