34 Questions
What is the primary goal of redoing a chest x-ray after a patient is weaned from ventilation?
To identify potential late herniation or missed injuries
What is the typical treatment approach for early presenters of diaphragmatic hernia?
Through the abdomen, using laparotomy and repair of the diaphragm
What is the most common site of tracheobronchial injury?
Approximately 2 cm from the bifurcation into the right main bronchus
What is the characteristic radiographic sign of tracheobronchial injury on a chest X-ray?
The fallen lung sign
What is the primary difference between stab wounds and gunshot wounds in penetrating chest trauma?
The path of the wound
What is the characteristic presentation of stabbed hearts in penetrating cardiac trauma?
Cardiac tamponade with Beck's triad
What percentage of workload in SA is blunt trauma?
60%
What is the main risk associated with penetrating trauma?
Sepsis
Which of the following organs is more likely to be injured in penetrating trauma?
Liver
When is the management of penetrating abdominal trauma typically done?
During the secondary survey
What is the primary concern when lifting an eviscerated bowel?
The bowel mesentery becomes ischemic
What is the default operation for a patient with penetrating abdominal trauma who has not achieved hemodynamic stability?
Laparotomy
Why is it essential to ask if the patient is stable or not during the management of penetrating abdominal trauma?
To determine the need for further investigations
What is the recommended pre-hospital management for evisceration?
Apply nonadherence wet dressings over the abdomen and move the patient to a hospital
What is the typical location of a small bowel injury in direct blunt abdominal trauma?
On the anti-mesenteric side of the bowl
Why is it necessary to refer the patient for a laparotomy after reducing the bowel?
To exclude other injuries and repair the bowel more definitively
What type of organs are most commonly injured in blunt trauma?
Solid organs
What is the risk of not properly managing evisceration in hospital?
The bowel may die off
What is the classic injury in a patient with an acceleration-deceleration injury?
Rupture of the antimesenteric part of the small bowel
What is the typical injury resulting from a crush of the duodenum and the pancreas complex against the spine by the seat belts?
Blow out of the lateral part of the duodenum
What is the approach to managing a patient with blunt trauma who is stable after primary survey?
Start clinical investigations
What is used to determine whether or not there's bleeding in the abdomen?
Ultrasound and diagnostic peritoneal lavage
Why is it important to use special examinations in patients with blunt trauma?
Because there is no external wound
When is laparotomy required in a patient with blunt trauma?
When the patient does not respond to resuscitation
What is the ideal range for pCO2 to maintain normocapnia?
35-45mmHg
What is the main concern if a patient becomes hypercapnic?
Vasodilatation leading to increased intracranial pressure
Why is it important to avoid hypocapnia?
It leads to vasoconstriction and decreased blood flow
What is the recommended tidal volume to maintain normocapnia?
8-10ml/kg
What is the target saturation level to avoid hypoxia?
90%
What is the minimum systolic blood pressure recommended?
90mmHg
What is the fluid of choice for non-bleeding patients?
Ringer's lactate
What is the purpose of the Glasgow Coma Score?
To gauge response to interventions and detect deterioration
What is the Monroe-Kelly doctrine?
A concept that describes the intracranial space as a compartment
What is the pressure at which capillaries are compressed and brain becomes ischemic and swollen?
20mmHg
Learn about the risks and complications of penetrating trauma in the ICU, including injury to internal organs and the risk of sepsis. This quiz covers the common injuries and potential outcomes of penetrating trauma.
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