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49 Cards in this Set
- Front
- Back
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In trauma deaths there are three peaks, what is the 1st peak & what are some of the causes?
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within minutes of the trauma
C: brain, upper spinal cord, heart, aorta & other major blood vessel injuries |
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In trauma deaths there are three peaks, what is the 2nd peak & what are some of the causes?
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within 2 hours of the trauma
C: r/t subdural or epidural hematomas, hemothorax, ruptured spleen, lacerated liver, fractured femur |
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In trauma deaths there are three peaks, what is the 3rd peak & what are some of the causes?
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days to weeks
C: r/t complication like sepsis, multiple organ failure |
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During triage assessment, what is subjective information?
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Chief complaint/symptoms
events/hx surrounding illness/injury immunizations, isolation allergies medications past medical hx *female: last menstrual period, pregnancy hx |
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During triage assessment, what is objective information?
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VS, W, breath sounds, skin color, perpheral motor/sensory examination
visual/pupil exam pain assessment determine appropriate triage decision |
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What is acuity classification of emergent for triage?
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life, limb, or eye sight
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what is acuity classification of urgent for triage?
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conditions requiring prompt but not immediate attention, should be seen w/in 20 min - 2hr
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What is acuity classification of non-urgent for triage?
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stable condition, the wait could be up to 2 hr, etc. sprains, minor laceration, cold symptoms
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In the primary survey, what does A stand for & what is done at this stage?
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airway w/cervical spine immobilization
open airway suction as needed assess need for oral airway or ET intubation |
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In the primary survey, what does B stand for & what is done at this stage?
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Breathing
L/L/F breathing effectiveness, need assistance supplemental O2 |
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In the primary survey, what does C stand for & what is done at this stage?
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Circulation
palpate pulses, check for bleeding skin color 2 large bore IV lines |
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In the primary survey, what does D stand for & what is done at this stage?
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Disability
quick neurological exam AVPU |
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In the primary survey, what does E stand for & what is done at this stage?
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Exposure & evaluation
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What is the most common cause of traumatic shock?
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hypovolemia d/t acute blood loss
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When does the secondary survey begin?
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after 1 assessment complete & all life threatening injuries are addressed
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What does the F,G,H,I stand for in the secondary survey?
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F-full set of vitals
G-give comfort measures...pain meds H-hx & head to toe assessment I-identify all injuries Re-assess |
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What are most injuries in pediatric trauma?
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sprains, lacerations, contusions, fractures, mild head injury
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What are some differences between adult and children injuries?
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smaller body size
greater relative body surface area internal organs are more anterior & protected by less subc. fat cervical spine differences |
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how does the child have greater capacity to compensate?
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increased HR & systemic vascular resistance
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What organs are more commonly injuried in children?
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liver and spleen
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What is the difference between minor and major trauma?
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minor- single part or system injury
major-multi-system or serious single injury |
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Is respiratory failure a disease, yes or no, & why?
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No
consequence of blood gas abnormalities |
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What is the critical values of PaO2, saturation SaO2, & PCO2?
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PaO2 - <60mmHg
SaO2 - < 90% PCO2 - >50mmHg w/pH <7.30 |
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What are the different types of respiratory failure?
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-mechanical abn. of the lung or chest wall
-defect in the respiratory control center in the brain -impaired ventilatory muscle function |
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What are some of the assessments used to identify respiratory failure?
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dyspnea, ABG's, HA, confusion
Dysrhythmias: PVC, A-fib, tachycardia |
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What are the interventions for respiratory failure?
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treat the cause
decrease CO2 Support O2 sedatives/narcotics |
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What are some of the causes of RF?
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blunt or penetrating chest wall trauma, COPD, ARDS, neurogenic causes
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What is the treatment for a flail chest?
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O2, pain management, promotion of deep breaths, positioning, mechanical ventilation
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Anything above ____ normally requires a chest tube when dealing w/ pneumo or hemothorax?
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20%
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What are some of the s/s of pneumothorax?
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asymmetry of the chest
restlessness respiratory distress absence of breath sounds on affected side cyanosis tracheal deviation - late- |
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What is ARDS commonly a result from?
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Sepsis, trauma, & severe pulmonary infections. No exact cause
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What are some clinical manifestations of ARDS?
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dyspnea, profound hypoxemia, decreased lung compliance, & diffuse bilateral infiltrates
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How does ARDS develop and when?
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usually develops 24-48hr after original injury
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Decreased O2 caused by ARDS & the leakage of ______ produced by the lung cells & white blood cells can lead to this_________ & ______.
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Cytokines
inflammation MSOF (multiple system organ failure) |
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What are the treatments of ARDS?
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Mechanical ventilation
Diuretics Fluid management Use of PEEP use of sedatives |
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What are temporary modes of mechanical ventilation with someone who has ARDS?
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Continuous positive airway pressure or CPAP
bi-level positive airway pressure or BiPAP |
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How does a negative pressure ventilator work?
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noninvasive & works by changing pressures in the chest cavity rather than forcing air directly into the lungs
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How does a positive-pressure ventilator work?
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During the inspiratory phase, air is pushed into the lungs and expands the chest
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What are the 3 ways a ventilator can do positive pressure ventilation?
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pressure cycled
time cycled Volume cycled |
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what is the estimate of tidal volume used by most clinicians?
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7-10ml/kg of body weight + 0 added
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What can a ventilator deliver in fraction of inspired oxygen (FiO2)?
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21-100%
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What is PIP & how is it indicated?
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peak inspiratory pressure
pressure needed by the vent to deliver a set tidal volume |
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If the lungs become stiff, what will the PIP do? why?
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go up
peak pressure is highest pressure during the inspiratory phase |
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What is PEEP & what does it enhance?
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positive end expiratory pressure
during expiratory phase of ventilation -gas exchange & preventing atelectasis |
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When is PEEP used most often?
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when PO2 drops below 70%
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What is a major care of the ventilator dependent patient?
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oral care
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In drug overdose, one way of death is cerebral depression. What is the cause of death?
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leads to drowsiness & coma.
usually breathing stops, followed by heart or pt will V/& aspirate |
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In drug overdose, one way of death is cerebral depression. What is a medication that causes cerebral depression?
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Tricyclic Antidepressants
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What do you want to do for an unconscious pt. expected of a drug overdose?
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get tablets out of the pt. system
identifying what the pt. has taken providing specific treatment |
