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Flashcards in Adult Trauma - Moran Deck (14)
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1
Q

What are the three main specific causes of death after trauma?

A

***Hypovolemic shock due to acute blood loss

Hypotension: (

2
Q

What is the primary and secondary survey in the stabilization of trauma patients? Definitive Care?

A

Primary Survey: ABC’s (+ DE) = Airway, Breathing, Circulation, Disability, Exposure

Secondary Survey: Complete Exam – Head to Toe

Definitive Care: OR vs ICU vs. Transfer

3
Q

How do you assess the level of consciousness during the Primary Assessment of Neurological Disability?

A

Level of consciousness: AVPU

	1. Alert
	2. Response of verbal stimuli
	3. Response to pain stimuli
	4. Unresponsive
4
Q

After resuscitation, what is the best and most important predictor of TBI?

A

GCS = Glasgow Coma Scale

5
Q

How often do you repeat GCS assessment? What if score increases/decreases?

A

Assess every 5 minutes & as needed

GCS is obtained by direct patient interaction, not simply patient observation. You must ask direct questions and perform specific actions to obtain GCS score.

Good sign: GCS goes up by 2 points or more

Bad sign: GCS goes down by 2 points or more

Regular re-assessment is important.

Do GCS before intubation.

6
Q

What is the lowest GCS score a patient can have?

A

3

7
Q

What GCS scores indicate TBI Severity (post-trauma)?

A

GCS 14-15 — MILD

GCS 9-13 — MODERATE

GCS 3-8 — SEVERE

8
Q

Why is pupillary assessment important?

A

Can indicate impending cerebral herniation. A fixed and dilated pupil is a warning sign!

9
Q

What are the indicators of brain herniation?

A

Bilateral dilated unresponsive pupils OR Asymmetric pupils

AND

Abnormal extension (decerebrate posturing) OR No motor response to painful stimuli

10
Q

What is the most commonly injured organ in Pediatric abdominal trauma?

A

Spleen

11
Q

What is the most common FATAL abdominal injury in pediatric abdominal trauma?

A

Liver

12
Q

What diagnostic studies are appropriate if pediatric patient is unstable? stable?

A

Unstable => ultrasound (don’t do CT), or go straight to OR

Stable => do CT

13
Q

Severe head injury in children less than one year of age is usually the result of what kind of trauma?

A

ABUSE => be suspicious!

14
Q

Where do you place a chest tube in a pediatric patient? Why?

A

Always place chest tubes lateral and above the nipple (about 5th ICS) to avoid intra-abdominal injury to liver or spleen