Erstellt von Elizabeth Then
vor etwa 6 Jahre
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Frage | Antworten |
Trauma definition | - injury/trauma is a structural or physiologic alteration caused by an outside source of energy applied to the body |
Energy exists in 5 physical forms | mechanical, chemical, thermal, radiation, electrical |
Mechanism of injury | by which energy is transferred from the environment to the person |
Mechanical injury: damage dependent on: | tissue type and consistency - external force, area, duration, direction predictor for potention of injury and patterns of injury |
Force | mass of object, velocity mass doubled = energy doubled velocity doubled = energy quadrupled |
Energy transfer | Blunt - tissue not penetrated penetrating - tissue penetrated |
Injury Identification | Positive findings are useful negative finding can be falsely reassuring Blunt vs penetrating Airway burns Head and c spin Chest and pelvis - abdomen |
Assessment and management | - systematic approach - ABCDE approach to treating life threatening injuries - Oxygenation and perfusion at all times - well organised trauma team |
Prehospital assessment | - ABCDEs - Early transport - Trauma bypass -MIST mechanism of injury, injury sustained, signs (vitals), treatment (what, when, timing, transport) |
Priorities | - ABCDE approach - oxygenation and perfusion - identify and treat life threatening injuries - prevent secondary injury |
Response to intervention | what are you assessing for? assess, intervene, re-assess, intervene |
predicting severe injury | co -morbid factors - extremes of age - underlying disease, pregnancy, poor health, environmental extremes, time |
Patterns of injury determined by folowing | age, mechanism of injury, anatomy, pre-existing factors |
Types of impact on motor vehicle accidents | frontal impact lateral/side impact rotational impact rear impact rollover |
Blast/explosion | pressure wave, structural collapse, wind, burns, projectiles |
Blast injury phases | primary - heat of explosion, fuel and oxidant secondary - trauma caused by projectiles tertiary - personnel displacement and structural collapse |
Penetration injuries assessment and management | - systematic approach - ABCDE approach - oxygenation and perfusion at all times |
Primary survey | - ABCDE rapid - 60 secs - A - c spine stabilisation Identify and treat life threatening injuries |
Secondary - FGHIJ | F - temp recording - G - set of vital signs - H - history - I head to toe exam - J document return to ABCDEs |
Phases of trauma management | Phase 1- field stabilisation and resus phase 2 - in hosp resus and operative phase 3 - critical care phase 4 - intermediate and acute care phase 5 - rehab |
Trimodal death in trauma | 1st peak - within mins of injury 2nd peak - Primary survery, abdo injury 3rd peak - occurs after days/weeks, sepsis |
Phase 2 - hospital resus and operative phase | - goal = survival - primary survey - airway maintenance and c - spine protection - 'golden hour of shock' - damage control procedures - control of bleeding - surgical control |
End points of resus for poly trauma | - stable haemodynamics without inotrope support - no hypoxaemia or hypercpania - serum lactate - normothermia |
Phase 3 - crit care | physical and monitoring assessments prevention of complications assessment of oxygen delivery versus oxygen demand - triad of trauma management and prevention of - persistent metabolic acidosis - hypothermia - coagulopathy |
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