Trauma and Life Support Questions with Answers

Trauma and Life Support Questions with Answers What makes up the ITLS Primary Survey - ANSWER- Scene size up Initial assessment Rapid trauma survey or Focused exam Critical interventions and transport decisions Contact medical direction What makes up the ITLS Secondary Survey - ANSWER- Repeat initial assessment Repeat vital signs Perform neuro exam Perform head to toe exam What makes up the ITLS Ongoing Exam - ANSWER- Repeat initial assessment Repeat vital signs Reassess abdomen Check injuries and interventions What are the steps of the Scene Size Up - ANSWER- Standard precautions Scene safety Initial triage Assess need for help / equipment Mechanism of injury What is the purpose of the Primary Survey - ANSWER- To determine if immediately life threatening conditions exist and to identify those patients who should have immediate transport to the hospital What is the purpose of the Ongoing Exam - ANSWER- It is meant to identify changes in the patient's condition When do you perform a Rapid Trauma Survey - ANSWER- For generalized mechanisms of injury When do you perform a Focused Exam - ANSWER- For injuries that are localized to a discrete area What are the 3 types of collisions that occur during an MVC - ANSWER- Machine Body Organ What is a secondary collision that occurs during an MVC - ANSWER- Objects that are in the vehecile that hit the occupents What is machine collision - ANSWER- Damage to the vehicle What is body collision - ANSWER- Damage to a person in the vehicle What is organ collision - ANSWER- Internal organs that are damaged from the sudden decelearation What is Primary Blast - ANSWER- The initial air blast from an explosion. Usually affects air-filled organs What is Secondary Blast - ANSWER- The patient being struck by material propelled by the blast force What is Tertiary Blast - ANSWER- The body being thrown and impacting on ground or other objects What is Quanternary Blast - ANSWER- Thermal burns from the explosion or respiratory injuries from inhalation of toxic dust or fumes What is Quniary Blast - ANSWER- Contamination by chemical, biological, or radiological material that was dispersed by the explosion What are the reasons that would interrupt the Primary Survey - ANSWER- Scene becomes unsafe, Obstructed airway, Cardiac arrest For critical patients, the goal of the Primary Survey should be how long - ANSWER- 2 and on scene time 5 What is the purpose of the Initial Assessment - ANSWER- To prioritize the patient and to determine the existence of immediately life threatening conditions What is External Laryngeal Manipulation (ELM) - ANSWER- A maneuver to improve visulization of the vocal cords during endotracheal intubation What is Sellick maneuver - ANSWER- Posterior pressure on the cricoid cartilage to prevent gastricc insufflation and vomiting How much does the endotracheal tube move if the patient's head is flexed or extended - ANSWER- 2 to 2.5cm What does "BOOTS" mean - ANSWER- It is used to predict difficulties during mask ventilation What does the mnemonic BOOTS stand for - ANSWER- B Beards O Obesity O Older patients T Toothlessness S Snores or stridor What are the signs / symptoms of a tension pneumothorax - ANSWER- Decreased LOC Labored breathing Weak / thready pulse Cool / clammy skin Distended neck veins Decreased or absent breath sounds of affected side What are the signs / symptoms of a hemothorax - ANSWER- Decreased LOC Labored breathing Weak / thready pulse Cool / clammy skin Flat neck veins Decreased or absent breath sounds of affected side What are signs / symptoms of a cardiac tamponade - ANSWER- Normal breath sounds Distended neck veins Hypotension Narrow pulse pressure Beck's triad What is Beck's Triad - ANSWER- Consists of 3 clinical findings which are distended neck veins, muffled heart sounds, and pulsus paradoxus. It is indicitive of a cardiac tamponade What is pulsus paradoxus - ANSWER- When a palpated radial pulse disappears during inspiration. What is pulse pressure - ANSWER- The pressure driving blood through the vascular system. It is calculated by subtracting the diastolic from the systolic blood pressures What are the 3 states that shock can be catergorized into - ANSWER- Low volume (Absolute hypovolemia) High space (Relative hypovolemia) Mechanical (Cardiogenic or Obstructive) What is primary brain injury - ANSWER- The immediate damage to the brain tissue that is the direct result of an injury force What is secondary brain injury - ANSWER- An injury to the brain that is the result of hypoxia or decreased perfusion of brain tissue after a primary injury What is Cushing's Triad - ANSWER- Consists of 3 clincial findings which are irregular respirations, bradycardia, and hypertension. It is indicitive of increased ICP What is an Emergency Rescue - ANSWER- The immediate removal, without use of SMR, of a patient from an immediately lifethreatening situation What is Rapid Extrication - ANSWER- The rapid removal of a patient from a dangerous position or situation using modified SMR What are the 5 essential components of full SMR - ANSWER- Backboard Cervical collar Straps Head motion restriction device Airway management kit What is the zone of coagulation - ANSWER- The portions of the skin that are necrosed by the thermal insult What is the zone of stasis - ANSWER- It is the zone surrounding the zone of coagulation. Blood flow is compromised and tissues will die if blood flow is not restored What is the zone of hyperemia - ANSWER- It is the zone surrounding the zone of statsis. Blood flow is incresed to the tissues as a result of the actions of inflammatory mediators released by damaged skin When the injuy occurs, what clock just started - ANSWER- The "Golden Period" formally the Golden Hour Minimum BP for perfusion - ANSWER- 50 to 60mmHg Max length of time to have a tourniquet on - ANSWER- 2 hours The 3 places that you do not use hemostatic agents - ANSWER- Head Abdomen Chest What is the only time you are allowed to hyperventilate a patient - ANSWER- Suspected herniation