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58 Cards in this Set

  • Front
  • Back
what are some SUBJECTIVE triage assessments
chief complaint
traumatic event
immunizations
allergies
last menses
pregnancy
name some OBJECTIVE triage assessments
VS
weight
breath sounds
skin color
neuro
pupil
pain
members of a trauma team
ED physician
surgeon
nurses - 2 ED or 1 ED + 1 ICU
lab tech
chaplain
recorder (RN)
RT
radiology
acuity classifications
emergent
urgent
non-urgent
describe EMERGENT acuity class
life/limb threat
trauma, chest pain, cardiac arrest, severe resp dist, limb amput, acute neuro deficit, chemicals in eye
describe URGENT acuity class
reqs prompt attention <2 hrs
fever > 104, DBP > 130, kidney stone, simple frax, abd pain, asthma w/o resp dist
describe NON-URGENT acuity class
stable condition >2hrs
sprains, minor laceration, cold symptoms, rash, simple HA, chronic pain
describe primary survey trauma assessment
ID & intervene life-threating sx
rapid approach
consider multi-system damage
describe primary survey ABCDE approach
A - airway
B - breathing
C - circulaiton
D - disability
E - exposure
describe AIRWAY assessment in primary survey ABCDE approach
airway w/ cervical spine immob
open airway
suction as needed
assess need for oral airway/ET intubation
describe BREATHING assessment in primary survey ABCDE approach
look, listen, feel
breathing, effectiveness, assistance
supplemental O2
describe CIRCULATION assessment in primary survey ABCDE approach
palpate pulses
bleeding - hypovol shock
skin color, temp, cap refill
2 IVs
describe DISABILITY assessment in primary survey ABCDE approach
neuro
AVPU for LOC
what does AVPU stand for
A - alert
V - responds to verbal command
P - responds to pain stim
U - unresponsive
describe EXPOSURE assessment in primary survey ABCDE approach
undress & visualize
prevent hypothermia
determine need for transport
prevent blood loss/hypovol shock
what is the most common cause of traumatic shock
hypovolemia r/t blood loss
how fast is blood initially lost
250ml/min
how is traumatic shock tx
large bore cath followed by crystalloids (2-4L) then transfuse blood
describe secondary survey for trauma assessment
after primary survey complete
after life-threat injuries addressed
what does FGHI in secondary survey stand for
F - Full set VS / Family present
G - give comfort - pain meds
H - hx and head-toe assess
I - identify injuries, inspect
if pt becomes unstable during secondary assessment what should nurse do
revert back to PRIMARY survey
what are most common causes of pediatric trauma
falls, MVC, bicycle crash, drowning, burns, poison
how much blood can a child lose and still maintain normal BP
30%
what are PaO2 critical values
<60mmHg
what is critical O2 sat
<90%
what is critical PCO2
PCO2 > 50% w/ pH < 7.30
s/s of resp failure
dyspnea
ABGs
HA, restlessness, confusion
dysrhythmias, PVC, A-fib, tachy
interventions for resp failure
treat cause - trauma or PNA
decrease CO2 levels
support oxygenation
sedatives
how do we decrease CO2 levels
bronchodilators
TCDB
hi fowlers postition
s/s of pneumothorax
chest assymetry
restless
resp distress
absent breath sounds
cyanosis
tracheal deviation
s/s of ARDS
profound hypoxemia
dyspnea
decreased lung compliance
diffuse bilat infiltrates
describe patho of ARDS
alveoli & small lung BVs injured
blood/fluid leaks into spaces btw alveoli then INTO alveoli
alveoli collapse
when does ARDS most commonly happen
24-48 hrs post injury
how does ARDS lead to multi-system failure
decreased O2 caused by ARDS and leakage of cytokines leads to inflammation and complication of other organs
how is ARDS tx
mech vent
diuretics
fluid management
PEEP
sedatives
when is mech vent used
when pt has hypoxemia and progressive alveolar hypoventilation w/ resp acidosis
what kind of sedatives are used to tx resp failure
ativan, versed, morphine, fentanyl
what causes flail chest
blunt trauma leaves a loose segment
what is the hallmark sign of flail chest
paradoxic chest expansion - expands when it should be contracting and vice versa
in the field what would the nurse do for flail chest
apply pressure until intubation can be accomplished
what % of lung collapse reqs chest tube
>20% collaps
is tracheal deviation early or late sign of pneumothorax?
late
what is considered aggresive nursing interventions for an ARDS pt
extreme turning
monitor vent settings CLOSELY b/c chances of getting pneumothorax are big
put on rotorest bed
fluid management b/c leaky capillaries in lungs
what do we call lung trauma caused by a ventilator
barotrauma
what is the hallmark dx for ARDS
white-out on CXR
what are the bare minimum settings for ventilators
tidal volume
rate
FiO2
if tidal volume, rate and FiO2 are NOT enuf for pt, what else can be done
add PEEP
what rhythm will be seen with hypoxia
bradicardia then asystole
what is the biggest problem for the nurse to consider with overdose
cerebral depression
when is gastric lavage recommended for an OD pt
within 60 mins of ingestions of a known non-caustic, life-threatening drug
how is OD on tricyclic antidepressants tx
gastric lavage
admit to hospital
tele - monitor for V-tach
after tx and OD w/ lavage, what is the next step
tx w/ antidote
what is the chief s/s of anemia
fatigue
what are important labs to dx anemia
CBC
what is the biggest problem with sickle cell anemia
PAIN - cells clump together and obstruct flow causing ischemia and pain to distal parts
thalassemia is common to what race of people
mediteranean, african, middle eastern, southeast asian
how does lead cause anemia problems
lead binds to hemoglobin so O2 CANT bind
why would kidney dz cause anemia
erythropoetin