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Questions and Answers
Which is NOT a contraindication of Methoxyflurane?
According to the QAS DTP, which is NOT a side effect of morphine administration?
The aim of a State Trauma System is to:
Components of a well-organized State Trauma System include:
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The main cause of injury in Australia is:
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The number of patients sustaining penetrating trauma identified in the Victorian Prehospital Trauma Triage study was:
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The onset time for IM Midazolam is:
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The angle that outlines a space over the kidneys is known as:
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A 6-year-old does not know how much they weigh, using the Luscombe age weight calculation, how much may this child weigh?
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A 24-month-old child is complaining of nausea, your management would include:
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In the Zero Point Survey, S: self refers to:
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In the Zero Point Survey, Egg-timer model of disparity, where is the patient identified?
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A pulse is a good predictor of major trauma.
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Prolonged scene times should be avoided when managing trauma patients.
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Paediatric patients are:
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A paediatric patient has the capacity to maintain a normal blood pressure despite loss of up to 25% to 30% of total blood volume.
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In a paediatric patient, solid organs are the least commonly injured in blunt trauma.
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Organs in elderly patients:
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In trauma, elderly patients have an impaired coronary response to increased O2 demand, causing ischaemia, AMI, and arrhythmias.
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In pregnant patients, which trimester does foetal development, and the uterus move into the abdomen?
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ECG changes in pregnancy includes:
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Blunt and penetrating trauma on pregnant patients can lead to:
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What are the locations for a patient >12 years of age, an IO needle can be inserted?
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What is your loading dose and follow up dose of lignocaine when using an IO via QAS DTPs?
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What is the bony part on the tibia called, used as a reference point when locating your proximal IO injection site?
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Study Notes
Methoxyflurane Contraindications
- Allergy, ADR, Malignant Hyperthermia, Liver or Renal Disease, Age < 2 years: These are all contraindications for the use of Methoxyflurane.
- Methoxyflurane is a general anesthetic: It is important to note that Methoxyflurane should not be used in patients with these conditions due to potential risks and complications.
### Morphine Side Effects
- Hypotension, Euphoria, Dilated Pupils, Drowsiness: These are all possible side effects of morphine administration.
- QAS DTP refers to the Queensland Ambulance Service Drug and Therapeutics Protocols: The QAS DTP provides guidance on the proper use and management of medications in prehospital settings.
State Trauma System
- Aim: To ensure prompt and efficient transport of trauma patients to appropriate trauma centers within designated timeframes.
- Timeframes: The aim is to get a patient to a major trauma service within 60 minutes.
- Components: Components of a well-organized system include triage, communications, education/training, retrieval/transfer, audit/quality control, and emergency department procedures.
Injury in Australia
- Leading Cause: Transportation accidents are the primary cause of injury in Australia
- Other Causes: Self-inflicted and inflicted by other persons are also significant contributors to injury rates.
Penetrating Trauma
- Victorian Prehospital Trauma Triage Study: The study identified 1.4% of patients sustaining penetrating trauma.
### Midazolam Onset Time
- IM Administration: The onset of action for Midazolam when administered intramuscularly is typically between 5 to 10 minutes.
Anatomy
- Costo-vertebral Angle: This angle defines a space over the kidneys.
Age-Weight Calculation
- Luscombe Calculation: For a 6-year-old child with unknown weight, the Luscombe calculation can be used to estimate their weight, which might be around 23kg.
### Ondansetron Dosage
- Nausea Management in Toddlers (24 Months): Ondansetron is an anti-emetic used to combat nausea. The appropriate dose for a 24 month old child is 2mg delivered orally.
Zero Point Survey
- S: Self - This refers to the patient's self-awareness and physical readiness (safe), as well as their psychological readiness, including their ability to breathe, talk, see, and focus.
- Egg-timer Model: The patient is identified at the top of the egg-timer, representing the initial point of the assessment.
Trauma Assessment
- Pulse: A pulse is not a reliable predictor of major trauma.
- Prolonged Scene times: These should be avoided in trauma management as they can delay crucial care.
### Paediatric Trauma
- Increased Injury Severity: Paediatric patients are more susceptible to severe injuries with the same force, leading to greater internal organ damage.
- Surface Area to Weight Ratio: They have proportionally larger surface area to their weight, which influences body temperature regulation and potential fluid loss.
- Blood Volume Capacity: Paediatric patients can tolerate a significant blood volume loss (up to 25-30%) while maintaining normal blood pressure.
- Solid Organ Injuries: In blunt trauma, solid organs are the least commonly injured in paediatric patients.
### Elderly Trauma
- Hypoxia Tolerance: Elderly patients demonstrate lower tolerance to hypoxia compared to younger individuals.
- Blood Volume: Elderly individuals have lower blood volume, which may be a factor in their response to trauma.
- Coronary Response: Elderly patients have an impaired coronary response to increased oxygen demand, potentially leading to ischaemia, AMI, and arrhythmias.
Pregnant Trauma
- Uterine Development: The uterus moves into the abdomen during the second trimester of pregnancy.
- ECG Changes: Expect flattened or inverted T-waves and potential Q-waves in lead III, along with an increase in ectopic beats.
- Trauma Complications: Blunt or penetrating trauma can cause placenta abruption and injuries to organs that are not normally susceptible to injuries.
### Intraosseous Access
- IO Access Locations (> 12 Years): Suitable locations for insertion of an IO needle in individuals over 12 years old include the proximal tibia, distal tibia, and humeral head.
Lignocaine Dosage for IO
- Loading Dose: The loading dose of lignocaine when using an IO is 50mg (5ml) administered over 2 minutes.
- Follow-up Dose: The follow-up dose is 10mg (1ml) administered over 1 minute.
### IO Injection Site
- Reference Point: The tibial tuberosity, a bony prominence on the tibia, is a reference point when locating the proximal IO injection site.
Cushing’s Triad
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Cushing’s Triad: This is a classic set of neurological signs that indicate increased intracranial pressure. It consists of:
- Bradycardia: Slow heart rate
- Hypertension: Elevated blood pressure, specifically with a widening pulse pressure
- Respiratory Pattern Changes: Uncommon breathing patterns like irregular or gasping breaths
Cushing’s triad is a grave sign in traumatic brain injury and requires immediate emergency medical attention.
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Description
This quiz covers the contraindications of Methoxyflurane and the side effects of Morphine, focusing on their roles in trauma care management. It also highlights the purpose of the State Trauma System and the importance of timely transport to trauma centers. Assess your knowledge on medication safety and trauma protocols.
