Trauma Assessment and Management

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Flashcards on Trauma Assessment and Management, created by Elizabeth Then on 28/08/2018.
Elizabeth Then
Flashcards by Elizabeth Then, updated more than 1 year ago
Elizabeth Then
Created by Elizabeth Then over 5 years ago
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Question Answer
Trauma definition - injury/trauma is a structural or physiologic alteration caused by an outside source of energy applied to the body
Energy exists in 5 physical forms mechanical, chemical, thermal, radiation, electrical
Mechanism of injury by which energy is transferred from the environment to the person
Mechanical injury: damage dependent on: tissue type and consistency - external force, area, duration, direction predictor for potention of injury and patterns of injury
Force mass of object, velocity mass doubled = energy doubled velocity doubled = energy quadrupled
Energy transfer Blunt - tissue not penetrated penetrating - tissue penetrated
Injury Identification Positive findings are useful negative finding can be falsely reassuring Blunt vs penetrating Airway burns Head and c spin Chest and pelvis - abdomen
Assessment and management - systematic approach - ABCDE approach to treating life threatening injuries - Oxygenation and perfusion at all times - well organised trauma team
Prehospital assessment - ABCDEs - Early transport - Trauma bypass -MIST mechanism of injury, injury sustained, signs (vitals), treatment (what, when, timing, transport)
Priorities - ABCDE approach - oxygenation and perfusion - identify and treat life threatening injuries - prevent secondary injury
Response to intervention what are you assessing for? assess, intervene, re-assess, intervene
predicting severe injury co -morbid factors - extremes of age - underlying disease, pregnancy, poor health, environmental extremes, time
Patterns of injury determined by folowing age, mechanism of injury, anatomy, pre-existing factors
Types of impact on motor vehicle accidents frontal impact lateral/side impact rotational impact rear impact rollover
Blast/explosion pressure wave, structural collapse, wind, burns, projectiles
Blast injury phases primary - heat of explosion, fuel and oxidant secondary - trauma caused by projectiles tertiary - personnel displacement and structural collapse
Penetration injuries assessment and management - systematic approach - ABCDE approach - oxygenation and perfusion at all times
Primary survey - ABCDE rapid - 60 secs - A - c spine stabilisation Identify and treat life threatening injuries
Secondary - FGHIJ F - temp recording - G - set of vital signs - H - history - I head to toe exam - J document return to ABCDEs
Phases of trauma management Phase 1- field stabilisation and resus phase 2 - in hosp resus and operative phase 3 - critical care phase 4 - intermediate and acute care phase 5 - rehab
Trimodal death in trauma 1st peak - within mins of injury 2nd peak - Primary survery, abdo injury 3rd peak - occurs after days/weeks, sepsis
Phase 2 - hospital resus and operative phase - goal = survival - primary survey - airway maintenance and c - spine protection - 'golden hour of shock' - damage control procedures - control of bleeding - surgical control
End points of resus for poly trauma - stable haemodynamics without inotrope support - no hypoxaemia or hypercpania - serum lactate - normothermia
Phase 3 - crit care physical and monitoring assessments prevention of complications assessment of oxygen delivery versus oxygen demand - triad of trauma management and prevention of - persistent metabolic acidosis - hypothermia - coagulopathy
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