Abos - Trauma Principles & Pelvic Trauma - Principles - Key Points For Specific Injury Conditions

Front 1

How much blood can an unsplinted closed femur fracture lose?

Back 1

Up to 4 units

Front 2

What is the incidence of femoral neck fracture associated with femoral shaft fracture?

Back 2

1 to 9%
20 to 50% are missed on initial radiographs

Front 3

Coverage within what time period has been shown to result in improved outcomes?

Back 3

72 hours

Front 4

What is the recommended antibiotic for Gustillo stage I and II open fractures?

Back 4

Cephalosporin

Front 5

What are the two recommended antibiotics for Gustillo stage III open fractures?

Back 5

Cephalosporin
Aminoglycoside

Front 6

Which antibiotic should be added with heavy contamination, farm injury, or anaerobic risk?

Back 6

Penicillin or ampicillin

Front 7

For how long should antibiotic therapy be continued?

Back 7

72 hours after each debridement, and 72 hours after definitive wound closure

Front 8

In addition, what should all open fractures be treated with?

Back 8

Tetanus booster on immunoglobulin based on immunization history

Front 9

When should soft tissue injuries in the setting of open fractures be closed?

Back 9

Either local flap or free vascularized flap should be preformed within 72 hours or injury

Front 10

In what six clinical situations should a "damaged control" approach be considered?

Back 10

Polytrauma with ISS score >20 and a thoracic trauma AIS of >2
Polytrauma with abdominal/pelvic injury and hemorrhagic shock
ISS >40
Chest radiograph or computed tomography (CT) evidence of bilateral pulmonary contusion
Initial mean pulmonary arterial pressure of >24 mm Hg
Pulmonary artery pressure increase during intramedullary (IM) nailing >6mm Hg

Front 11

What is the rate of noncontiguous injury in a spine-injury patient?

Back 11

5 to 20%

Front 12

Diagnosis of complete SCI can only be made after what condition resolves? What is the key reflex?

Back 12

Spinal shock
Bulbocavernosus reflex

Front 13

What chest X-ray findings is characteristic of lung injury?

Back 13

Pulmonary edema

Front 14

What are the three physical exam findings of tension pneumothorax?

Back 14

Mediastinal shift

Front 15

What are the two components of treatment for tension pneumothorax?

Back 15

Insert large-bore needle in second intercostal pace at the midclavicular line
Follow by placement of a chest tube

Front 16

What are the components of treatment for an open pneumothorax?

Back 16

Occlusive dressing over the wound sealed on three sides
Place a chest tube as far from the wound as possible

Front 17

In the setting of massive hemothorax, what are two indications for thoracotomy?

Back 17

More than 1500 mL of blood is obtained with chest tube placement
Drainage of more than 200 mL/hour for 2 hours

Front 18

What are the series of events leading to acute respiratory distress syndrome (ARDS) after initial lung injury? Then what happens?

Back 18

Arterial blood gas (ABG)

Front 19

How is ARDS treated?

Back 19

High peak end-expiratory pressure (PEEP) ventilation

Front 20

What two organs are most commonly affected with blunt trauma?

Back 20

Kidney
Spleen

Front 21

What is the advantage of abdominal ultrasound over CT scan? What is the disadvantage?

Back 21

Fast
Operator dependent

Front 22

What are the three contraindications to an abdominal ultrasound?

Back 22

Obesity
Subcutaneous air
Prior abdominal surgery

Front 23

What is the role of the ankle-brachial index (ABI) in diagnosis of vascular injury? What is the gold standard?

Back 23

An ABI of 0.9 or higher generally excludes arterial injury
Arteriography is still the gold standard

Front 24

In what two ways can rhabdomyolysis be diagnosed on urinalysis?

Back 24

Presence of heme
Absence of red blood cells

Front 25

How is rhabdomyolysis treated?

Back 25

Administration of bicarbonate

Front 26

What are the three clinical signs of fat embolism?

Back 26

Hypoxemia
Central nervous system (CNS) depression
Petechiae

Front 27

In what three places are the petechiae found?

Back 27

Axilla
Conjunctivae
Palate

Front 28

How is fat embolism treated?

Back 28

High PEEP ventilation

Front 29

What is the threshold velocity for determining low-versus high -velocity gunshot wound?

Back 29

Low <2000 ft/sec
High > 2000 ft/sec

Front 30

What are the general indications for removal of a retained projectile?

Back 30

Subcutaneous position in a pressure area where painful when sitting or lying
Visible bulge beneath the skin
In a joint space
In the globe of the eye
In a vessel lumen causing ischemia or embolic risk to heart, lungs or periphery
Impinging on a nerve or nerve root and causing pain
Localized abscess formation
Required for forensic investigation if no expected increase in pain or suffering
Documented elevated lead level

Front 31

How are burn injuries classified and what is the status of the vascular supply for each?

Back 31

I (coagulation): most damaged, no blood flow
II (stasis): sluggish blood flow
III (hyperemia): capillary leakage

Front 32

Copper sulfate is a treatment for what type of burn?

Back 32

White phosphorus

Front 33

Calcium gluconate is a treatment for what type of burn?

Back 33

Hydrofluoric acid

Front 34

At what temperature range should extremity frostbite injuries be rewarmed?

Back 34

104 to 107 degrees F

Front 35

What factor is most important in heterotopic ossification development after polytrauma?

Back 35

Duration of ventilation

Front 36

What is the principal risk factor for secondary post traumatic brain injury? If it occurs, with what outcome measure is it associated?

Back 36

Hypotension
Correlates with increased mortality