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9 Cards in this Set
- Front
- Back
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Define major trauma
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also known as “multiple trauma” is defined as “serious single system injury or multiple system injuries” (LeMone & Burke, 2011, pg 268)
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Describe the classifications of trauma
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3 ways
*Intent Intentional Unintentional No longer use the term accident *Mechanism of Injury Defined by type of incident that caused the trauma e.g. car crash, fall from roof, gun shot Includes forces involved e.g. speed, compression, shearing *Impact on skin integrity and internal / underlying structures Blunt Penetrating Burns Inhalation Blast |
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mechanical forces in trauma
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Shearing
Compression Torsion Tension Acceleration Deceleration |
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“Lethal Triad” or “Triad of Death
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Combination of hypothermia, metabolic acidosis and coagulopathy
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Define minor trauma
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“Minor trauma” is defined as injury to a single part or system that requires minimal treatment
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What happens in hypothermia
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increased blood viscosity (2% increase in blood viscosity for each 1⁰C decrease in core temperature)
Increased haematocrit (percentage blood volume that is occupied by red blood cells) due to cold diuresis Inhibition of clotting cascade Thrombocytopenia (low platelet numbers) (reversible with rewarming) |
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Treatment of Haematological Disorders Related to Major Trauma
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Dilution
Administration of packed cells (red blood cells with minimal plasma) Diuretics Disseminated Intravascular Coagulation IV Heparin Studies have shown there aren’t any known negative effects of administering Prothrombinex, cryoprecipitate or fresh frozen plasma (FFP) however the standard treatment is still heparin to avoid “adding fuel to the fire |
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treatment of Hypothermia
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Maintaining a core body temperature above 36oC
If patient becomes hypothermic PASSIVE warming: Patients who shiver can warm themselves up to 2oC per hour. The body is unable to shiver once the core temperature drops to ~32oC Slow ACTIVE warming of 0.5-1oC per hour to prevent cardiac arrhythmias and DIC |
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What causes Coagulopathy Related to Major Trauma
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Dilution
Massive transfusions (blood) Overuse of colloidal volume expanders e.g. Gelofusine Overuse of crystalloid volume expanders e.g. Normal Saline Disseminated Intravascular Coagulation Clotting factors are used up causing increased coagulation time and potential for widespread haemorrhage Major Metabolic Derangements Increased pressures on all systems upset the acid-base balance as well as glucose/APT levels Hypothermia |
