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60 Cards in this Set

  • Front
  • Back
3 stages of ATLS
primary survey
resuscitation
secondary survey
primary survey means
airway
breathing
circulation
disability
exposure
3 causes of 1st wave (fastest) death
spinal cord transsection
bleeding from great vessels
severe brain injury
2nd wave death occurs at ___ (time) and is due to ___ problems such as ___ (3)
1st 2 hours
B, C
internal bleeding
cardiac tamponade
severe pulmonary hemorrhage
3rd wave of mortality occurs at ___ (time) and is due to ___
1 week
sepsis
A problems may be excluded if ___ (2)
patient is conscious
patient talks in normal voice
if A problems are present, determine ___
whether urgent intubation is required
6 indications for urgent intubation
cyanosis
apnea
hole in trachea
expanding hematoma present
active bleeding in mouth
black deposits in mouth (burn)
black deposits in mouth indicate risk for ___
fulminant edema of oropharynx
if A problems are present but urgent intubation not indicated, do ___ (3). if this improves A, do ___ (3). otherwise, do ___.
chin lift
jaw thrust
evacuate debris from mouth
stabilize C-spine
give 100% O2 via mask
proceed to B
intubate
after 2 failed attempts at intubation, do ___
surgical airway (cricothyroidotomy)
always do ___ (2) as part of A
stabilize C-spine
give 100% O2 via mask
5 life-threatening B problems
hemothorax
tension PTX
open PTX
flail chest
cardiac tamponade
2 signs of hemothorax
hemodynamic instability
diminished breathing sounds
tx of hemothorax (2)
a hemothorax is massive if ___ or ___, since ___
chest tube
fluid resuscitation
>1500cc of blood via chest tube
>200cc/hour of blood via chest tube
bleeding that fast doesn't stop spontaneously
4 signs of tension PTX
tracheal deviation
JV distention
hemodynamic instability
unilaterally decreased breath sounds
JV distention in tension PTX is due to ___
kinking of SVC due to shift of mediastinum
hemodynamic instability in tension PTX is due to ___
kinking of SVC due to shift of mediastinum
tension PTX can be caused by ___ trauma
blunt or penetrating
first aid for tension PTX
after first aid, ___.
first aid should be attempted ___ times
needle application at 2nd intercostal space, midclavicularly
reassess signs of tension PTX
2
if first aid for tension PTX fails twice, do ___ at ___
chest tube
4th interspace, 1 cm lateral to ant axillary line
if chest tube for tension PTX fails, do ___ at ___.
second chest tube
2nd interspace, midclavicularly
open PTX is aka ___
sign of open PTX
sucking chest wound
hole in chest
tx for open PTX (3)
closure of chest wound
chest tube
if converts to tension PTX, treat as such
flail chest is fracture of ___ ribs in ___ places
2 or more
2 or more
sign of flail chest
paradoxical inspiration
flail chest is bad because ___
pulmonary contusion is likely
tx for flail chest (2)
intubate
ventilate with PEEP
3 signs of cardiac tamponade
JV distension
distant heart sounds
hypotension
severity of tamponade is given by ___
BP
impending death from tamponade is indicated by ___. tx is with ___ (2)
sys BP=50
anterolateral thoracotomy
pericardotomy
intermediate severity of tamponade is indicated by ___. tx is with ___.
sys BP = 80--90
chest CT angio
lowest severity of tamponade is indicated by ___. tx is with ___ (2).
hemodynamic stability
further stabilization
CT angio
grade 1 shock corresponds to ___% IVV loss, which is ___cc in a 70kg person, and observable as ___.
15
750
tachycardia
grade 2 shock corresponds to ___% IVV loss, which is ___cc in a 70kg person, and observable as ___.
30
750-1500
tachycardia
grade 3 shock corresponds to ___% IVV loss, which is ___cc in a 70kg person, and observable as ___ (3).
40
1500--2000
hypotension
tachycardia
oliguria
grade 4 shock corresponds to ___% IVV loss, which is ___cc in a 70kg person, and observable as ___ (4).
50
>2000
hypotension
tachycardia
oliguria
loss of consciousness
tx for shock grades 1--3 (2)
stop external bleeding
IVF
tx for grade 4 shock
surgery
external bleeding should be stopped with ___. if this is not possible, use ___ (2)
direct pressure
packing
inflating foley cath
IVF for hypovolemic shock
2L of lactated ringer's
response to fluids is measured by ___ (3)
BP
HR
urine
minimal urine output for adults is ___/hr
minimal urine output for kids is ___/hr
minimal urine output for infants is ___/hr
.5 cc/kg
1 cc/kg
2 cc/kg
if BP is completely normalized after IVF, do ___.
stop fluids
if full responder deteriorates after stopping fluids, do ___. otherwise do ___
tx as partial responder
CT
tx for partial responder (2)
1L bolus
search for source of bleeding
tx for non-responder (2)
blood
search for source of bleeding
blood type for adults
blood type for kids, child-bearing age women
O+
O-
T/F: head is never source of hemorrhagic bleeding in adults
true
imaging studies for bleeding localization
CXR
FAST
in neck hemorrhage is ___
visible
when searching for bleeding in chest, do ___.
bilateral chest tubes
if <___ of blood is obtained from chest tubes, ___.
1.5L
chest is not the only source of bleeding
if FAST is positive, do ___. otherwise, ___.
go to OR for laparotomy
check pelvis
checks performed for D
pupils (symmetry, reflexes)
GCS
basic motor exam
E phase
exposure (strip patient)
7 procedures performed in resuscitation phase
ECG
insert NGT
PR
insert foley cath
CXR
portable pelvic XR
FAST
FAST is for finding ___ (2)
free abdominal fluid
rule out cardiac tamponade
5 methods of reducing ICP
ventriculostomy
diuresis (mannitol)
hyperventilation
barbiturate coma
craniotomy (last resort)
hyperventilation is only performed on scene if ___ or ___
anisocoria present
fulminant deterioration wihhout hypovolemic shock or hypoxia