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20 Cards in this Set
- Front
- Back
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Definition of massive haemothorax? |
> 1500 mls initially or >200ml/hr
Needs surgery |
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Where’s the danger box? |
Clavicles to xiphisternum. Right nipple to left lateral chest wall |
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Indications for ED thoracotomy? (According to ETC?) |
Arrest with penetrating trauma with <15 mins CPR Arrest with blunt trauma with <10 mins CPR Refractory hypotension <60mmHg despite vigorous fluid resus in thoracic injury |
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What constitutes a wide mediastinum? |
>8cm |
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4 principles of resuscitative thoracotomy? |
Equipment Expertise Environment Elapsed time |
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Describe the uterus’ vulnerability to trauma over time in pregnancy? |
First trimester sheltered in the pelvis Second trimester ascends but thick walled and relatively large amount of amniotic fluid Third trimester ascends further and wall thins - vulnerable |
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True pelvis vs false pelvis? |
True pelvis is area between sacrum, both acetabula and symphysis pubis and contains infraperitoneal organs ie bladder False pelvis is area above pelvic brim and between iliac wings and contains lower peritoneal organs |
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Describe the Tile system for pelvic fractures? |
Type A stable Type B rotational deformity only ie lateral compression or open book Type C vertical shear rotational and vertical instability |
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What should be done regarding urethral catheterisation in pelvic trauma? |
Single attempt by experienced doctor even if urethral injury suspected radiologically |
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What should be done regarding urethral catheterisation in pelvic trauma? |
Single attempt by experienced doctor even if urethral injury suspected radiologically |
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What medical therapy is indicated by urine leak from bladder or urethra? |
Treat as open fracture with antibiotics |
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How is bladder rupture managed? |
Intraperitoneal needs laparotomy and direct repair Extraperitoneal can be managed with catheter drainage conservatively however if there is a surgical repair of an unstable pelvic fracture it can be repaired at this time Extraperitoneal bladder neck rupture will always leak (?as dependent area) and needs surgical repair |
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How is bladder rupture managed? |
Intraperitoneal needs laparotomy and direct repair Extraperitoneal can be managed with catheter drainage conservatively however if there is a surgical repair of an unstable pelvic fracture it can be repaired at this time Extraperitoneal bladder neck rupture will always leak (?as dependent area) and needs surgical repair |
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How is urethral rupture managed? |
For men delayed repair in 3 months in most cases Women and children should be discussed at a tertiary level |
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In a patient with an extradural and a fixed blown pupil which side is the lesion on? |
Ipsilateral to the pupil abnormality the motor weakness will be on the other side |
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What’s the dose of mannitol? |
2.5ml/kg of 20% Or 0.5g/kg |
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What is a Jefferson’s fracture? |
Burst fracture C1 |
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What is a Jefferson’s fracture? |
Burst fracture C1 |
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Is hypotensive resuscitation different in children? |
Not recommended as hypotension is a very late sign suggestive of a periarrest state |
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Differences between adult and paediatric airway? |
Large occipital - flexion Obligate nasal breathers <6 months Large tongue Floppy epiglottis Short trachea Narrowest diameter is the subglottis |
