Injured Lower Extremity Flashcards Preview

Emergency Med/Trauma > Injured Lower Extremity > Flashcards

Flashcards in Injured Lower Extremity Deck (26)
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1
Q

Level 1 trauma

A

Complete care
Surgery residency
Required volume
Surgeons on duty 24 hrs per day

2
Q

Level 2 trauma

A

Initial care

Surgeons out of house but readily available

3
Q

Level 3 trauma

A

Immediate care
Prearranged transfer
Prompt availability of surgeon
Rural/Community hospital

4
Q

Level 4 and 5 trauma

A

Advanced trauma life support

Trauma trained nurse immediately available and physician available upon patient arrival

5
Q

Glasgow Coma Scale

A

8 or lower is severe, coma
9-12 is moderate
13-15 is minor

6
Q

Understand revised trauma score

A

scale is ranged from 0-4 and added together based on Glasgow, Systolic BP, and RR

7
Q

What does the RTS help you do?

A

Directs triage and evaluates patient outcomes

-Less than 4 requires treatment at trauma center

8
Q

Primary Survey includes?

A

ABCDE

-Life threatening injuries are identified and addressed until the patient is stable

9
Q

ABCDE includes?

A
Airway
Breathing
Circulation
Disability
Exposure/Environmental Control
10
Q

Secondary survey includes?

A

Complete head to toe eval w/ definitive diagnosis and treatment
Repeat vitals
Extensive testing

11
Q

Tertiary survey includes?

A

Repeat head to toe w/ reevaluation w/ labs and studies
Comprehensive review of medical records
Repetition of the surveys and review
Changes are evaluated and treated

12
Q

HPI

A

Local injury as well as associated injuries

13
Q

Scoring system used to determine risk for amputation

A

Mangled Extremity Score

-Greater than 7 is high risk

14
Q

How are the specificity and sensitivity for amputation of the MES?

A

GOOD specificity

POOR sensitivity

15
Q

What are MES scores used for>

A

Help guide decision but NOT used in isolation

16
Q

When do you consider limb salvage?

A
Intact Tibial n.
Reconstruct vascular supply
Moderate tissue injury/loss
Moderate bone loss
Functional foot/ankle
Younger patient
17
Q

Tetanus vaccine

A

Vaccine produces immune response that takes several months

18
Q

Tetanus Immunoglobulin

A

Produces immediate but temporary protection

19
Q

When to give Tdap

A

Adults who have never received Tdap
More than ten years since the last
More than 5 years since the last

20
Q

IV Antibiotics are based on…?

A
Severity
Timing
Contamination
Co-morbidities
Contra-indications
21
Q

What classification is used to determine antibiotics for open fractures?

A

Gustilo and Anderson

22
Q

Explain gross debridement/wash out

A

Performed after patient is stabilized
Remove all debris and foreign material
Decrease bacterial burden

23
Q

Explain initial stabilization/reduction

A
After the patient is stabilized
Address neurovasculature
Decrease trauma to soft tissue
Prevent 2nd hit
**Damage control
24
Q

First hit

A

Trauma activates SIRS

Soft tissue and bone

25
Q

Second Hit

A

Surgery in the early phase accelerates SIRS

Increased local soft tissue damage

26
Q

Lag period

A

Surgery just past the peak of SIRS

Surgery may overwhelm soft tissues already damaged