Trauma Flash Cards

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Title: Trauma
Description: trauma different types, locations for treatment
Number of Cards: 49
Save Count: 1
Author: nufevah8811
Created: 2010-11-09
Tags: trauma
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    • Question
    • Answer
    • Side 3
    • In trauma deaths there are three peaks, what is the 1st peak & what are some of the causes?
    • within minutes of the trauma
      C: brain, upper spinal cord, heart, aorta & other major blood vessel injuries
    • In trauma deaths there are three peaks, what is the 2nd peak & what are some of the causes?
    • within 2 hours of the trauma
      C: r/t subdural or epidural hematomas, hemothorax, ruptured spleen, lacerated liver, fractured femur
    • In trauma deaths there are three peaks, what is the 3rd peak & what are some of the causes?
    • days to weeks
      C: r/t complication like sepsis, multiple organ failure
    • During triage assessment, what is subjective information?
    • Chief complaint/symptoms
      events/hx surrounding illness/injury
      immunizations, isolation
      allergies
      medications
      past medical hx
      *female: last menstrual period, pregnancy hx
    • During triage assessment, what is objective information?
    • VS, W, breath sounds, skin color, perpheral motor/sensory examination
      visual/pupil exam
      pain assessment
      determine appropriate triage decision
    • What is acuity classification of emergent for triage?
    • life, limb, or eye sight
    • what is acuity classification of urgent for triage?
    • conditions requiring prompt but not immediate attention, should be seen w/in 20 min - 2hr
    • What is acuity classification of non-urgent for triage?
    • stable condition, the wait could be up to 2 hr, etc. sprains, minor laceration, cold symptoms
    • In the primary survey, what does A stand for & what is done at this stage?
    • airway w/cervical spine immobilization
      open airway
      suction as needed
      assess need for oral airway or ET intubation
    • In the primary survey, what does B stand for & what is done at this stage?
    • Breathing
      L/L/F
      breathing effectiveness, need assistance
      supplemental O2
    • In the primary survey, what does C stand for & what is done at this stage?
    • Circulation
      palpate pulses, check for bleeding
      skin color
      2 large bore IV lines
    • In the primary survey, what does D stand for & what is done at this stage?
    • Disability
      quick neurological exam
      AVPU
    • In the primary survey, what does E stand for & what is done at this stage?
    • Exposure & evaluation
    • What is the most common cause of traumatic shock?
    • hypovolemia d/t acute blood loss
    • When does the secondary survey begin?
    • after 1 assessment complete & all life threatening injuries are addressed
    • What does the F,G,H,I stand for in the secondary survey?
    • F-full set of vitals
      G-give comfort measures...pain meds
      H-hx & head to toe assessment
      I-identify all injuries
      Re-assess
    • What are most injuries in pediatric trauma?
    • sprains, lacerations, contusions, fractures, mild head injury
    • What are some differences between adult and children injuries?
    • smaller body size
      greater relative body surface area
      internal organs are more anterior & protected by less subc. fat
      cervical spine differences
    • how does the child have greater capacity to compensate?
    • increased HR & systemic vascular resistance
    • What organs are more commonly injuried in children?
    • liver and spleen
    • What is the difference between minor and major trauma?
    • minor- single part or system injury
      major-multi-system or serious single injury
    • Is respiratory failure a disease, yes or no, & why?
    • No
      consequence of blood gas abnormalities
    • What is the critical values of PaO2, saturation SaO2, & PCO2?
    • PaO2 - <60mmHg
      SaO2 - < 90%
      PCO2 - >50mmHg w/pH <7.30
    • What are the different types of respiratory failure?
    • -mechanical abn. of the lung or chest wall
      -defect in the respiratory control center in the brain
      -impaired ventilatory muscle function
    • What are some of the assessments used to identify respiratory failure?
    • dyspnea, ABG's, HA, confusion
      Dysrhythmias: PVC, A-fib, tachycardia
    • What are the interventions for respiratory failure?
    • treat the cause
      decrease CO2
      Support O2
      sedatives/narcotics
    • What are some of the causes of RF?
    • blunt or penetrating chest wall trauma, COPD, ARDS, neurogenic causes
    • What is the treatment for a flail chest?
    • O2, pain management, promotion of deep breaths, positioning, mechanical ventilation
    • Anything above ____ normally requires a chest tube when dealing w/ pneumo or hemothorax?
    • 20%
    • What are some of the s/s of pneumothorax?
    • asymmetry of the chest
      restlessness
      respiratory distress
      absence of breath sounds on affected side
      cyanosis
      tracheal deviation - late-
    • What is ARDS commonly a result from?
    • Sepsis, trauma, & severe pulmonary infections. No exact cause
    • What are some clinical manifestations of ARDS?
    • dyspnea, profound hypoxemia, decreased lung compliance, & diffuse bilateral infiltrates
    • How does ARDS develop and when?
    • usually develops 24-48hr after original injury
    • Decreased O2 caused by ARDS & the leakage of ______ produced by the lung cells & white blood cells can lead to this_________ & ______.
    • Cytokines
      inflammation
      MSOF (multiple system organ failure)
    • What are the treatments of ARDS?
    • Mechanical ventilation
      Diuretics
      Fluid management
      Use of PEEP
      use of sedatives
    • What are temporary modes of mechanical ventilation with someone who has ARDS?
    • Continuous positive airway pressure or CPAP
      bi-level positive airway pressure or BiPAP
    • How does a negative pressure ventilator work?
    • noninvasive & works by changing pressures in the chest cavity rather than forcing air directly into the lungs
    • How does a positive-pressure ventilator work?
    • During the inspiratory phase, air is pushed into the lungs and expands the chest
    • What are the 3 ways a ventilator can do positive pressure ventilation?
    • pressure cycled
      time cycled
      Volume cycled
    • what is the estimate of tidal volume used by most clinicians?
    • 7-10ml/kg of body weight + 0 added
    • What can a ventilator deliver in fraction of inspired oxygen (FiO2)?
    • 21-100%
    • What is PIP & how is it indicated?
    • peak inspiratory pressure
      pressure needed by the vent to deliver a set tidal volume
    • If the lungs become stiff, what will the PIP do? why?
    • go up
      peak pressure is highest pressure during the inspiratory phase
    • What is PEEP & what does it enhance?
    • positive end expiratory pressure
      during expiratory phase of ventilation
      -gas exchange & preventing atelectasis
    • When is PEEP used most often?
    • when PO2 drops below 70%
    • What is a major care of the ventilator dependent patient?
    • oral care
    • In drug overdose, one way of death is cerebral depression. What is the cause of death?
    • leads to drowsiness & coma.
      usually breathing stops, followed by heart or pt will V/& aspirate
    • In drug overdose, one way of death is cerebral depression. What is a medication that causes cerebral depression?
    • Tricyclic Antidepressants
    • What do you want to do for an unconscious pt. expected of a drug overdose?
    • get tablets out of the pt. system
      identifying what the pt. has taken
      providing specific treatment