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25 Cards in this Set
- Front
- Back
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What are the 4 phases of a proper assessment of a trauma pt?
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1. Primary Survey
2. Resuscitation 3. Secondary Survey 4. Definitive Care |
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What does the primary survey involve?
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- Dx & Tx of all life-threatening injuries.
- organized by ABCDEFG |
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What does ABCDEFG stand for?
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A = Airway & Spine Immobilization
B = Breathing C = Circulation D = Disability = Neuro deficits E = Exposure (take ALL clothes off) & Environment (keep pt warm) F = Foley G = Gastric tube |
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What parts of respiratory tract are evaluated in Airway Management?
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Mouth
Oropharynx Larynx Trachea |
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An adequately immobilized pt has a...
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...cervical collar & is secured to a rigid backboard
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What's the proper technique to immobilize pt's spine while airway is assessed?
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Dr. A assesses airway.
Dr. B immobilizes spine by - kneeling at head of bed - placing his hands on pt's shoulders - with wrists alongside pt's head - keep pt's head from moving while Dr. A intubates |
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Which 2 maneuvers are used to open mouth in pt who's unconscious & supine?
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Jaw-Thrust
or Chin-Lift maneuvers |
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a) Describe Jaw-Thrust maneuver.
b) Disadvantage? |
a) - place fingers behind angle of the jaw b/l & grasp jaw on both sides
- lift jaw forward - use thumbs to draw chin down & open mouth b) Disadvantage: reqs 2 hands |
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a) Describe Chin-Lift Maneuver
b) Pros? c) Cons? |
a) - place fingers of one hand under chin & thumb just below lips
- lift chin fwd & downward, opening mouth - now insert thumb behind lower teeth for more secure grip b) Pros: reqs only 1 hand so you can intubate with other hand c) Cons: risk thumb'll be bitten in semiconscious pt |
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The Oral Airway:
a) scientific name? b) goes from where to where? c) describe the tube. d) risks/watch out for.... e) should not be used for which pts? |
a) oropharyngeal airway
b) from mouth to pharynx c) rigid plastic hook d) risks: if improperly done, can push tongue back & block airway e) do NOT use in awake pts w/ an intact gag reflex ---> gag & aspiration |
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The Nasal Airway:
a) scientific name? b) goes from where to where? c) describe the tube. d) SHOULD be used for which pts? |
a) nasopharyngeal airway
b) goes from nostril to hypopharynx c) soft, flexible rubber tube w/ trumpet-like flange on one end d) good for awake pts w/ intact gag reflex |
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Name types of Definitive Airways.
Which are used in an Emergency? |
1. Orotracheal intubation
2. nasotracheal intubation 3. surgical cricothyroidotomy 4. needle cricothyroidotomy 5. tracheostomy Emergency options are surgical & needle cricothyroidotomy |
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Proper location for cricothyroidotomy?
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Through cricothyroid membrane.
Find it by placing finger at sternal notch & moving up trachea. You'll feel: 1. Tracheal rings 2. Cricoid cartilage (more prominant than tracheal rings) 3. a depression (the Cricothyroid membrane) 4. Thyroid Cartilage Descending: 1. Thyroid Cartilage, 2. |
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Difference bt a surgical cricothyroidotomy & a needle cricothyroidotomy?
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Surgical: you insert a size 6 endotracheal tube
Needle: you insert an IV tube (#1 choice in emergency in kids, temporary choice in adults) |
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If you can palpate a radial pulse, that means SBP is > ____?
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> or = 80 mmHg
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If you CANNOT palpate carotid or femoral pulse, means SBP < ___?
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< 60 mmHg
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How do you calculate the GCS (Glasgow Coma Scale)?
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E) Eye Opening:
4 - spontaneous 3 - to verbal command 2 - to painful stimuli 1 - No response V) Best Verbal Response: 5 - Ox3 4 - Disoriented, confused conversation 3 - Innapropriate words w/o sustained conversation 2 - Incomprehensible sounds, moans, groans 1 - No response M) Best Motor Response: 6 - follows verbal commands 5 - localizes pain by reaching twds painful areas 4 - Withdraws from painful stimulus 3 - Decorticate posturing (elbows bent, legs extended) 2 - Decerebrate posturing (elbows & legs extended) 1 - No Response |
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What does the calculated GCS score tell you?
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GCS = 3 DEAD
GCS < 9 COMA, SEVERE head injury GCS 9-12 MODERATE head injury GCS > 12 MINOR head injury GCS = 15 NORMAL |
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Radiographic signs of Blunt Aortic Injury?
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1. wide mediastinum
2. partial obliteration of the descending aorta 3. a left pleural apical cap 4. downward displacement of the left bronchus 5. tracheal deviation to the right 6. obscuration of the aortic arch 7. a right paratracheal stripe thickening 8. deviation of the nasogastric (NG) tube to the right 9. enlarged abnormal aortic contour 10. left hemothorax 11. a displaced left paraspinal stripe 12. a displaced right paraspinal stripe 13. a fracture of the first rib |
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Anatomy.
Name the 5 layers of the scalp. |
"SCALP"
Skin subCutaneous tissue galea Aponeurotica Loose areolar tissue Periosteum (pericranium) |
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Mxn of the Cushing Reflex?
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a response to increased ICP...
increased ICP -->> cerebral BVs get squished -->> ischemia -->> low pH & high PCO2 ->(+) central chemoreceps -->(+) Symp NS -->(+) alpha-Rs -->> vasctcn -->> HTN -->> baroreceps in carotid -->(+) vagus -->> bradycardia -->> increase HR (tachycardia) & CO NET RESULT: (kinda paradoxical) bradycardia HTN decreased resp rate INDICATES IMPENDING HERNIATION!! |
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In a Co-Tenancy, what are the incidents of co-ownership? (3)
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[1] Possession;
[2] Accountability; [3] Contribution. “Co-Tenant” refers to any of the multiple owners of any of the three concurrent estates) |
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Pupils don't need to be identical but need to be w/in ___mm of each other
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1 mm
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Why should you never put an NG tube in a pt w/ raccoon eyes.
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If raccoon eyes are due to ecchymoses, could indicate cribriform plate fx & NG tube would enter brain!
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How to tell if CSF is coming out of pt's nose with all that blood.
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Look for RING SIGN or TARGET SIGN:
- put drop of bloody d/c on lab filter paper - if circle of red blood is surrounded by concentric circles of clearer pink, yes there's CSF |
