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Emergency & Acute > TARMS > Flashcards

TARMS Flashcards

1
Q

When is NPA contraindicated?

A

Basal skull fracture

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2
Q

What is a sign of basal skull fracture?

A

Bruising around the eyes

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3
Q

What is primary traumatic brain injury?

A

What happens at the event

e.g. skull fracture, concussion, intracranial haematoma

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4
Q

What is secondary traumatic brain injury?

A

Inflammatory response to the primary injury

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5
Q

What is CPP?

What is the issue in traumatic head injury?

A

CPP = MAP-ICP

Blood supply to the brain is dependent on the difference between BP & ICP

In head injury, ICP is rising & BP reducing - difference between the two is reducing (brain is less likely to be perfused)

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6
Q

What happens in brain injury with a decompensated state

A

Coning

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7
Q

What does ATOM FC stand for?

A 
Causes of thoracic trauma
Airway obstruction
Tension pneumothorax
Open pneumothorax
Massive haemothorax
Flail chest
Cardiac tamponade
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8
Q

What are the signs of a tension pneumothorax?

A

Severe respiratory distress
Unilateral hyperexpansion with reduced movement
Hyperresonance with reduced air entry
Tracheal deviation (late sign)

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9
Q

How is tension pneumothorax managed?

A

Cannula into 2nd IC space, mid-clavicular line

Followed by a chest drain into the 5th IC space, mid-axillary

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10
Q

How is an open pneumothorax managed?

A

Flutter valve (opens on expiration)

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11
Q

What causes massive haemothorax?

A

Significant injury to major vessels in the chest

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12
Q

What is the definition of a massive haemothorax?

A

> 1.5L blood in the chest

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13
Q

How is massive haemothorax managed?

A

Chest drain + fluids

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14
Q

What is flail chest?

A

Mobile segment of the chest wall (e.g. 2 or more ribs broken in 2 or more places)

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15
Q

Why is tidal volume reduced in flail chest?

A

Can’t take deep breaths in

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16
Q

How is cardiac tamponade managed?

A

Thoracotomy

17
Q

Systolic BP can stay normal until what % reduction in circulating volume?

A

30-40% reduction

18
Q

What is an early sign of hypovolaemia?

A

Increased resp rate

before HR!!

19
Q

What are the 5 common sites of a large haemorrhage?

A 
'On the floor + 4 more'
External
Femur
Chest
Abdo
Pelvis
20
Q

What is a fast scan?

A

Abdo USS

Can detect >500ml

21
Q

What is the aim of a pelvic binder?

A

Haemostatic (NOT bone control)

22
Q

How do you manage long bone fracture?

A

Splint them!!

23
Q

How do you replace blood in haemorrhage?

A

With blood!

Blood, FFP + platelets

24
Q

If someone on warfarin is haemorrhaging what do you give them?

A

TXA + octuplex

25
Q

Why is it particularly bad if someone on a DOAC is haemorrhaging?

A

Very difficult ot reverse

Emergency & Acute (21 decks)

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