Term
| What survey stage includes CPR survey and key vital functions (checking for life threatening conditions? How long should this take? |
|
Definition
| Primary survey; < 30 seconds |
|
|
Term
| What survey stage includes checking for conditions that could become life-threatening? |
|
Definition
|
|
Term
| As the ABCs are being checked what should someone be doing? |
|
Definition
| Removing all clothing to aid in faster survey |
|
|
Term
| What are the components of the primary survey? |
|
Definition
A - Airway with C-Spine Control
B - Breathing
C - Circulation with hemorrhage control
D - Disability: Neuro status
E - Exposure/Environmental Control |
|
|
Term
| How do you open the airway? |
|
Definition
| Chin-lift / head-tilt maneuver |
|
|
Term
| What is the most rapidly fatal problem in a pt with trauma? |
|
Definition
|
|
Term
| How do you assess the adequacy of respirations? |
|
Definition
Assess rate of respirations
Assess depth of respirations
Assess Accessory muscle use (scalene, SCM, trapezius)
Assess cyanosis
Assess LOC (confusion) |
|
|
Term
| Which airway device is described as a tube inserted through the mouth and pharynx so that the tongue does not block air flow in an unconscious person? |
|
Definition
|
|
Term
| What type of airway is described as a tube inserted through a nostril, across the floor of the nose, and through the nasopharynx so that the tongue does not block air flow in an unconscious person? |
|
Definition
|
|
Term
| Which type of airway device is described as a device for maintaining a patent airway without tracheal intubation, consisting of a tube connected to an oval inflatable cuff that seals the larynx? |
|
Definition
|
|
Term
| What airway is described as the placement of a tube into the trachea (windpipe) in order to maintain an open airway in patients? |
|
Definition
|
|
Term
| Which type of cricothyroidotomy is preferable in infants and children, Needle or Surgical? |
|
Definition
|
|
Term
| When should you hyperventilate a pt? |
|
Definition
| If there is increased ICP, hyperventilation can drop the ICP |
|
|
Term
| If the pt has no spontaneous breathing in the field and you are alone, what should you do? |
|
Definition
| Deliver two breaths and call for help |
|
|
Term
| How do you evaluate circulation in adults? |
|
Definition
|
|
Term
| How do you evaluate circulation in a child? |
|
Definition
|
|
Term
| With trauma, what kind of shock is MC? |
|
Definition
|
|
Term
| What is the quick neuro assessment? |
|
Definition
A = Alert
V = Verbal response
P = Pain response
U = Unresponsive |
|
|
Term
| In the glasgow coma scale, what are the levels of eye response? |
|
Definition
4 - Eyes open spontaneously
3 - Eye opening to verbal command.
2 - Eye opening to pain.
1 - No eye opening. |
|
|
Term
| In the glasgow coma scale, what are the levels of motor response? |
|
Definition
6 - Obeys
5 - localizes to pain
4 - Withdrawls from pain
3 - Flexion to pain
2 - Extension to pain
1 - No response |
|
|
Term
| In the glasgow coma scale, what are the levels of verbal response? |
|
Definition
5 - Oriented
4 - Confused
3 - Inappropriate Words
2 - Incomprehensible sounds
1 - No verbal response |
|
|
Term
| If the glasgow coma scale score is < 8 after 6 hours, what is the % mortality? |
|
Definition
|
|
Term
| What is the most accurate predictor of future outcome of a trauma? |
|
Definition
| Initial "post-resuscitation" glasgow coma score |
|
|
Term
| What is a 'mild' glasgow coma scale score? |
|
Definition
|
|
Term
| What is a 'moderate' glasgow coma scale score? |
|
Definition
|
|
Term
| What is a 'severe' glasgow coma scale score? |
|
Definition
|
|
Term
| When should the c-spine be cleared? |
|
Definition
| cleared after primary and secondary survey (must be cleared early |
|
|
Term
| What should all patients with head or maxillofacial trauma be presumed to have? |
|
Definition
| presumed to have an unstable C-spine injury until positively excluded |
|
|
Term
| If a life-threatening injury requiring emergent surgery is present, what should your next step be? |
|
Definition
| Delay secondary survey and stabilize the pt |
|
|
Term
| What is the rapid history? |
|
Definition
A - Allergies
M - Medications
P - PMHx
L - Last Meal
E - Events preceding the trauma, environment |
|
|
Term
| Which type of fracture is an Anterior displacement of C2 on C3? |
|
Definition
|
|
Term
| What MOI causes Hangman's fracture? |
|
Definition
| Severe hyperextension; Seen in judicial hangings or MVAs |
|
|
Term
| What MOI causes a Jefferson burst fracture? |
|
Definition
| Axial loading: Blow to top of the head |
|
|
Term
| What vertebrae is affected in a jefferson burst fracture? |
|
Definition
|
|
Term
| What vertebrae are affected in a Hangman's fracture? |
|
Definition
|
|
Term
| What is the MOI of a clay-shoveler's fracture? |
|
Definition
|
|
Term
| What is the MOI in a flexion teardrop fracture? |
|
Definition
|
|
Term
| With a percussion of the chest that is dull after a trauma, what condition would you suspect? |
|
Definition
|
|
Term
| With a percussion of the chest that is hyperresonant after a trauma, what condition would you suspect? |
|
Definition
|
|
Term
| What are fractures of the sternum often associated with? |
|
Definition
|
|
Term
| What condition is described as a physical bruising of the cardiac muscle? |
|
Definition
|
|
Term
| What are the complications of a myocardial contusion? |
|
Definition
| All the same effects of an MI |
|
|
Term
| If a myocardial contusion is suspected, what study should be done? |
|
Definition
|
|
Term
| What trauma injury is described as multiple rib fractures allow the chest wall to become unstable? |
|
Definition
|
|
Term
| You notice that as the patient breathes in, the negative pressure “sucks in” the unstable segment of ribs, what is this a sign of? |
|
Definition
|
|
Term
| What trauma injury can be described as an open wound allows air to be sucked into the chest with inspiration? |
|
Definition
|
|
Term
| What trauma injury is described as bruising of the lung results from passage of a shock wave through the tissue? |
|
Definition
|
|
Term
| What type of injury is more likely to cause a pulmonary contusion, a slow crushing or high velocity injury? |
|
Definition
|
|
Term
| What is the MC sign of a pulmonary contusion? What other sign might be present on exam? |
|
Definition
| blood in the lungs; Rales |
|
|
Term
| A CXR shows an opacity in the peripheral lung near to the injured chest wall, what condition do you suspect? |
|
Definition
|
|
Term
| What is a massive hemothorax most often due to? |
|
Definition
| bleeding from the major central chest vessels |
|
|
Term
| What clinical finding can indicate a massive hemothorax? |
|
Definition
| Breath sounds will usually be decreased on the affected side |
|
|
Term
| How is a hemothorax differentiated from a pneumothorax on PE? |
|
Definition
hemothorax = dullness to percussion
pnuemothorax = hyperresonance to percussion |
|
|
Term
| When is respiratory depression with a pneumothorax usually seen? |
|
Definition
| After 40% of the lung is compromised - unless the pt has underlying pulmonary conditions |
|
|
Term
| What is a pneumothorax usually due to? |
|
Definition
| usually due to blunt rupture of the lung surface |
|
|
Term
| What is cardiac tamponade usually due to? |
|
Definition
| usually due to penetrating injuries of the heart. |
|
|
Term
| What type of shock can be caused by cardiac tamponade? |
|
Definition
|
|
Term
| What do you assume all trauma patients in shock with a penetrating wound of the chest have until proven otherwise? |
|
Definition
|
|
Term
| What is the classic triad of cardiac tamponade post-trauma? In what amount of pts is it present? |
|
Definition
| distended neck veins, low blood pressure, and muffled heart tones; present in 1/3rd of pts |
|
|
Term
| What percent of pts with aortic rupture die within minutes of injury? |
|
Definition
|
|
Term
| What are most aortic ruptures due to? |
|
Definition
|
|
Term
| In an MVA, what is the MC location of an aortic rupture? |
|
Definition
| just beyond the left subclavian artery near the ligamentum arteriosum |
|
|
Term
| Pt presents post-MVA with weak leg pulses, hypertension in the arms, and a new murmur what is the diagnosis? |
|
Definition
|
|
Term
| In which type of trauma pts is an aortic rupture more likely? |
|
Definition
| more likely in patients with 1st or 2nd rib fractures |
|
|
Term
| What condition is described as compression of the heart due to fluid accumulation within the pericardium? |
|
Definition
|
|
Term
| On CXR there is deviation of the trachea to the left side of the chest, what diagnosis do you suspect? |
|
Definition
|
|
Term
| What injuries do lap belt marks correlate with? |
|
Definition
| correlated with rupture of the small intestine and an increased incidence of other intra-abdominal injuries |
|
|
Term
| What does flank bruising and swelling raise suspicion for? |
|
Definition
| raise suspicion for a retroperitoneal injury. |
|
|
Term
| What may abdominal bruits indicate? |
|
Definition
| may indicate underlying vascular disease or traumatic arteriovenous fistula. |
|
|
Term
| What does an abdominal fullness or doughy texture upon palpation indicate? |
|
Definition
| intra-abdominal hemorrhage |
|
|
Term
| If there is crepitus or instability of the lower thoracic rib cage, what other conditions might you suspect? |
|
Definition
|
|
Term
| What does pelvic instability indicate? |
|
Definition
| Potential for Lower Urinary Tract injury, pelvic injury or retroperitoneal injury |
|
|
Term
| What percent mortality are open pelvic fractures associated with? |
|
Definition
|
|
Term
| What type of injury can interfere with an accurate assessment of the abdomen? |
|
Definition
|
|
Term
| What does signs of peritonitis (guarding and rigidity), soon after an injury suggest? What about peritonitis that develops hours after an injury? |
|
Definition
moments after injury suggest leakage of intestinal contents
hours after injury suggests intra-abdominal hemorrhage |
|
|
Term
| What are the MCC of abdominal trauma? |
|
Definition
| MVA and automobile-pedestrian accidents |
|
|
Term
| What is more common, blunt trauma or penetrating trauma? |
|
Definition
| Blunt trauma is 5x more common |
|
|
Term
| With blunt trauma to the abdomen, what organ is MC injured? |
|
Definition
|
|
Term
| In children what is the MC injured isolated system? |
|
Definition
|
|
Term
| What is the leading COD in injured children? |
|
Definition
|
|
Term
| In children aged 2 years and younger, what is the MC cause of serious head injury? |
|
Definition
|
|
Term
| What condition is characterized by retinal hemorrhage, subdural or subarachnoid hemorrhage, and some evidence of external trauma to the head in a child under 2y/o? |
|
Definition
|
|
Term
| In children 3 yrs and older, what is the MC causes of head trauma? |
|
Definition
| falls, MVA, bicycle and pedestrian accidents |
|
|
Term
| What is the better indicator of impending circulatory collapse, BP or HR in children? |
|
Definition
|
|
Term
| Norm HR for 0 - 6 m/o? Systolic BP? RR? Wt? |
|
Definition
HR 160-180 beats per minute (bpm)
Systolic BP - 60 - 80mmHg
RR - 60bpm
Wt - 3 - 6kg |
|
|
Term
| Norm HR for an infant >6mo? Systolic BP? RR? Wt? |
|
Definition
HR - 160 bpm
Systolic BP - 80mmHg
RR - 40bpm
Wt - 12kg |
|
|
Term
| Norm HR for a pre-school aged child? Systolic BP? RR? Wt? |
|
Definition
HR - 120
Systolic BP - 90mmHg
RR - 30bpm
Wt - 16kg |
|
|
Term
| Norm HR for an adolescent? Systolic BP? RR? Wt? |
|
Definition
HR - 100bpm
Systolic BP - 100mmHg
RR - 20bpm
Wt - 35kg |
|
|
Term
| For an adult, how many breaths and how many chest compressions in CPR? |
|
Definition
| 2 breaths: 30 compressions |
|
|
Term
| How much of your hand do you use for infant CPR? Child CPR? Adult CPR? |
|
Definition
infant = 1 finger
child = 2 fingers
adult = 2 hands |
|
|
Term
| How many compressions and breaths per cycle in pediatric CPR? |
|
Definition
| 30 compressions followed by 2 breaths |
|
|
Term
| What is cardiac arrest in children most commonly caused by? |
|
Definition
Poisoning
Smoke Inhalation
Head Trauma
(Rarely caused by heart failure) |
|
|
Term
| If the child is unresponsive and you are alone with him, what should you do? |
|
Definition
| start rescue efforts immediately and perform CPR for at least 1 to 2 minutes before dialing 9-1-1 |
|
|
Term
| What should be performed on any child with hx of trauma, LOC > 5 min, or who has an altered level of consciousness? |
|
Definition
|
|
Term
| What is the modified Verbal section of the GCS for children <4y/o? |
|
Definition
5 - Appropriate words, social smile, fixes and follows
4 - Cries, but consolable
3 - Persistently irritable
2 - Restless, agitated
1 - None |
|
|
Term
| What condition is characterized by a harsh, barking cough, which occurs in intermittent bursts, and the inspiration is prolonged and especially noisy? |
|
Definition
|
|
Term
| What condition is characterized by child appearing febrile, toxic or anxious, child is in tripod posture with the neck extended and stridor frequently present, and drooling is typical? |
|
Definition
|
|
Term
| 3 y/o pt presents with 1 day hx of refusal of food, sore throat, cough, and stridor. What is a common cause of these symptoms? |
|
Definition
|
|
Term
| What are the MCC of dehydration? |
|
Definition
|
|
Term
| What is the tx for dehydration? |
|
Definition
| IV infusion of isotonic fluids |
|
|
Term
| What are the risk factors for febrile seizures? |
|
Definition
FHx of febrile seizures
High Temp
Parental report of developmental delay
Neonatal d/c from hospital at age >28days
Day care attendance |
|
|
Term
| What are the risk factors for reoccurrence of febrile seizures? |
|
Definition
Young age of first seizure
Low fever w/first seizure
FHx of febrile seizures
Brief duration btwn fever onset & initial seizure |
|
|
Term
| What is a complication of crush injuries? |
|
Definition
| Muscle Necrosis and Compartment Syndrome |
|
|
Term
| What do severe burns require first? |
|
Definition
| extensive resuscitation and fluid and blood replacement |
|
|
Term
| Which type of burn is described as area is reddened and blanches with pressures; no edema present; area is generally painful to touch? |
|
Definition
| Superficial or first-degree burn |
|
|
Term
| Which type of burn is described as dermis and epidermis are affected; formation of large, thick-walled blisters; underlying skin is erythematous? |
|
Definition
| Partial thickness or second-degree burn |
|
|
Term
| Which type of burn is described as all of the skin is destroyed; may have damage to the subcutaneous tissue and muscle; usually has a dry appearance, may be white or charred; will require skin grafting to cover area? |
|
Definition
| Full-thickness or third-degree burn |
|
|
Term
| Which type of burn is described as full-thickness burn in which underlying structures (fascia, tendons, and bones) are severely damaged, usually blackened? |
|
Definition
|
|
Term
| What is the rule of nine in adults? |
|
Definition
Head = 9%
Arms = 9% each (4.5% front, 4.5% back)
Trunk = 18% (9% front, 9% back)
Leg = 18% each leg (9% front, 9% back)
Peritoneum = 1% |
|
|
Term
| What is the rule of nines in children? |
|
Definition
Head = 18% (9% front, 9% back)
Arms = 18% (9% each arm)
Trunk = 18% front and 18% back
Legs = 13.5% each
Peritoneum = 1% |
|
|
Term
| What chart is the most accurate method for estimating burn extent, and must be used in the evaluation of all pediatric patients? |
|
Definition
|
|
Term
| What percentage of surface area coverage in adult requires hospitalization? in kids? |
|
Definition
|
|
Term
| What specific areas of the body when burned require hospitalization? |
|
Definition
| Deep burns of the hands, face, & perineum |
|
|
Term
| What is the treatment for rhabdomyolysis? |
|
Definition
| Early and aggressive fluids (hydration) may prevent kidney damage |
|
|
