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44 Cards in this Set

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Trauma is the leading cause of death in which group of people?
Under 40 y.o.
What are the most common injuries?
Limb injuries
What the the most lethal injuries?
Head and visceral injuries
What is the leading cause of accidental deaths?
MVA
What is the leading cause of non-fatal injury?
Falls
What is the trimodal distribution of death and describe each.
1. Death within minutes --> lethal injury resulting in death at scene of accident.

2. Death in first hour --> life threatening injury requiring urgent attention.

3. Death in days/weeks --> resulting from complications of initial injury sustained.
When is the most trauma death seen?
During first hour.
When is the second peak of trauma mortality and why death?
Between 1-4 hours. Mainly b/c of blood loss "golden hour." Death can be prevented.
When is the golden hour?
During 1-4 hours..
When is the final peak for trauma mortality and why?
2 weeks and beyond b/c of late complication (e.g. - organ failure)
What are the steps of Initial assessment?
1. Resuscitation
2. Primary Survey
3. Detailed Secondary survey
4. Initiation of definitive care.
What are the components of the primary survey? x 5
A. Airway maintenance with cervical spine control.
B. Breathing and ventilation
C. Circulation
D. Disability (neurological status)
E. Exposure
Secondary survey defined.
Detailed head to toe examination of the patient undertaken after the patient has been resuscitated and stabilized.
What are the components of the secondary survey?
A - Allergies
M - Meds
P - Pertinent Past Medical Hx
L - Last time for food/drink
E - Events/environments related to injury
Treatment stages of trauma patients. x 5
1. Tx at scene of accident (EMS)
2. Eval. and resuscitation in ED.
3. Early Tx. of Chest and Abd.
4. Tx. of musculoskeletal injuries.
5. Long term rehabilitation
What are the components of MESS criteria with point values.
Shock --------------(2pts)
Energy of Trauma ---(4pts)
Age ----------------(2pts)
Limb Ischemia ------(3pts)
What is the MESS criteria for primary amputation.
6 pts
For fx, the only demand for tx is? x2
1. Vascular compromise due to position
2. Hemorrhage from an open fx
For fx, what should be applied for stopping hemorrhage?
Sterile pressure dressings.....and NOT tourniquets.
For Fx treatment, what should be removed?
Rings and constricting jewelry
How should the fx be stabilized?
Stabilized in anatomical position.
T/F - Force is sometimes necessary for fx reduction.
FALSE - It is rarely necessary for the reduction of a fx and represents an error in technique or an unrecognized anatomical obstruction.
For fx involving joint surface, what is essential?
Accurate reduction, though this may not always be possible.
For fx tx, when and what do you immobilize?
Only the injured part after reduction. Preferably one joint rather than more.
When do you begin exercise of non-injured joints?
Immediately.
Define sprains
stretching or partial tear of supporting structures of a joint
Define strains
Stretching or partial tear of a muscle
How do you differentiate between sprains and strains from fractures and complete ruptures? x2
1. X-ray (for fx)
2. P.E. and MRI (for complete rupture.
Define dislocation.
When joint surfaces are completely displaced and are no longer in contact.
Define subluxation.
Implies a lesser degree of displacement such that the articular surfaces are still partly apposed.
How should dislocation/subluxations be reduced?
Promptly
When will relief of dislocation/subluxation occur?
Only with reduction of dislocation
What is the most frequent dislocated joint?
Shoulder
Fracture defined.
Disruption in the continuity of bone.
Fx occur b/c of what? x3
1. Repetitive stress
2. Abnormal weakening of bone
3. Traumatic events
What is the only tissue in the body that heals without a scar?
Bone.
Fx description should also match what?
X-ray description
Criteria for Fx classification and description. x4
1. Orientation/extent of fx line.
2. Location on bone
3. Displacement amount of fx fragments.
4. Integrity of skin and soft tissue around fx.
Fx classification. x5
1. Comminuted
2. Transverse
3. Oblique
4. Spiral
5. Segmented
Define transverse fx.
Fx that is perpendicular to the shaft of the bone.
Define oblique fx.
Angulated fracture line
Define spiral fx.
A multiplanar and complex fx line.
Define comminuted fx.
More than two fx fragments
Define segmental fx.
A completely separate segment of bone bordered by fx lines.