Definitive control of the airway is achieved by ____________
Endotracheal intubation
How do you treat hypothermia in the ED?
crystalloid fluids at 102.2 degrees F and warmed treatment area
What does definitive hemorrhage control refer to?
(3)
1) Possible surgery
2) Stabilizing of pelvis
3) Angioembolization
What are rates of fluid administration measured by?
Size and length of catheter
Minimum flow rate of oxygen reservoir mask
11 L/min
MCC of shock in trauma pt
Hypovolemia due to hemorrhage
Describe the 3 for 1 rule
Replace each mL of blood loss with 3 ml of crystalloid solution
What metabolic state can result from continued hemorrhage or
decreased perfusion?
Metabolic acidosis
In what survey, primary or secondary, are these identified?
1) Simple PTX
2) Pulmonary contusion
3) Traumatic aortic disruption
Secondary
Via thorough PE, CXR, pulse ox, ECG and ABG
What imaging study is preferred for penetrating abdominal trauma?
CT
What can FAST rapidly diagnose?
Abdominal hemorrhage
When is a laparotomy indicated?
Fascial penetration with intraperitoneal bleeding or peritonitis
What does the Monro Kellie doctrine describe?
The relationship between IC volume and pressure
Normal resting ICP
10 mm Hg
, How do you reduce elevated ICP?
Mannitol in a 20% solution
How do you temporarily control pelvic hemorrhage and instability?
Internal traction and external counter-pressure
How do you initially manage major arterial injury?
Direct pressure and fluid resuscitation
Full thickness burn
Third degree burn
What is used to estimate the size and depth of burns?
Rule of 9's
Head= 9%
Each arm=9%
Front Trunk= 18%
Back Trunk= 18%
Upper leg= 9%
Lower leg= 9%
What type of burns appear wet and blistered?
Partial thickness burns (second degree)
How do you treat CO exposed pt?
100% oxygen flow through non re-breather mask
What is a reliable measure of circulating blood volumes in burn
patients?
Hourly urine output
Goal= 0.5-1.0 ml/kg body weight
Hospital admission criteria for burn pt
(8)
1) Partial-thickness burns greater than 10% total BSA (TBSA)
2) Full-thickness burns greater than 2% TBSA
3) Burns involving the face, hands, genitalia, perineum, or major
joints
4) Circumferential extremity burns
5) All high-voltage electrical burns, including lightning injury--
Admission of low-voltage electrical burns is selective
6) Chemical burns
7) Inhalation injury
8) Burn injuries in patients with preexisting medical disorders that
could complicate management, prolong recovery, or affect mortality
(eg, diabetes, immunosuppression)
Parkland Formula for Fluid Resuscitation in Burn pt
3-4 mL Ringer lactate X weight (kg) X %TBSA burned (second-degree and
third degree);
half administered over the first 8 hours (from time of injury),
remaining half administered over the next 16 hours
Endotracheal intubation
How do you treat hypothermia in the ED?
crystalloid fluids at 102.2 degrees F and warmed treatment area
What does definitive hemorrhage control refer to?
(3)
1) Possible surgery
2) Stabilizing of pelvis
3) Angioembolization
What are rates of fluid administration measured by?
Size and length of catheter
Minimum flow rate of oxygen reservoir mask
11 L/min
MCC of shock in trauma pt
Hypovolemia due to hemorrhage
Describe the 3 for 1 rule
Replace each mL of blood loss with 3 ml of crystalloid solution
What metabolic state can result from continued hemorrhage or
decreased perfusion?
Metabolic acidosis
In what survey, primary or secondary, are these identified?
1) Simple PTX
2) Pulmonary contusion
3) Traumatic aortic disruption
Secondary
Via thorough PE, CXR, pulse ox, ECG and ABG
What imaging study is preferred for penetrating abdominal trauma?
CT
What can FAST rapidly diagnose?
Abdominal hemorrhage
When is a laparotomy indicated?
Fascial penetration with intraperitoneal bleeding or peritonitis
What does the Monro Kellie doctrine describe?
The relationship between IC volume and pressure
Normal resting ICP
10 mm Hg
, How do you reduce elevated ICP?
Mannitol in a 20% solution
How do you temporarily control pelvic hemorrhage and instability?
Internal traction and external counter-pressure
How do you initially manage major arterial injury?
Direct pressure and fluid resuscitation
Full thickness burn
Third degree burn
What is used to estimate the size and depth of burns?
Rule of 9's
Head= 9%
Each arm=9%
Front Trunk= 18%
Back Trunk= 18%
Upper leg= 9%
Lower leg= 9%
What type of burns appear wet and blistered?
Partial thickness burns (second degree)
How do you treat CO exposed pt?
100% oxygen flow through non re-breather mask
What is a reliable measure of circulating blood volumes in burn
patients?
Hourly urine output
Goal= 0.5-1.0 ml/kg body weight
Hospital admission criteria for burn pt
(8)
1) Partial-thickness burns greater than 10% total BSA (TBSA)
2) Full-thickness burns greater than 2% TBSA
3) Burns involving the face, hands, genitalia, perineum, or major
joints
4) Circumferential extremity burns
5) All high-voltage electrical burns, including lightning injury--
Admission of low-voltage electrical burns is selective
6) Chemical burns
7) Inhalation injury
8) Burn injuries in patients with preexisting medical disorders that
could complicate management, prolong recovery, or affect mortality
(eg, diabetes, immunosuppression)
Parkland Formula for Fluid Resuscitation in Burn pt
3-4 mL Ringer lactate X weight (kg) X %TBSA burned (second-degree and
third degree);
half administered over the first 8 hours (from time of injury),
remaining half administered over the next 16 hours
