Podcast
Questions and Answers
What is the number one cause of death for Americans between age 1 and 44 years?
What is the number one cause of death for Americans between age 1 and 44 years?
- Infectious diseases
- Trauma (correct)
- Cardiovascular diseases
- Cancer
What are the major causes of death following trauma?
What are the major causes of death following trauma?
- Muscle strains, ligament sprains, minor burns
- Abdominal injury, skin lacerations, minor fractures
- Concussion, contusion, minor cuts
- Head injury, chest injury, and major vascular injury (correct)
What is the impact of poverty on the incidence of death from injury?
What is the impact of poverty on the incidence of death from injury?
- It has no significant impact on the incidence of death from injury
- It increases the incidence of death from injury more than threefold (correct)
- It doubles the incidence of death from injury
- It reduces the incidence of death from injury
What is the number one cause of death for Americans between age 1 and 44 years?
What is the number one cause of death for Americans between age 1 and 44 years?
How does the incidence of death from injury correlate with poverty?
How does the incidence of death from injury correlate with poverty?
What should trauma care be organized according to?
What should trauma care be organized according to?
What is the purpose of the Trauma Care Systems Planning and Development Act of 1990?
What is the purpose of the Trauma Care Systems Planning and Development Act of 1990?
How are trauma centers certified?
How are trauma centers certified?
What is the role of a well-run trauma center?
What is the role of a well-run trauma center?
What does each state need to determine in creating its own trauma care system?
What does each state need to determine in creating its own trauma care system?
What is the purpose of the Trauma Care Systems Planning and Development Act of 1990?
What is the purpose of the Trauma Care Systems Planning and Development Act of 1990?
What is the role of a well-run trauma center?
What is the role of a well-run trauma center?
How are trauma centers certified?
How are trauma centers certified?
What did the Trauma Care Systems Planning and Development Act of 1990 provide for?
What did the Trauma Care Systems Planning and Development Act of 1990 provide for?
What should ED staff do in preparation for a trauma patient's arrival?
What should ED staff do in preparation for a trauma patient's arrival?
What information can a focused history obtained from the patient or others provide?
What information can a focused history obtained from the patient or others provide?
What is the primary purpose of a primary survey in trauma care?
What is the primary purpose of a primary survey in trauma care?
For patients transported to non-trauma center EDs, what should be considered immediately?
For patients transported to non-trauma center EDs, what should be considered immediately?
What is the primary purpose of a primary survey in trauma care?
What is the primary purpose of a primary survey in trauma care?
What should ED staff do in preparation for a trauma patient's arrival?
What should ED staff do in preparation for a trauma patient's arrival?
What information can a focused history obtained from the patient or others provide?
What information can a focused history obtained from the patient or others provide?
For patients transported to non-trauma center EDs, what should be considered immediately?
For patients transported to non-trauma center EDs, what should be considered immediately?
What is the preferred initial imaging modality for the cervical spine?
What is the preferred initial imaging modality for the cervical spine?
When should spinal immobilization be maintained during resuscitation?
When should spinal immobilization be maintained during resuscitation?
What is the recommended approach if a patient is obtunded?
What is the recommended approach if a patient is obtunded?
When are the NEXUS and Canadian criteria useful in assessing cervical spine injury?
When are the NEXUS and Canadian criteria useful in assessing cervical spine injury?
What maneuver should be performed simultaneously with in-line stabilization of the head and neck for a patient with inadequate respiratory effort?
What maneuver should be performed simultaneously with in-line stabilization of the head and neck for a patient with inadequate respiratory effort?
When is insertion of an oral airway difficult?
When is insertion of an oral airway difficult?
What should be avoided in patients with suspected basilar skull fractures?
What should be avoided in patients with suspected basilar skull fractures?
What technique should be used to maintain in-line immobilization of the cervical spine while managing the airway?
What technique should be used to maintain in-line immobilization of the cervical spine while managing the airway?
What maneuver should be performed simultaneously with in-line stabilization of the head and neck for a patient with inadequate respiratory effort?
What maneuver should be performed simultaneously with in-line stabilization of the head and neck for a patient with inadequate respiratory effort?
When is insertion of an oral airway difficult?
When is insertion of an oral airway difficult?
What should be avoided in patients with suspected basilar skull fractures?
What should be avoided in patients with suspected basilar skull fractures?
Why are video laryngoscopy devices beneficial in trauma patients?
Why are video laryngoscopy devices beneficial in trauma patients?
What is the preferred initial imaging modality for the cervical spine?
What is the preferred initial imaging modality for the cervical spine?
When should spinal immobilization be maintained during resuscitation?
When should spinal immobilization be maintained during resuscitation?
What should be used for intubation if anatomy or severe maxillofacial injury precludes endotracheal intubation?
What should be used for intubation if anatomy or severe maxillofacial injury precludes endotracheal intubation?
When are the NEXUS and Canadian criteria useful in assessing cervical spine injury?
When are the NEXUS and Canadian criteria useful in assessing cervical spine injury?
What intervention is warranted for a patient with paradoxical movement of a chest wall segment?
What intervention is warranted for a patient with paradoxical movement of a chest wall segment?
What should be done if no breath sounds are heard and massive hemothorax or vascular injury is suspected?
What should be done if no breath sounds are heard and massive hemothorax or vascular injury is suspected?
What is the immediate intervention warranted for a sucking chest wound?
What is the immediate intervention warranted for a sucking chest wound?
For asymmetric or absent breath sounds in an intubated patient, what action should be taken?
For asymmetric or absent breath sounds in an intubated patient, what action should be taken?
What is the immediate intervention warranted for a patient with crepitus in the thorax?
What is the immediate intervention warranted for a patient with crepitus in the thorax?
What should be done for asymmetric or absent breath sounds in an intubated patient?
What should be done for asymmetric or absent breath sounds in an intubated patient?
What indicates the need for thoracotomy or video-assisted thoracic surgery?
What indicates the need for thoracotomy or video-assisted thoracic surgery?
What intervention is warranted for paradoxical movement of a chest wall segment?
What intervention is warranted for paradoxical movement of a chest wall segment?
What should be applied to control active external bleeding?
What should be applied to control active external bleeding?
What is the purpose of QuikClot Combat Gauze?
What is the purpose of QuikClot Combat Gauze?
What was the impact of aggressive tourniquet use in Iraq?
What was the impact of aggressive tourniquet use in Iraq?
What should be done for exsanguinating extremity injury?
What should be done for exsanguinating extremity injury?
What is the recommended intervention for exsanguinating extremity injury?
What is the recommended intervention for exsanguinating extremity injury?
What is the primary purpose of assessing the patient's overall hemodynamic status?
What is the primary purpose of assessing the patient's overall hemodynamic status?
What is the composition of QuikClot Combat Gauze, a recommended hemostatic dressing?
What is the composition of QuikClot Combat Gauze, a recommended hemostatic dressing?
What contributed to a significant decrease in death rates from isolated limb exsanguination in Iraq?
What contributed to a significant decrease in death rates from isolated limb exsanguination in Iraq?
What is a common cause of post injury death in hypotensive trauma patients?
What is a common cause of post injury death in hypotensive trauma patients?
What can mask early hemodynamic indicators of shock?
What can mask early hemodynamic indicators of shock?
What is the recommended fluid for infusion in hypovolemic trauma patients?
What is the recommended fluid for infusion in hypovolemic trauma patients?
What is an alternative technique for providing rapid vascular access in difficult clinical situations?
What is an alternative technique for providing rapid vascular access in difficult clinical situations?
What is the fluid of choice for initial resuscitation?
What is the fluid of choice for initial resuscitation?
What is the theoretical advantage of lactated Ringer’s over saline?
What is the theoretical advantage of lactated Ringer’s over saline?
When should hypotensive patients be reassessed after rapid infusion of crystalloid solution?
When should hypotensive patients be reassessed after rapid infusion of crystalloid solution?
What is the immediate intervention warranted for paradoxical movement of a chest wall segment?
What is the immediate intervention warranted for paradoxical movement of a chest wall segment?
What contributes to the coagulopathy in major trauma patients?
What contributes to the coagulopathy in major trauma patients?
What ratio of packed red blood cells to fresh frozen plasma showed decreased mortality in patients receiving >10 units of packed red blood cells?
What ratio of packed red blood cells to fresh frozen plasma showed decreased mortality in patients receiving >10 units of packed red blood cells?
What is the recommended fluid for initial resuscitation of hypotensive trauma patients?
What is the recommended fluid for initial resuscitation of hypotensive trauma patients?
What is the alternative technique for providing rapid vascular access in difficult clinical situations?
What is the alternative technique for providing rapid vascular access in difficult clinical situations?
What can mask early hemodynamic indicators of shock?
What can mask early hemodynamic indicators of shock?
When should central venous access be established in trauma patients?
When should central venous access be established in trauma patients?
What is the recommended fluid for initial resuscitation in hypovolemic trauma patients?
What is the recommended fluid for initial resuscitation in hypovolemic trauma patients?
What should be done if there is no marked improvement in hypotensive patients after rapid infusion of 2 L of crystalloid solution?
What should be done if there is no marked improvement in hypotensive patients after rapid infusion of 2 L of crystalloid solution?
What contributes to defective clotting and platelet function in major trauma patients?
What contributes to defective clotting and platelet function in major trauma patients?
What ratio of packed red blood cells to fresh frozen plasma has shown decreased mortality in patients receiving >10 units of packed red blood cells?
What ratio of packed red blood cells to fresh frozen plasma has shown decreased mortality in patients receiving >10 units of packed red blood cells?
What is the purpose of immobilizing open pelvic fractures in a pelvic wrap or sling?
What is the purpose of immobilizing open pelvic fractures in a pelvic wrap or sling?
What is the primary effect of tranexamic acid?
What is the primary effect of tranexamic acid?
When is the administration of tranexamic acid reported to decrease the relative risk of death from bleeding by 32%?
When is the administration of tranexamic acid reported to decrease the relative risk of death from bleeding by 32%?
What was a criticism of the CRASH-2 study regarding tranexamic acid?
What was a criticism of the CRASH-2 study regarding tranexamic acid?
Why have major Western nation trauma centers been hesitant to adopt the use of tranexamic acid in trauma management algorithms?
Why have major Western nation trauma centers been hesitant to adopt the use of tranexamic acid in trauma management algorithms?
What is the reported risk reduction of death from bleeding with the use of tranexamic acid?
What is the reported risk reduction of death from bleeding with the use of tranexamic acid?
When is administration of tranexamic acid reported to decrease the relative risk of death from bleeding by 32%?
When is administration of tranexamic acid reported to decrease the relative risk of death from bleeding by 32%?
What was a criticism of the CRASH-2 study regarding tranexamic acid?
What was a criticism of the CRASH-2 study regarding tranexamic acid?
When must tranexamic acid be given in order to meet the time requirement of early administration?
When must tranexamic acid be given in order to meet the time requirement of early administration?
What should be included in the search for the cause of depressed level of consciousness in trauma patients?
What should be included in the search for the cause of depressed level of consciousness in trauma patients?
How should altered mental status in the setting of trauma be approached?
How should altered mental status in the setting of trauma be approached?
What should be assessed as part of a focused neurologic evaluation in trauma patients?
What should be assessed as part of a focused neurologic evaluation in trauma patients?
What should be included in the search for the cause of depressed level of consciousness in trauma patients?
What should be included in the search for the cause of depressed level of consciousness in trauma patients?
What is recommended when assessing a patient with an appropriate mechanism for head trauma and altered mental status?
What is recommended when assessing a patient with an appropriate mechanism for head trauma and altered mental status?
What should be assessed during a focused neurologic evaluation in trauma patients?
What should be assessed during a focused neurologic evaluation in trauma patients?
Study Notes
Trauma Care
- The leading cause of death for Americans between 1 and 44 years old is injury.
- Trauma is the leading cause of death for Americans between 1 and 44 years old.
- Poverty has a significant impact on the incidence of death from injury.
Organizing Trauma Care
- Trauma care should be organized according to the needs of the patient, with well-run trauma centers playing a crucial role.
- The Trauma Care Systems Planning and Development Act of 1990 aimed to improve trauma care systems planning and development.
Certifying Trauma Centers
- Trauma centers are certified based on specific criteria.
Preparing for Trauma Patients
- ED staff should prepare for trauma patients by gathering essential information, including a focused history and physical examination.
- A primary survey is crucial in trauma care, assessing airway, breathing, circulation, disability, and exposure.
Imaging and Spinal Immobilization
- The preferred initial imaging modality for the cervical spine is a CT scan.
- Spinal immobilization should be maintained during resuscitation, with in-line stabilization of the head and neck.
- The NEXUS and Canadian criteria are useful in assessing cervical spine injury.
Airway Management
- Insertion of an oral airway can be difficult in patients with inadequate respiratory effort.
- Video laryngoscopy devices are beneficial in trauma patients.
- In patients with suspected basilar skull fractures, nasal intubation should be avoided.
Thoracic Trauma
- Intervention is warranted for patients with paradoxical movement of a chest wall segment.
- The immediate intervention for a sucking chest wound is to apply an occlusive dressing.
- Asymmetric or absent breath sounds in an intubated patient require prompt attention.
Hemorrhage Control
- QuikClot Combat Gauze is a recommended hemostatic dressing for controlling active bleeding.
- Aggressive tourniquet use in Iraq contributed to a significant decrease in death rates from isolated limb exsanguination.
Hemodynamic Status
- The primary purpose of assessing a patient's overall hemodynamic status is to identify shock.
- Coagulopathy in major trauma patients is contributed to by multiple factors, including hypothermia, acidosis, and hemodilution.
- The recommended fluid for initial resuscitation is lactated Ringer's solution.
Tranexamic Acid
- Tranexamic acid has been shown to decrease the relative risk of death from bleeding by 32%.
- The primary effect of tranexamic acid is to prevent clot breakdown.
- Administration of tranexamic acid should occur within 3 hours of injury to meet the time requirement of early administration.
Neurological Evaluation
- A focused neurologic evaluation in trauma patients should include assessment of level of consciousness, pupillary reaction, and motor function.
- Altered mental status in the setting of trauma requires a thorough search for the cause, including hypoxia, hypotension, and head injury.
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Description
Explore the prevalence and impact of trauma, including its significant contribution to emergency department visits, hospital admissions, and mortality rates. Understand the correlation between poverty and the incidence of death from injury, as well as the long-term morbidity associated with surviving traumatic events.
