Ch. 43 Trauma Systems And Moi

Front 1

Leading cause of death in persons aged 1-44?

Back 1

Trauma

Front 2

Most prevelent MOI's (4)

Back 2

MVA

falls

poisonings

firearms

Front 3

Pre-event phase of trauma care is geared toward helping how?

Back 3

Prevention

Front 4

Trauma systems established by who?

Back 4

Federal Trauma Care Systems Planning and development in 1990

Front 5

Pre hospital care divided into 3 parts

Back 5

Treat

Transport

Trauma guidelines

Front 6

Level of hospitals

Back 6

Level 1-5

1 the best

5 the worst

Front 7

Single most important factor in trauma survival

Back 7

TIME

Front 8

Golden Hour

Back 8

Starts from incident

ends during surgery

Front 9

Who founded golden hour

Back 9

Cowley

Front 10

Platinum 10 minutes

Back 10

10 minutes on scene

Front 11

When to use ground transport

Back 11

Destination reached in reasonable time

60 minutes from time of injury

Front 12

Consider air transport when?

Back 12

Time is critical: distance, extrication exc..

Road conditions are poor

Higher level of care needed

Front 13

Trauma is described how in terms of energy?

Back 13

Application of physical energy from an external source onto the human body

Front 14

Types of energy discussed (4)

Back 14

Newtons first law

Conservation of energy

Kinetic energy

Force

Front 15

Conservation of energy:

Back 15

Energy cannot be created or destroyed only transferred

Front 16

Kinetic energy:

Back 16

1/2 Mass X (2)Velocity = KE

Velocity plays more of a role in KE

Front 17

Force

Back 17

Mass X Acceleration

Front 18

Cavitation

Back 18

Temporary or permanent opening produced by a force, pushing tissues away from projectile

Front 19

Body contains three types of density

Back 19

Air

Water

Bone

Front 20

Permanent cavities are produced by?

Back 20

Compression or tearing of the tissue and destruction of area around it

Front 21

Temporary cavitation can make you believe there is nothing wrong inside the body T Or F?

Back 21

T

Front 22

Crucial factors in severity of cavity?

Back 22

Density and Speed

Front 23

More dramatic from cavity lungs or liver

Back 23

Liver

Front 24

Trauma is classified as what two classes?

Back 24

Blunt or penetrating

Front 25

Both types can cause cavitation?

Back 25

True

Front 26

Kinematics:

Back 26

Process of predicting injury patterns based on MOI

Front 27

Index of Suspicion:

Back 27

expectation that certain injuries have resulted to a body part based on MOI

Front 28

2 types of blunt trauma

Back 28

Shear

Compression

Front 29

Shear

Back 29

Can be caused by body organs tearing from sudden acceleration of the person

Front 30

Compression

Back 30

Force directly applied to an organ or body part

Front 31

MVC's are leading cause of death for persons 1-45 years T or F?

Back 31

T

Front 32

Collision divided into 3 phases

Back 32

Vehicle hits object

Body hits the vehicle

Organs collide inside body

Front 33

MVC's have 5 distinct crash types

Back 33

Head on

Rear end

Side

Rotational

Roll over

Front 34

Down and under pathway

Back 34

Pt moves downward under dash

knees and legs become primary point of impact

Evidence may be dent in lower dashboard

Primarily leg injury

Front 35

Up and Over

Back 35

Head propelled into windsheild or roof

Chest and abdomen into steering column

Front 36

Side impact Injuries

Back 36

T boned: torsion of head neck torso

Hitting object with the side: absorbs the mass of impact, general injuries

Can be injured by other passengers or door intusion

Front 37

Rear end Injuries

Back 37

Head and neck extension/flexion

whiplash

Front 38

Person who rear ended the car could have?

Back 38

Paper bag injuries in lungs from bracing for impact

Front 39

Rotational INjuries

Back 39

All those in side and frontal impact

Front 40

Roll over Injuries

Back 40

Injury upon initial crash

Shear forces play big role in these crashes

Ejection if unrestrained

Front 41

Current restraints are designed to do what?

Back 41

Absorb energy

Limit distance of travel of the body

Front 42

4 types of occupant restraints

Back 42

Lap belts

Shoulder belts

Airbags

Child safety seats

Front 43

Most common restraint used?

Back 43

Lap belts

Front 44

How do you wear lap belt?

Back 44

across illiac crest

Not over tummy

if pregnant go under belly

Front 45

Shoulder restraints facts

Back 45

Can cause clavicle injury

Does not support neck

less effective if close to steering column

Front 46

Most common airbag location?

Back 46

Steering column

Front 47

Airbags may cause injury for passengers and drivers how close?

Back 47

Driver within 10 inches

Passenger within 18 inches

Front 48

People at risk for airbag deployment?

Back 48

Under 12 years old

Less than 5 feet 2 inches

Front 49

Leading cause of death for children 1-9 aged

Back 49

MVC's

Front 50

Predictiable injuries for child seats

Back 50

ABdomen

Acceleration or decel injuries

neck and spinal

Front 51

Those three injuries together are called

Back 51

Seatbelt syndrome

Lap belt complex

Front 52

Child safety seats be replaced after crash T or F? unless considered minor

Back 52

T

Front 53

Children and infants not needing c spine precautions should be transported how?

Back 53

Child safety seats

Front 54

Any medical patient it is appropriate you should transport them with gurney in what positon?

Back 54

45 degree angle

Front 55

Collision organ and brain injuries from decelleration

Back 55

Organ continues to move after body is suddenly deccelerated causing tearing or shearing

Or stretching of spinal cord

Front 56

Thoracic INjuries from deceleration

Back 56

Aorta being sheared

Tamponade

Front 57

Abdominal injuries from decel

Back 57

Kidneys liver spleen can all shear

Front 58

Compression head injuries

Back 58

open or closed

cervical fracture

Hemorrhage

Front 59

Compression thoracic injuries

Back 59

Paper bag effect

flail segment

tension pneumo

injury to heart

Front 60

Compression injuries to abdomen

Back 60

solid organ rupture and hemorrhage

Hollow organ perforation into peritoneal cavity

rupture of bladder spleen kidneys

Front 61

Motorcycle collisions front or head on impact injuries

Back 61

Over the handle bars

Femur breaks on bars

blunt trauma when pt hits ground

axial load

chest and abdomen trauma

Front 62

Trauma injuries by body part!

Back 62

YAY

Front 63

Head

Back 63

Open or closed fracture

Cerebral shear

Hemorrhage

Facial fracture

CNS impairment

Front 64

Neck

Back 64

Cervical fractures

Axial load

Odnotoid fracture (C1,C2 thing)

Hyperflexion injury

Front 65

Thorax Chest wall

Back 65

Compression

Fractured ribs

Flail segment

Pneumothorax

hemothorax

sternum fracture

THoracic spinal fracture

Front 66

Thorax Heart

Back 66

Myocardial contusion

aortic shear

Front 67

Abdomen

Back 67

Abdominal wall tear

Lumbar fracture

Organ shear or rupture

Diaphragm tear

Front 68

GAstrointestinal

Back 68

Shear injury

Kidney seperation

Front 69

Pelvis

Back 69

Pelvic fracture

Front 70

Groin

Back 70

Penile trauma

testicular avulsion

Front 71

Extremities

Back 71

Clavicle

humerous

femoral

tib fib

fractures

Front 72

Skin

Back 72

Abrasions or avulsions

Front 73

Laying it down for a motorcyclist will cause what predictable injuries?

Back 73

Road rash

fractures to affected side

Less serious injuries

Front 74

Rider who does not wear a helmet is how much more likely to have a TBI?

Back 74

300%

Front 75

Pedestrian vs vehivle includes 3 MOI

Back 75

First impact with bumper

second with windshield

third with ground

Front 76

Adult pedestrian injuries:

Back 76

First impact; legs, lateral and posterior injuries

Second impact; blunt impact to body systems, compression or shear.

Third; hips and shoulders, blunt trauma.

Front 77

Adults reaction vs peds reaction to oncoming vehicle?

Back 77

Adults turn away

Peds face threat

Front 78

Peds Predictable injuries

Back 78

1st impact; fractures of legs, pelvis, abdomen

2nd; thoracic, head, neck, abdomen, and facial

3rd; Same, however consider child may have been ran over by vehicle

Front 79

Waddells triad

Back 79

high speed injuries for children

first impact affects legs, 2nd affects thoracic cavity, 3rd affects head

Front 80

Don juan syndrome:

Back 80

IOS for pt who has fallen and lands on there feet,

bilateral calcanei, leg, femur, and hip fractures

compression of thoracic and lumbar spine

Front 81

4 aspects to consider from a fall injury

Back 81

Height

surface

objects struck during fall (tree branches)

Body part of first impact

Front 82

significant falls in elderly include which type of falls?

Back 82

ALL

Front 83

rule of thumb for height of fall causing severe injuries.

Back 83

3 times the height of pt

15-20 feet

Front 84

10% of people with calcaneus fractures also have what?

Back 84

spine fracture

Front 85

distance fallen less than 15 feet, what position do people land in?

Back 85

Position they fell

Front 86

What position do children typically fall in?

Back 86

Head first

Front 87

4 types of injuries from blasts

Back 87

primary

secondary

tertiary

quatenary

Front 88

Primary injuries are caused from what?

Back 88

Shock wave

Front 89

secondary injuries are caused from what?

Back 89

Shrapnel or debris

Front 90

tertiary injuries caused by what?

Back 90

Body hitting the ground or object

Front 91

Quatentary injuries are caused from what?

Back 91

other environmental effects, or agents added to explosives.

I.E. inhalation injuries, extreme heat; radiation, bacteria, chemicals

Front 92

Blast lung syndrome

Back 92

Occurs during shock wave

When poorly supported tissue (lungs) is stretched beyond its elasticity

Front 93

Managing blast injuries first priority

Back 93

Scene safety

Front 94

Penetrating trauma =?

Back 94

Tissue disruption

Front 95

Cavitation

Back 95

opening produced by a force pushing tissues away from penetrating object

Front 96

can cavitation injuries return to original shape?

Back 96

Yes

Front 97

Permenant cavitation

Back 97

By extreme penetrating forces

Front 98

Penetration trauma 3 energy levels

Back 98

Low

medium

high

Front 99

low energy example

Back 99

knife wound

Front 100

medium and high energy?

Back 100

Bullets

Front 101

are exit wounds typically larger or smaller in size?

Back 101

Larger

Front 102

what % of trauma patients die with in the first hour?

Back 102

50%

Front 103

What % of deaths account for early deaths in trauma?

Back 103

30%

Front 104

Early death implies death within?

Back 104

4 hours

Front 105

Late death implies?

Back 105

Death within weeks

Front 106

Late death accounts for what % of deaths in trauma?

Back 106

20%

Front 107

one of the first things to do on a scene of a trauma?

Back 107

Identify MOI

Front 108

Pt prioritization goal:

Back 108

Do the most good for the most people

Front 109

Goal of primary survey?

Back 109

Find and treat life threats

Front 110

How should you perform your eval?

Back 110

Systematically

Front 111

Airway initial considerations

Back 111

C- spine

Jaw thrust to open airway

Identify obstruction and clear airway

Simple and effective measures, OPA, BVM

Front 112

Breathing initial considerations

Back 112

Identify rate and depth for adequacy

If <10 or >29; or shallow begin BVM w/O2

Expose and inspect chest

Auscultate breath sounds

Treat anything initially comprimising breathing

Front 113

Circulation Initial considerations

Back 113

Pulse; rate, rhythm, quality

Skin color condition

Cap refill

External hemorrhage

Assess abdomen, or pelvis for internal bleeding

Front 114

Disabilty considerations

Back 114

Assess neurologic function

AVPU; GCS

pupils

CMS

C spine

Front 115

Exposure considerations

Back 115

Always cut off clothes!

Be mindful of hypothermia

Front 116

Absence of radial pulse would mean what?

Back 116

Shock indicated

Front 117

Present radial pulse indiactes?

Back 117

Pt is not in shock yet

Front 118

Secondary survey or head to toe survey is done where?

Back 118

Enroute

Front 119

Secondary survey includes what

Back 119

Head to toe

vitals

IV

Meds

HX

Front 120

What is the most important consideration in trauma?

Back 120

TIME AND TRANSPORT

Front 121

Time intervals for primary survey?

Back 121

1-2 minutes

Front 122

packaging time?

Back 122

2-3 minutes

Front 123

6-7 minutes is achievable? T OR F

Back 123

T

Front 124

4 things to assess for falls

Back 124

height

surface

body part hit first

objects struck on way down