Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
46 Cards in this Set
- Front
- Back
what injuries are the most common in trauma?
|
limb injuries are most common, but head and visceral injuries are the most fatal
|
|
what are the leading cause of accidental deaths?
|
MVA
|
|
what are the leading cause of non-fatal injuries?
|
falls
|
|
what changes have had signigicant effect on injury pattern in MVA's?
|
automobile design change; use of safety devices
airbags reduce abdominal and chest injuries, but increase ortho limb injuries |
|
tri-modal distribution of death
|
death within minutes
death in the first hour (golden hour) death in days/weeks |
|
initial assesment plans
|
resuscitation
primary survey detailed secondary survey initiation of definitive care |
|
primary survey
|
A: airway maintenance with C-spine control
B: breathing and ventilation C: circulation D: disability (neurological status) E: exposure (water, high/low temps) |
|
secondary survey
|
A: allergies
M: medication P: past medical history L: last time of food or drink E: events and environment related to injury |
|
stages of multiple trauma patient treatment
|
I: treatment at scene--EMS
II: evaluation and resuscitation in ER III: early treatment of chest and abdominal complications IV: treatment of musculo injuries V: long term rehab |
|
MESS
|
mangled extremity severity score--
energy of trauma: 4 points shock: 2 points limb ischemia: 3 points age: 2 points *primary amputation is more than 6 points |
|
fracture immediate demands
|
vascular compromise
hemorrhage |
|
sprains vs. strains
|
sprain= supporting structures of a joint
strain= stretching or partial tear of a muscle |
|
dislocation
|
joint surfaces are completely displaced and are no longer in contact
-should be reduced promptly -shoulder is most frequent dislocation |
|
subluxation
|
lesser degree of displacement such that the articular surfaces are still partly apposed
|
|
fracture
|
disrupt in continuity of a bone
|
|
closed fracture
|
skin over and near fracture is intact
|
|
open fracture
|
skin over and near fracture is lacerated or abraded by the injury
|
|
fractures occur because of:
|
1. traumatic events
2. repetitive stress 3. abnormal weakening of bone |
|
fracture classification and description
|
1. by location on bone
2. orientation/extent of fracture line(s) 3. amt of displacement of fracture fragments 4. integrity of skin and soft tissue envelop around fracture |
|
orient/extent of lines
|
-transverse (perpendicular to shaft of bone
-oblique (angulated) -spiral (multiplanar and complex) -comminuted (more than two fragments) -segmental |
|
location
|
epiphyseal- end of bone
metaphyseal-flared portion of bone at ends of shaft diaphyseal-shaft of long bone |
|
orientation, ctd.
|
intra-articular (line crosses articular cart and enters joint)
torus (buckle) compression (impaction; vert or proximal tibia) greenstick (incomplete with angulation deformity) pathologic (bone weakened by disease or tumor |
|
amt of displacement
|
nondisplaced
displaced angulated bayonetted (distal frag longitudinally overlaps proximal frag) distracted (distal frag separated from proximal by gap) |
|
diagnosis is confirmed with:
|
x-rays- always get joint above and below the bone involved
|
|
pathologic fracture
bone may be weakened by: |
tumor
osteoporosis metabolic conditions (paget's) |
|
secondary bone healing
|
1. inflammatory phase (1-5 days)
2. reparative phase (7-40) 3. remodeling phase (>50) |
|
delayed union
|
fracture fails to consolidaate in timeusually required for union to occur
|
|
causes of delayed union
|
inaccurate reduction, inadequate or interrupted immobilization, severe local trauma, infection, loss of bone substance, distraction of fragments
|
|
non-union
|
process of bone repair ceases after having failed to produce firm union (> 6 months)
|
|
causes of nonunion
|
separation of fragments, loss of bone substance, inadequate immobilization, repeated manipulation, interposition of soft tissue, infection, impairment of circulation
|
|
diaphyseal impaction
|
from axial compression load; usually intercondylar humerus, femur, tibial plafond
|
|
transverse
|
from bending; usually long bone diaphysis
|
|
spiral
|
torsion; any long bone diaphysis; often tibia, humerus
|
|
oblique transverse (butter-fly)
|
axial compression and bending; usually femur, tibia, humerus
|
|
oblique
|
axial compression + bending + torsion; usually tibial-fibular or forearm
|
|
fracture types
|
closed, open, fatigue, pathological
|
|
type I open fracture
|
clean wound less than 1 cm, inside/out injury, simple fractures (Ski injury)
no evidence of contamination |
|
type II
|
skin laceration larger than 1 cm, some minor contusion around laceration, minimal comminution (low velocity auto accident)
-no soft tissue stripped from bone |
|
type IIIA
|
moderate soft tissue injury, adequate soft tissue coverage of fractured bone
|
|
IIIB
|
extensive soft tissue injury, periosteal stripping with significant bone exposure
|
|
IIIC
|
all of IIIB and vascular injury
*this is an amputation risk |
|
treatment
|
dress wounds, splint fractures, irrigation and debridement
*open contamination of wounds should be left open |
|
treatment option
|
internal fixation, external fixation
|
|
complications of fractures
|
venous thrombosis and pulmonary embolism- dilemma is anticoagulant versus mechanical measures only
tetanus, gas gangrene, fat embolism, infection, avascular necrosis, amputation, malunion, delayed union, non-union |
|
compartment syndrome
|
compression of nerves and blood vessels within an enclosed space, leading to impaired blood flow and nerve damage; most common in lower leg and forearm, but can also occur in hand, foot, thigh, and upper arm
|
|
signs of compartment syndrome
|
extreme pain out of proportion, pain on passive ROM of fingers/toes, pt holds injured part in position of flexion, pallor of extremity, paralysis, paresthesias (early loss of vibratory sensation), pulses
|