Shared Flashcard Set

Details

Approach to the Trauma Patient
M2 ICE Spring Final
15
Other
Post-Graduate
04/21/2009

Additional Other Flashcards

 


 

Cards

Term
Sequence of priorities in the eval of the trauma patient?
Definition

1. Airway: normal voice ensures an adequate airway

2. Breathing: assessment of neck veins is initial assessment

3. Circulation: level of consciousness, skin color, pulse rate

4. Neuro: AVPU and Glasgow Coma scale

5: Exposure: check EVERYWHERE for injury, undress patient completely

 

Term

Identify the critical diagnoses for each phase of the trauma evaluation

 

Definition

1. Airway: Airway obstruction

2. Breathing: Tension pneumothorax, massive hemothorax, sucking chest wound, and flail chest

3. Circulation: Massive hemothorax, Intraabdominal hemorrhage, cardiac tamponade, external hemorrhage

4. Neuro: Coma, Disability

 

Term

Airway obstruction

Definition

 

tongue, blood, vomit, foreign bodies, injury

   a. intervention: jaw thrust (best) and chin lift/head tilt

      - oral/nasal airway

- endotracheal intubation with in-line stabilization

      - Cricothyrotomy

Term
Trauma in breathing?
Definition

Tension pneumo

Massive Hemothorax

Sucking chest wound

Flail chest

Term
Tension Pneumothorax
Definition

JVD, tracheal deviation to contralateral side, absent breath sounds, tympany to percussion.

   

a. treatment: needle decompression:

insert 12-14 G needle into 2-3rd intercostal space at midclavicular line as well as chest tube placement

 

Term
Massive Hemothorax
Definition

tachycardia, hypotension decreased/absent breath sounds, dullness to percussion, chest X-ray.

    a. treatment: insert chest tube. If > 1500 ml blood or 300 ml/h a thoracotomy is required.

 

Term
Sucking Chest Wound
Definition

open pneumothorax with 2/3 diameter of trachea

    a. treatment: occlusive dressing taped on 3 sides followed by a chest tube

 

Term
Flail Chest
Definition

 

chest lacks bony continuity with surrounding chest wall (broken ribs). Identified by paradoxical motion of the chest wall with inspiration.

    a. treatment: chest tube

Term
Circulation traumatic events?
Definition

Massive hemothorax

Intra-ab hemorrhaging

Cardiac Tamponade

External Hemorrhage

Shock

Term
  Intraabdominal Hemorrhage
Definition

spleen and liver are most common origins

 

Term
Cardiac Tamponade
Definition

 

impairing right ventricular filling and decreasing CO.

   - Beck’s triad: hypotension, distended neck veins, muffled heart tones

   - Echo

    a. treatment: IV fluids, pericardiocentesis

Term
External Hemorrhage
Definition

 

a. treatment: IV access with two large bore peripheral IV’s

       - direct pressure to sites of hemorrhage

       - 2 L NS IV and blood transfusion if no response to IVF

Term
Shock
Definition

 

usually hemorrhagic but can be non-hemorrhagic (pneumothorax, cardigenic, neurogenic). First sign of shock is coolness and tachycardia.

     a. treatment: Re-establishing perfusion to the organs is the primary goal

-restoring and maintaining the blood circulating volume

-ensuring oxygenation and blood pressure are adequate

-achieving and maintaining effective cardiac function

-preventing complications

Term
Neuro signs of trauma?
Definition

 

- AVPU: Alert, respond to Verbal, respond to Painful stimulus, Unresponsive

    - Glascow Coma: Motor, verbal, eye opening

         - <8 is bad

Term
Environmental/exposure related trauma?
Definition

 

1. Hypothermia: warm blankets.

2. Logroll with c-spine immobilization

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