|| MOST RECENT EXAM ACTUAL COMPLETE REAL EXAM
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
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1. Preparation and Triage
2. Primary Survery (ABCDE) with resuscitation adjuncts (F,G)
3. Reevaluation (consideration of transfer)
4. Secondary Survey (HI) with reevaluation adjuncts
5. Reevaluation and post resuscitation care
6. Definitive care of transfer to an appropriate trauma nurse
Initial Assessment (TNCC)
1. The tongue obstructing the airway
2. loose or missing teeth
3. foreign objects
4. blood, vomit, or secretions'
5. edema
6. burns or evidence of inhalation injury
Auscultiate or listen for:
1. Obstructive airway sounds such as snoring or gurgling
2. Possible occlusive maxillofacial bony deformity
3. Subcutaneous emphysema
Inspect the mouth for:
,1. Check the presence of adequate rise and fall of the chest with assisted
ventilation
2. Absence of gurgling on auscultation over the epigastrium
3. Bilateral breath sounds present on auscultation
4. Presence of carbon dioxide (CO2) verified by a CO2 device or monitor
If the pt has a definitive airway in what should you do?
1. Suction the airway
2, Use care to avoid stimulating the gag reflex
3. If the airway is obstructed by blood or vomitus secretions, use a rigid
suction device
If foreign body is noted, remove it carefully with forceps or another
appropriate method
If Airway is not patent
1. Apnea
2. GCS 8 or less
3. Maxillary fractures
4. Evidence of inhalation injury (facial burns)
5. Laryngeal or tracheal injury or neck hematoma
6. High risk of aspiration and patients inability to protect the airway
7. Compromised or ineffective ventilation
Following conditions might require a definitive airway
,Breathing: To assess breathing expose the chest:
1. Inspect for
a. spontaneous breathing
b. symmetrical rise and fall
c. depth, pattern, and rate of respiration
d. signs of difficulty breathing such as accessory muscle use
e. skin color (normal, pale, flushed, cyanotic)
f. contusions, abrasions, deformities (flail chest)
g. open pneumothoraces (sucking chest wounds)
h. JVD
i. signs of inhalation injury (singed nasal hairs, carbonaceous sputum)
B
tracheal deviation and jvd
Late signs of tension pneumo:
, 1. equal breath sounds bilaterally at the second intercostal space
midclavicular line and the bases for fifth intercostal space at the axillary
line
Auscultate the chest for:
1. bony fractures and possible rib fractures, which may impact ventilation
2. palpate for crepitus
3. subcutaneous emphysema which may be a sign for a pneumothorax
4. soft tissue injury
Palpate the chest for
1. open the airway, use jaw thrust
2. insert an oral airway
3. assist ventilations with a bag mask
4. prepare for definitive airway
If breathing is absent..
trauma its need early supplemental oxygen, start with 15 mL O2 and titrate
oxygen delivery.
Oxygen on trauma patients