TCRN Exam Review Qs& As 2024-25 A+ Graded Kehr's sign - ANS-Referred left shoulder pain, usually indicates a splenic injury Base deficit - ANS-Base deficit more than -6 indicates the need for agressive resuscitation and determination of the etiology CXR - ANS-Most important tool providing useful information in the early minutes. Can identify major sources of blood loss from injuries in the chest or elevated diaphragm with displacement of abdominal organs Tracheobronchial injury - ANS-Should be suspected if after chest tube placement a significant air leak is present Diagnostic Peritoneal Lavage - ANS-Alternative to FAST scan to detect abd bleeding. A urinary catheter and gastric tube should be in place prior to procedure. FAST - ANS-Focused Assessment with Sonography in Trauma. Used to detect free fluid in peritoneum or hemoperitoneum. Free fluid appears "black" on the screen. Has replaced DPL when available. Positive FAST scan - ANS-Hemodynamically unstable trauma patient with a positive fast are taken directly to the OR for laparotomy Ultrasound abd exam - ANS-Not useful to detect injuries to the diaphragm, intestine and pancreas. In patients with obesity, ascites and/or subQ emphysema the accuracy is reduced. CT scan - ANS-
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