Trauma/SCI 7 Q

Question 1

What order does the primary survey occur in?

Answer 1

ABCDE: Airway, Breathing, Circulation, Disability, Exposure

Question 2

Maintain the airway by keeping the head ____ and stabilized

Answer 2

midline

Question 3

What is one way to open the airway?

Answer 3

using the jaw-thrust maneuver

Question 4

Assess the pt’s breathing and administer high-flow O2 via a ________, or an ambu bag for life-threatening conditions.

Answer 4

nonrebreather face mask

Question 5

Circulation is checked via the ______ pulse

Answer 5

carotid

Question 6

Insert two large-bore IVs and provide aggressive fluid resuscitation using ___ or ___

Answer 6

LR or NS

Question 7

When assessing disability, we will measure the patient’s _____ with a brief neuro exam

Answer 7

LOC

Question 8

When inspecting posterior surfaces, we need to ______ the patient while maintaining cervical spine immobilization.

Answer 8

logroll

Question 9

When logrolling, you will need at least __ people to help, with one person responsible for keeping the head midline

Answer 9

4

Question 10

What are the five Hs (and the additional H) of PEA?

Answer 10

1. hypovolemia
2. hypoxia
3. hydrogen ion
4. hyper/hypokalemia
5. Hypothermia
   extra = hypoglycemia

Question 11

What are the five Ts of PEA?

Answer 11

1. Toxins
2. Tamponade
3. Tension pneumo
4. Thrombosis
5. Trauma

Question 12

Treatment for a pneumothorax includes

Answer 12

• simple = chest tube
• open = cover wound with occlusive dressing (secured on 3 sides) then chest tube
• tension = needle decompression then chest tube

Question 13

What is used to determine the presence of blood in the peritoneal space?

Answer 13

Focused abdominal sonography for trauma (FAST)

Question 14

Deceleration injuries consist of restraint injuries and great vessel disruption, what do you see with these?

Answer 14

• restraint = hands/face/small bowel rupture (seat belt sign)
• great vessel disruption (aortic tear) = abnormal mediastinum on X-ray

Question 15

Blood loss for a closed femur fracture is..

Answer 15

1000 to 1500 mL

Question 16

For open and unstable _____ fractures, need to immobilize and control hemorrhage

Answer 16

pelvis

Question 17

Amount of blood loss with an unstable pelvic fracture

Answer 17

> 15 units of blood

Question 18

Due to the disintegration of muscle that occurs with crush injuries, the patient is at risk of developing ________

Answer 18

rhabdomyolysis

Question 19

For ____ _____, many symptoms of TBI overlap symptoms of PTSD

Answer 19

military personnel

Question 20

The extent of injury and recovery is determined at least _______ or longer after the initial injury due to edema

Answer 20

72 hrs

Question 21

What is given ASAP after the injury to reduce secondary spinal cord injury and has no benefit after 8 hours of injury?

Answer 21

Steroids (methylprednisolone / decadron)

Question 22

Spinal Shock lasts days to months and is characterized by…

Answer 22

1. decreased reflexes
2. loss of sensation
3. flaccid paralysis below level of injury

Question 23

_____ ____ occurs in spinal cord injuries level T6 or higher, and is characterized by hypotension, bradycardia, poikilothermia, peripheral vasodilation, venous pooling, and decreased cardiac output

Answer 23

Neurogenic shock

Question 24

What is the gold standard for SCI diagnostics?

Answer 24

CT scan

Question 25

Bradycardia (< 60 bpm) results due to an unopposed vagal response, any increase in vagal stimulation can result in cardiac arrest. So, what can we NOT do?

Answer 25

suctioning, turning

Question 26

An injury at or above C3 results in a total loss of respiratory function and requires ______

Answer 26

intubation

Question 27

An injury below C3 results in ________ _______, indicating respiratory insufficiency

Answer 27

diaphragmatic breathing

Question 28

An emergency that occurs with injuries above T6 after spinal shock subsides is...

Answer 28

Autonomic Dysreflexia

Question 29

Most common precipitating factor of autonomic dysreflexia is

Answer 29

distended bladder/bowel

Question 30

Management of autonomic dysreflexia includes...

Answer 30

position pt upright/HOB at 45+ degrees, assess for trigger and remove cause, notify MD, catheterize/remove fecal impaction using lidocaine jelly, administer vasodilators to decrease BP (Procardia, Apresoline)