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;
36 Cards in this Set
- Front
- Back
|
What is the ATLS approach to trauma
|
1. Prepare
2. Triage 3. Primary survey 4. Resuscitation of vital signs 5. Secondary survey 6. Intervention 7. Definitive care |
|
|
How do you wan to prepare
|
Proper equipment (i.e airway support, warm IV)
|
|
|
How do you triage
|
1. Abnormal Vital signs (RR < 10 or > 29; BP < 90; HR < 50 or >120)
2. Penetrating trauma proximal to knees and elbows 3. Fall > 20 ft 4. Co-morbid conditions (pregnancy, elderly) 5. Burns 6. MVA |
|
|
Which MOI would be considered triaged in a MVA
|
1. Ejection from car
2. Death of another person 3. Person hit by a car 4. High speed (> 65 kph; bike > 20) 5. Major car deformity 6. Roll over |
|
|
Who do you triage if you have multiple casualties that does not exceed capacity
|
Treat people with life threatening problems first
|
|
|
Who do you triage if you have mass casualties that exceed capacity
|
Treat this who have a greatest chance of survival with the least expenditure resources
|
|
|
What is the primary survey
|
ABCDEs
Resuscitation Adjunct to primary survey |
|
|
What are you trying to identify and manage in the primary survey
|
Life threatening conditions
|
|
|
What does ABCDE stand for in primary survey
|
Airway & cervical spine
Breathing Circulation Disability or neurologic status Exposure (undress) Environment (Temp control) |
|
|
How can you tell if a patient has a patent airway
|
They can talk
|
|
|
If a patient is not breathing what should you look at
|
1. Obstruction or snoring
2. Facial or neck trauma 3. Foreign body 4. Is there going to be a deterioration |
|
|
How do you manage an airway
|
1. Jaw thrust chin lift
2. Nasopharyngeal or oropharyngeal airway if unconscious |
|
|
When should you assume a cervical spine injury and how long do you keep it stabilized
|
Assume if:
Multiple injuries Blunt trauma above clavicle Altered LOC Maintain with: Collar Foam block Manual in line immobilization |
|
|
How do you deal with Breathing
|
Get O2 to lungs by supplemental O2 make and monitor O2 Saturation
|
|
|
If the person is not breathing well how would you manage it
|
1. Support ventilation by bag valve mask
2. Tracheal intubation (endotracheal, cricothyrotomy, tacheostomy) 3. Combi-tube 4. Laryngeal mask |
|
|
What do you consider if there is unequal or poor air way entry
|
1. Assure airway is patent
2. Think hemo/pneumothorax 3. Feel chest for abnormal movement or crepitus 4. Decompression of chest 5. Percussion of chest |
|
|
What is the main cause of death in trauma
|
Hemorrhage
|
|
|
Which do you treat first hypotension or blood loss
|
Blood loss
|
|
|
What are signs of hypovolemia
|
Decreased LOC
Skin Pallor Rapid thready central pulse (carotid or femoral) |
|
|
What type of bleeding is managed n the primary survey
|
Rapid external bleeding
|
|
|
How do you manage rapid external bleeding
|
1. Start 2 14-18 gage IV and draw blood for group match of pRBC
2. Infuse 1 litre Crystalloid (NS or RL) at 37-40 degrees |
|
|
How do you control a hemorrhage
|
1. Direct pressure
2. Tourniquet 3. Don't clamp (destroys other structures) |
|
|
How do you determine disability
|
AVPU
Alert Verbal Stimuli Painful Stimuli Unconscious |
|
|
Is glasgow coma scale part of the the primary or secondary survey
|
Secondary
|
|
|
What do you do for exposure/environmental exam
|
1. Fully undress the patient
2. Cover with warm blanket (may need active external re-warming if hypothermic) |
|
|
What do you do to reassess and resuscitate
|
1. Reassess O2 and ventilation
2. Shock Management -IV fluid and blood 3. Mange life threats |
|
|
What are the adjuncts to the primary survey
|
1. Monitoring (BP, pulse ox)
2. Urinary and gastric catheter 3. X-Ray |
|
|
What should you do as soon as the primary survey is complete
|
Get vital signs
|
|
|
What does dysrhythmia suggest
|
Cardiac contusion
|
|
|
What does pulseless electrical activity (no pulse but sinus rhythm) suggest
|
Tension pneumothorax
Pericardial Tamponade Hypovolema |
|
|
What does bradycardia suggest
|
Hypoxia
|
|
|
What do you want to put in a urinary catheter
|
Urine output is reassuring for adequate renal perfusion
|
|
|
Why do you want to use a gastric catheter
|
Reduce the risk of aspiration
|
|
|
What diagnostic imaging would you do
|
1 . Portable x-ray
2. AP chest and pelvis 3. Cross table lateral c-spine |
|
|
Do negative x-rays rule out c-spine injury
|
No
|
|
|
Should you do an x-ray on a pregnant women
|
yes if necessary
|
