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Paramedic COPY > Trauma > Flashcards

Flashcards in Trauma Deck (76):
1

Trauma

Primary cause of death in ages between 1-44 years old
-occurs when external source of energy affects the body beyond its ability to sustain and dissipate it

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Mechanical energy

Energy from motion-KINETIC ENERGY

3

Potential energy

Energy an object can have when stationary

4

Chemical Energy

Energy released as a result of a chemical reaction and can be found in an explosive or an acid

5

Electrical Energy

Form of high voltage

6

Barometric Energy

Sudden radical changes in pressure

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Biomechanics

Study of a living organism using tools

8

Kinetics

Study of speed, mass, direction of force, and physical injury

9

Organs

Organs that have gas inside can be easily compressed

10

Types of injury

Depend on force and energy delivered

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Blunt Trauma

When skin is not broken and the force and energy is made to dissipate

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Duration of force application

Affects trauma because rapidly applied amounts of energy are less tolerated than an identical amount over a longer period of time

13

Impact resistance of body parts

Determined by what is inside the organs (gas, liquid, solid)

14

Index of suspicion

Suspecting an injury is present

15

Velocity

Distance an object travels per unit time

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KE

=m/2XV2

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Phases of MVC

First: deceleration of vehicle
Second: deceleration of occupant
Third: deceleration of organs
Fourth: secondary collision
Fifth: additional impacts

18

Head on Impact

Brain Injury
Scalp
Spinal
Chest
Pneumo
Femoral
Aortic tear
-less survivors

19

Rear end

Whiplash bleeding inside skull
-more survivors

20

Abrupt deceleration forces

Sudden stop
-shearing, avulsing, rupturing of organs
-chest vulnerable to aortic injury
-blunt abdominal injuries

21

Organs commonly affected

Kidneys, small intestine, liver, large intestine, pancreas and spleen

22

Lateral Impact

Pelvis and chest

23

Rotational or quarter panel impacts

Forward and diagonal Impact
-three angled seatbelts

24

Rollovers

May be ejected without seatbelt
-ejection increased death by 25%
- 1 in every 13 people in ejection sustain major cervical spine damage

25

Airbags

Will not deployed unless hit from the front and won't if hit lateral quarter
-abrasions to face, arms and hands
-cornstarch used in airbags to load
-pediatrics can be killed with airbag deployment

26

Motorcycle Crashes

Helmets transmit forces to the spine
4 types of crashes:
Head on- hit and continue forward until stopped by outside force yielding bilateral femur or tibia fractures
Angular Impact- direct crushing injuries to lower extremity between object and motorcycle
Ejected rider- laying down or sliding results in road rash

27

MOI's

First: auto strikes body
Second: body hits hood
Third: body hits grund

28

Waddell Triad

Bumper hits pelvis, chest and abdomen hit grille, head strikes vehicle and ground

29

Don Juan Syndrome

Jumping down to ground
Energy transferred to heel, legs, pelvis and chest
T12-L1 and L2
-children younger than 3 have fewer injuries from falls greater than three stories than children and adults

30

Stab Wounds

Low versus high velocity.
Depends on length, blade, and motion of weapon

31

Cavitation

Cavity formation from a bullet wound
-Entrance: bullet goes in
-Exit: bullet comes out

32

Obtain information

What caliber was used? What range was fired? What kind of bullet?

33

Primary Blast Wounds

The wave from a blast and affect hollow membranes
-Can tell severity of ruptured pulmonary tissue by observing the tympanic membrane

34

Secondary Blast

Debris hitting a person such as shrapnel set in motion by shrapnel

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Tertiary Blast

When a person is hurled boy the force and hits ridged objects

36

Quaternary Blast

Miscellaneous injuries acquired from primary blast

37

Quinary Blast

Biological, chemical exposure

38

RTS

Asses injury severity in patients with head trauma
Lowest is 0 Max is 12
-GCS, PR & Sbp
GCS
13-15 4
9-12. 3
6-8. 2
4-5. 1
3. 0
SBP
>89. 4
76-89. 3
50-75. 2
1-49. 1
0. 0
RR
10-29. 4
>29. 3
6-9. 2
1-5. 1
0. 0

39

Level 1 Trauma

Every injury possible

40

Level 4 Trauma

Able to provide ATLS

41

MOI criteria

Adults fall more than 20 feet or three times height
Children falls more than 10 feet or <10ft with LOC
High risk auto crash
Intrusion intompassenger compartment
Ejection from automobile
High risk injury
Pedestrian/bicyclist thrown
Burns with other Trauma
EMS provider judgment

42

Special Considerations

Age>55
Systolic <110 in age >65
Using anticoagulants
Pregnancy
Burns with trauma
EMS Judgement

43

Oxygen Dissisociation Curve

Affinity of oxygen on hemoglobin and oxygen in plasma
Spo2 and PaCo2
-too much fluid can transfer oxygen from hemoglobin to a larger plasma if there is more fluid cause an increase in paco2 and decrease in spo2
-temperature also effects (sweet tea) and how molecules dissolve
-pH also effects trauma by decreasing chance of transporting oxygen

44

Trauma Triad

Ph, hypothermia, infection

45

Pain Management

Need to so that there isn't a massive catecholamines dump

46

Coagulopathy

Free bleeders because the body uses all clotting ability when bleeding and runs out so bleeding can not clot

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Compensated

HR increase, lethargic, skin

48

Decompensated

Pressure changes signify decompensation

49

Burns

Hypovolemia, hypothermia, infection, pain

50

Superficial

Burn to epidermis
-Red color
-Vulnerable to temp regulation

51

Partial Thickness Burns

Burn to dermis
Glands, Nerves, vessels
-Massive fluid shift ! Fluid forms in bubbles

52

Full Thickness Burn

Burn to sub
- no ability to thermos regulate
- no sensory
- no fluid containment

53

Airway Burns

Stridor, burns to pharynx, nasal hairs
-Edema causes loss of airway

54

Parkland Burn Formula

4xBSAxkg half over first 8 then rest over last 16hours

Easy way = BSAxKg/4 = fluid over first 8 hours

55

Dry sterile dressing

Dry because the lint does not stick and because bacteria is easier to travel through water than through air. Also, water could cause further hypothermia

56

Wet sterile dressing

If moderate burns use wet to smooth. If full Thickness burns then use dry

57

Rule of Nines

Adult head 9 Child head 12 Infant Head 18

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Palm Rule

The palm is 1% of TBSA

59

Chemical Burns Acids Examples

Battery Acid
HCl Acid
HFl Acid
-immediate pain and coagulation necrosis

60

Chemical Bases and Alkalis examples

Potassium
Hydroxide
Lime
Drain Cleaner
Lye
-little pain but extensive damage by liquification necrosis. Breakdown of protein, collagen, fats, dehydration of tissues, thrombosis of vessels

61

Oxidizing Agents

Hydrogen Peroxide
Sodium Chlorate
-can cause systemic poisoning

62

Phosphrous

Ammunition and fireworks
-burns when exposed to air and can cause systemic posioning

63

Vesicants

Sulfur mustard
Phosgene oxide
-blister agents. Respiratory compromised if inhaled

64

Dry Lime

Alkali
-becomes corrosive with water so clean as much off as possible then irrigate with copious amounts of water with hose or shower

65

Sodium Metals

Produce cosiderable heat when mixed with water and may explode
-cover burn with oil

66

HFl

Use Calcium Chloride of 10% Solution and make a jelly to apply to site of burn

67

Eye Solution for ocular anasthetic

Put 100mg of Lidocaine in a 1000ml bag of NaCl to make a analgesic flush solution

68

Arc Flash Burn

When an arc makes connection with a person.

69

Flame Burn from electricity

When the electric current ignites someone's clothing

70

Radiation Burns

Acute Radiation Exposure is highly seen in industrial sections of work

71

Alpha Particles

Have little penetrating energy and easily stopped by the skin

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Beta Particles

Are stronger than alpha and can penetrate skin but be blocked by very simple clothing

73

Gamma Particles

Easily passes through the body and solid materials

74

Radiation

Measured in units of RAD or Radiation Absorbed Dose

75

Acute Radiation Syndrome

Causes hematologic, CNS and GI chnages
-patients who unresponsive by radiation or manifest vomiting in 10 minutes will die
-patients who manifest vomiting less than an hour have a 30/80% chance of survival
-patients who manifest vomiting within one to two hours have a 95-100% chance of surviving

76

Radiation Contact Burns

Local soft tissue injury