Penetrating Trauma in ICU
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Questions and Answers

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 (correct)
  • To monitor lung function
  • To diagnose tracheobronchial injury
  • To assess the effectiveness of ventilation

    • What is the typical treatment approach for early presenters of diaphragmatic hernia?

  • Through the abdomen, using laparotomy
  • Through the chest, using laparoscopy
  • Through the abdomen, using laparotomy and repair of the diaphragm (correct)
  • Through the chest, using thoracoscopy

    • What is the most common site of tracheobronchial injury?

  • Approximately 2 cm from the bifurcation into the right main bronchus (correct)
  • At the level of the larynx
  • Approximately 1 cm from the bifurcation into the right main bronchus
  • At the level of the carina

    • What is the characteristic radiographic sign of tracheobronchial injury on a chest X-ray?

    <p>The fallen lung sign</p> Signup and view all the answers

    What is the primary difference between stab wounds and gunshot wounds in penetrating chest trauma?

    <p>The path of the wound</p> Signup and view all the answers

    What is the characteristic presentation of stabbed hearts in penetrating cardiac trauma?

    <p>Cardiac tamponade with Beck's triad</p> Signup and view all the answers

    What percentage of workload in SA is blunt trauma?

    <p>60%</p> Signup and view all the answers

    What is the main risk associated with penetrating trauma?

    <p>Sepsis</p> Signup and view all the answers

    Which of the following organs is more likely to be injured in penetrating trauma?

    <p>Liver</p> Signup and view all the answers

    When is the management of penetrating abdominal trauma typically done?

    <p>During the secondary survey</p> Signup and view all the answers

    What is the primary concern when lifting an eviscerated bowel?

    <p>The bowel mesentery becomes ischemic</p> Signup and view all the answers

    What is the default operation for a patient with penetrating abdominal trauma who has not achieved hemodynamic stability?

    <p>Laparotomy</p> Signup and view all the answers

    Why is it essential to ask if the patient is stable or not during the management of penetrating abdominal trauma?

    <p>To determine the need for further investigations</p> Signup and view all the answers

    What is the recommended pre-hospital management for evisceration?

    <p>Apply nonadherence wet dressings over the abdomen and move the patient to a hospital</p> Signup and view all the answers

    What is the typical location of a small bowel injury in direct blunt abdominal trauma?

    <p>On the anti-mesenteric side of the bowl</p> Signup and view all the answers

    Why is it necessary to refer the patient for a laparotomy after reducing the bowel?

    <p>To exclude other injuries and repair the bowel more definitively</p> Signup and view all the answers

    What type of organs are most commonly injured in blunt trauma?

    <p>Solid organs</p> Signup and view all the answers

    What is the risk of not properly managing evisceration in hospital?

    <p>The bowel may die off</p> Signup and view all the answers

    What is the classic injury in a patient with an acceleration-deceleration injury?

    <p>Rupture of the antimesenteric part of the small bowel</p> Signup and view all the answers

    What is the typical injury resulting from a crush of the duodenum and the pancreas complex against the spine by the seat belts?

    <p>Blow out of the lateral part of the duodenum</p> Signup and view all the answers

    What is the approach to managing a patient with blunt trauma who is stable after primary survey?

    <p>Start clinical investigations</p> Signup and view all the answers

    What is used to determine whether or not there's bleeding in the abdomen?

    <p>Ultrasound and diagnostic peritoneal lavage</p> Signup and view all the answers

    Why is it important to use special examinations in patients with blunt trauma?

    <p>Because there is no external wound</p> Signup and view all the answers

    When is laparotomy required in a patient with blunt trauma?

    <p>When the patient does not respond to resuscitation</p> Signup and view all the answers

    What is the ideal range for pCO2 to maintain normocapnia?

    <p>35-45mmHg</p> Signup and view all the answers

    What is the main concern if a patient becomes hypercapnic?

    <p>Vasodilatation leading to increased intracranial pressure</p> Signup and view all the answers

    Why is it important to avoid hypocapnia?

    <p>It leads to vasoconstriction and decreased blood flow</p> Signup and view all the answers

    What is the recommended tidal volume to maintain normocapnia?

    <p>8-10ml/kg</p> Signup and view all the answers

    What is the target saturation level to avoid hypoxia?

    <p>90%</p> Signup and view all the answers

    What is the minimum systolic blood pressure recommended?

    <p>90mmHg</p> Signup and view all the answers

    What is the fluid of choice for non-bleeding patients?

    <p>Ringer's lactate</p> Signup and view all the answers

    What is the purpose of the Glasgow Coma Score?

    <p>To gauge response to interventions and detect deterioration</p> Signup and view all the answers

    What is the Monroe-Kelly doctrine?

    <p>A concept that describes the intracranial space as a compartment</p> Signup and view all the answers

    What is the pressure at which capillaries are compressed and brain becomes ischemic and swollen?

    <p>20mmHg</p> Signup and view all the answers

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