Podcast
Questions and Answers
What is predicted to become the fifth leading cause of death worldwide by 2030?
What is predicted to become the fifth leading cause of death worldwide by 2030?
Which age group accounts for nearly half of all deaths due to trauma?
Which age group accounts for nearly half of all deaths due to trauma?
What are the highest case fatality rates in the United States related to trauma?
What are the highest case fatality rates in the United States related to trauma?
What should trauma care be organized according to?
What should trauma care be organized according to?
Signup and view all the answers
What is predicted to become the fifth leading cause of death worldwide by 2030?
What is predicted to become the fifth leading cause of death worldwide by 2030?
Signup and view all the answers
What is the leading cause of death among children and adults under the age of 46 years?
What is the leading cause of death among children and adults under the age of 46 years?
Signup and view all the answers
What are the major causes of death following trauma?
What are the major causes of death following trauma?
Signup and view all the answers
What concept should trauma care be organized according to?
What concept should trauma care be organized according to?
Signup and view all the answers
What did the Trauma Care Systems Planning and Development Act of 1990 aim to establish?
What did the Trauma Care Systems Planning and Development Act of 1990 aim to establish?
Signup and view all the answers
How are trauma centers certified for their designation?
How are trauma centers certified for their designation?
Signup and view all the answers
What is the purpose of a well-run trauma center?
What is the purpose of a well-run trauma center?
Signup and view all the answers
What do some states rely on for the designation of certain hospitals as trauma centers?
What do some states rely on for the designation of certain hospitals as trauma centers?
Signup and view all the answers
What did the Trauma Care Systems Planning and Development Act of 1990 aim to establish?
What did the Trauma Care Systems Planning and Development Act of 1990 aim to establish?
Signup and view all the answers
What is the purpose of a well-run trauma center?
What is the purpose of a well-run trauma center?
Signup and view all the answers
How are trauma centers certified for their designation?
How are trauma centers certified for their designation?
Signup and view all the answers
What should trauma care be organized according to?
What should trauma care be organized according to?
Signup and view all the answers
What should EMS providers inform the receiving ED about prior to the patient's arrival at the hospital?
What should EMS providers inform the receiving ED about prior to the patient's arrival at the hospital?
Signup and view all the answers
What is the purpose of a focused history obtained from the patient, family members, witnesses, or prehospital providers?
What is the purpose of a focused history obtained from the patient, family members, witnesses, or prehospital providers?
Signup and view all the answers
What is undertaken quickly in ED care of the trauma patient to identify and treat immediately life-threatening conditions?
What is undertaken quickly in ED care of the trauma patient to identify and treat immediately life-threatening conditions?
Signup and view all the answers
For patients transported to EDs that are not trauma centers, what should be considered immediately?
For patients transported to EDs that are not trauma centers, what should be considered immediately?
Signup and view all the answers
What should EMS providers inform the receiving ED about prior to the patient's arrival at the hospital?
What should EMS providers inform the receiving ED about prior to the patient's arrival at the hospital?
Signup and view all the answers
What is the purpose of a focused history obtained from the patient, family members, witnesses, or prehospital providers?
What is the purpose of a focused history obtained from the patient, family members, witnesses, or prehospital providers?
Signup and view all the answers
What is undertaken quickly in ED care of the trauma patient to identify and treat immediately life-threatening conditions?
What is undertaken quickly in ED care of the trauma patient to identify and treat immediately life-threatening conditions?
Signup and view all the answers
For patients transported to EDs that are not trauma centers, what should be considered immediately?
For patients transported to EDs that are not trauma centers, what should be considered immediately?
Signup and view all the answers
In what situation may cricothyroidotomy be needed?
In what situation may cricothyroidotomy be needed?
Signup and view all the answers
When are the NEXUS and Canadian Cervical Spine Rule useful for assessing cervical spine injury?
When are the NEXUS and Canadian Cervical Spine Rule useful for assessing cervical spine injury?
Signup and view all the answers
What is recommended for patients meeting NEXUS or Canadian criteria for low risk of cervical spine injury?
What is recommended for patients meeting NEXUS or Canadian criteria for low risk of cervical spine injury?
Signup and view all the answers
What maneuver should be performed simultaneously with in-line stabilization of the head and neck to determine airway patency?
What maneuver should be performed simultaneously with in-line stabilization of the head and neck to determine airway patency?
Signup and view all the answers
In which patients may insertion of an oral airway be difficult?
In which patients may insertion of an oral airway be difficult?
Signup and view all the answers
When should nasal airway insertion be avoided?
When should nasal airway insertion be avoided?
Signup and view all the answers
Why are video laryngoscopy devices beneficial in trauma patients?
Why are video laryngoscopy devices beneficial in trauma patients?
Signup and view all the answers
What technique is recommended for intubation in trauma patients?
What technique is recommended for intubation in trauma patients?
Signup and view all the answers
When might cricothyroidotomy be necessary in trauma patients?
When might cricothyroidotomy be necessary in trauma patients?
Signup and view all the answers
In which patients are NEXUS or Canadian criteria useful for assessing cervical spine injury?
In which patients are NEXUS or Canadian criteria useful for assessing cervical spine injury?
Signup and view all the answers
In patients with suspected basilar skull fractures, what airway management technique should be avoided?
In patients with suspected basilar skull fractures, what airway management technique should be avoided?
Signup and view all the answers
In comatose patients with a Glasgow Coma Scale score between 3 and 8, what is recommended to protect the airway and prevent secondary brain injury from hypoxemia?
In comatose patients with a Glasgow Coma Scale score between 3 and 8, what is recommended to protect the airway and prevent secondary brain injury from hypoxemia?
Signup and view all the answers
What technique is beneficial in trauma patients as it aids in vocal cord visualization while minimizing cervical spine manipulation?
What technique is beneficial in trauma patients as it aids in vocal cord visualization while minimizing cervical spine manipulation?
Signup and view all the answers
When managing agitated trauma patients with head injury, hypoxia, or drug- or alcohol-induced delirium, what should be considered to prevent self-injury?
When managing agitated trauma patients with head injury, hypoxia, or drug- or alcohol-induced delirium, what should be considered to prevent self-injury?
Signup and view all the answers
What is the preferred initial imaging modality for the cervical spine in trauma patients?
What is the preferred initial imaging modality for the cervical spine in trauma patients?
Signup and view all the answers
When should spinal immobilization be maintained during resuscitation of a trauma patient?
When should spinal immobilization be maintained during resuscitation of a trauma patient?
Signup and view all the answers
How should urgent operative procedures be affected by imaging results in trauma patients?
How should urgent operative procedures be affected by imaging results in trauma patients?
Signup and view all the answers
In trauma system entry criteria, what fall height would warrant consideration for triage and trauma system entry?
In trauma system entry criteria, what fall height would warrant consideration for triage and trauma system entry?
Signup and view all the answers
In the context of trauma system entry criteria, what speed of motorcycle crash would warrant consideration for triage and trauma system entry?
In the context of trauma system entry criteria, what speed of motorcycle crash would warrant consideration for triage and trauma system entry?
Signup and view all the answers
In the context of trauma system entry criteria, what type of collision at a certain speed would warrant consideration for triage and trauma system entry?
In the context of trauma system entry criteria, what type of collision at a certain speed would warrant consideration for triage and trauma system entry?
Signup and view all the answers
In trauma system entry criteria, what fall height would warrant consideration for triage and trauma system entry?
In trauma system entry criteria, what fall height would warrant consideration for triage and trauma system entry?
Signup and view all the answers
In the context of trauma system entry criteria, what speed of motorcycle crash would warrant consideration for triage and trauma system entry?
In the context of trauma system entry criteria, what speed of motorcycle crash would warrant consideration for triage and trauma system entry?
Signup and view all the answers
What type of collision at a certain speed would warrant consideration for triage and trauma system entry in the context of trauma system entry criteria?
What type of collision at a certain speed would warrant consideration for triage and trauma system entry in the context of trauma system entry criteria?
Signup and view all the answers
What is a requirement for Level 1 Trauma Centers?
What is a requirement for Level 1 Trauma Centers?
Signup and view all the answers
What is a characteristic of Level 1 Trauma Centers' critical care service?
What is a characteristic of Level 1 Trauma Centers' critical care service?
Signup and view all the answers
What is an activity that Level 1 Trauma Centers are expected to conduct?
What is an activity that Level 1 Trauma Centers are expected to conduct?
Signup and view all the answers
What is a requirement for Level 1 Trauma Centers?
What is a requirement for Level 1 Trauma Centers?
Signup and view all the answers
What is an essential characteristic of Level 1 Trauma Centers' critical care service?
What is an essential characteristic of Level 1 Trauma Centers' critical care service?
Signup and view all the answers
What activity is Level 1 Trauma Centers expected to conduct?
What activity is Level 1 Trauma Centers expected to conduct?
Signup and view all the answers
What should be assessed in the Disability portion of the trauma assessment?
What should be assessed in the Disability portion of the trauma assessment?
Signup and view all the answers
What is the recommended action for identifying and controlling scalp wound bleeding?
What is the recommended action for identifying and controlling scalp wound bleeding?
Signup and view all the answers
What is the purpose of logrolling the patient during the Exposure portion of trauma assessment?
What is the purpose of logrolling the patient during the Exposure portion of trauma assessment?
Signup and view all the answers
What should be evaluated for in the Secondary Survey of trauma assessment?
What should be evaluated for in the Secondary Survey of trauma assessment?
Signup and view all the answers
What is the recommended intervention for a patient with a depressed level of consciousness or inability to protect the airway in trauma resuscitation?
What is the recommended intervention for a patient with a depressed level of consciousness or inability to protect the airway in trauma resuscitation?
Signup and view all the answers
What should be considered for suspected tension pneumothorax in trauma resuscitation?
What should be considered for suspected tension pneumothorax in trauma resuscitation?
Signup and view all the answers
What is the initial step to assess blood volume status in trauma resuscitation?
What is the initial step to assess blood volume status in trauma resuscitation?
Signup and view all the answers
What should be considered for suspected pericardial tamponade in trauma resuscitation?
What should be considered for suspected pericardial tamponade in trauma resuscitation?
Signup and view all the answers
What is the recommended action for identifying and managing airway obstruction in trauma resuscitation?
What is the recommended action for identifying and managing airway obstruction in trauma resuscitation?
Signup and view all the answers
What should be considered for suspected tension pneumothorax in trauma resuscitation?
What should be considered for suspected tension pneumothorax in trauma resuscitation?
Signup and view all the answers
What should be assessed to determine blood volume status in trauma resuscitation?
What should be assessed to determine blood volume status in trauma resuscitation?
Signup and view all the answers
When should central venous or interosseous access be considered in trauma resuscitation?
When should central venous or interosseous access be considered in trauma resuscitation?
Signup and view all the answers
What should be assessed in the Disability portion of the trauma assessment?
What should be assessed in the Disability portion of the trauma assessment?
Signup and view all the answers
What is the recommended action for identifying and controlling scalp wound bleeding?
What is the recommended action for identifying and controlling scalp wound bleeding?
Signup and view all the answers
What should be considered for suspected pericardial tamponade in trauma resuscitation?
What should be considered for suspected pericardial tamponade in trauma resuscitation?
Signup and view all the answers
When managing agitated trauma patients with head injury, what should be considered to prevent self-injury?
When managing agitated trauma patients with head injury, what should be considered to prevent self-injury?
Signup and view all the answers
What is the recommended intervention for controlling active external bleeding in trauma patients?
What is the recommended intervention for controlling active external bleeding in trauma patients?
Signup and view all the answers
What is the purpose of applying a tourniquet in trauma resuscitation?
What is the purpose of applying a tourniquet in trauma resuscitation?
Signup and view all the answers
In which setting is the use of tourniquets common for trauma patients?
In which setting is the use of tourniquets common for trauma patients?
Signup and view all the answers
What intervention is warranted for asymmetric or absent breath sounds in an intubated patient?
What intervention is warranted for asymmetric or absent breath sounds in an intubated patient?
Signup and view all the answers
What is indicated if massive hemothorax or vascular injury is suspected in a trauma patient?
What is indicated if massive hemothorax or vascular injury is suspected in a trauma patient?
Signup and view all the answers
What should be performed for a patient with tension pneumothorax in trauma resuscitation?
What should be performed for a patient with tension pneumothorax in trauma resuscitation?
Signup and view all the answers
What intervention is warranted for a sucking chest wound in a trauma patient?
What intervention is warranted for a sucking chest wound in a trauma patient?
Signup and view all the answers
What is the recommended intervention for controlling active external bleeding in trauma patients?
What is the recommended intervention for controlling active external bleeding in trauma patients?
Signup and view all the answers
What is the purpose of noting the heart rate and pulse pressure in young, previously healthy trauma patients?
What is the purpose of noting the heart rate and pulse pressure in young, previously healthy trauma patients?
Signup and view all the answers
What is QuikClot Combat Gauze used for in trauma resuscitation?
What is QuikClot Combat Gauze used for in trauma resuscitation?
Signup and view all the answers
What intervention is indicated if massive hemothorax or vascular injury is suspected in a trauma patient?
What intervention is indicated if massive hemothorax or vascular injury is suspected in a trauma patient?
Signup and view all the answers
What should be done if there are asymmetric or absent breath sounds in an intubated patient?
What should be done if there are asymmetric or absent breath sounds in an intubated patient?
Signup and view all the answers
For a trauma patient with paradoxical movement of a chest wall segment, what intervention is warranted?
For a trauma patient with paradoxical movement of a chest wall segment, what intervention is warranted?
Signup and view all the answers
What is the recommended action for identifying and managing airway obstruction in trauma resuscitation?
What is the recommended action for identifying and managing airway obstruction in trauma resuscitation?
Signup and view all the answers
According to NEXUS criteria, which of the following indicates the need for cervical spine imaging?
According to NEXUS criteria, which of the following indicates the need for cervical spine imaging?
Signup and view all the answers
What is the significance of meeting all NEXUS criteria?
What is the significance of meeting all NEXUS criteria?
Signup and view all the answers
What does failure to meet any one NEXUS criterion indicate?
What does failure to meet any one NEXUS criterion indicate?
Signup and view all the answers
What is the initial step to assess blood volume status in trauma resuscitation?
What is the initial step to assess blood volume status in trauma resuscitation?
Signup and view all the answers
What should be avoided during airway management in patients with suspected basilar skull fractures?
What should be avoided during airway management in patients with suspected basilar skull fractures?
Signup and view all the answers
What is the second-line option for administering medications and blood products in trauma patients?
What is the second-line option for administering medications and blood products in trauma patients?
Signup and view all the answers
What should be used to maximize flow rates during infusion for trauma patients?
What should be used to maximize flow rates during infusion for trauma patients?
Signup and view all the answers
What is the fluid of choice for initial resuscitation?
What is the fluid of choice for initial resuscitation?
Signup and view all the answers
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 should be done if there is no marked improvement in hypotensive patients?
Signup and view all the answers
What is the recommended ratio of packed red blood cells to fresh frozen plasma in massive transfusion protocols?
What is the recommended ratio of packed red blood cells to fresh frozen plasma in massive transfusion protocols?
Signup and view all the answers
What contributes to the coagulopathy and should be corrected as quickly as possible?
What contributes to the coagulopathy and should be corrected as quickly as possible?
Signup and view all the answers
When is resuscitative endovascular balloon occlusion of the aorta (REBOA) potentially indicated?
When is resuscitative endovascular balloon occlusion of the aorta (REBOA) potentially indicated?
Signup and view all the answers
What is an emerging tool in the management of noncompressible torso hemorrhage?
What is an emerging tool in the management of noncompressible torso hemorrhage?
Signup and view all the answers
What complications are associated with REBOA?
What complications are associated with REBOA?
Signup and view all the answers
What does data from both military and civilian experience reveal about patients receiving >10 units of packed red blood cells and fresh frozen plasma?
What does data from both military and civilian experience reveal about patients receiving >10 units of packed red blood cells and fresh frozen plasma?
Signup and view all the answers
What is the initial recommended fluid for resuscitation in trauma patients?
What is the initial recommended fluid for resuscitation in trauma patients?
Signup and view all the answers
What is the second-line option for administering medications and blood products in trauma patients?
What is the second-line option for administering medications and blood products in trauma patients?
Signup and view all the answers
What should be avoided in airway management for patients with suspected basilar skull fractures?
What should be avoided in airway management for patients with suspected basilar skull fractures?
Signup and view all the answers
What is recommended for controlling active external bleeding in trauma patients?
What is recommended for controlling active external bleeding in trauma patients?
Signup and view all the answers
What is the fluid of choice for initial resuscitation?
What is the fluid of choice for initial resuscitation?
Signup and view all the answers
What is the recommended action if hypotensive patients do not show marked improvement after rapid infusion of 2 L of crystalloid solution?
What is the recommended action if hypotensive patients do not show marked improvement after rapid infusion of 2 L of crystalloid solution?
Signup and view all the answers
What is the recommended ratio of fresh frozen plasma to packed red blood cells in massive transfusion protocols?
What is the recommended ratio of fresh frozen plasma to packed red blood cells in massive transfusion protocols?
Signup and view all the answers
What contributes to the coagulopathy in major trauma patients?
What contributes to the coagulopathy in major trauma patients?
Signup and view all the answers
When is resuscitative endovascular balloon occlusion of the aorta (REBOA) potentially indicated?
When is resuscitative endovascular balloon occlusion of the aorta (REBOA) potentially indicated?
Signup and view all the answers
What are the potential complications of resuscitative endovascular balloon occlusion of the aorta (REBOA)?
What are the potential complications of resuscitative endovascular balloon occlusion of the aorta (REBOA)?
Signup and view all the answers
What does aggressive volume resuscitation not substitute for?
What does aggressive volume resuscitation not substitute for?
Signup and view all the answers
How does administration of fresh frozen plasma affect mortality in patients receiving >10 units of packed red blood cells?
How does administration of fresh frozen plasma affect mortality in patients receiving >10 units of packed red blood cells?
Signup and view all the answers
What is the effect of early administration of tranexamic acid within 1 hour of injury?
What is the effect of early administration of tranexamic acid within 1 hour of injury?
Signup and view all the answers
What is a criticism of the CRASH-2 study?
What is a criticism of the CRASH-2 study?
Signup and view all the answers
When is administration of tranexamic acid less effective and potentially harmful?
When is administration of tranexamic acid less effective and potentially harmful?
Signup and view all the answers
What did studies involving >20,000 patients report regarding the risk reduction of death from bleeding with tranexamic acid?
What did studies involving >20,000 patients report regarding the risk reduction of death from bleeding with tranexamic acid?
Signup and view all the answers
What is the reported risk reduction of death from bleeding with the administration of tranexamic acid?
What is the reported risk reduction of death from bleeding with the administration of tranexamic acid?
Signup and view all the answers
When is the administration of tranexamic acid less effective and potentially harmful?
When is the administration of tranexamic acid less effective and potentially harmful?
Signup and view all the answers
What is the effect of early administration of tranexamic acid within 1 hour of injury?
What is the effect of early administration of tranexamic acid within 1 hour of injury?
Signup and view all the answers
What is the purpose of assessing the Glasgow Coma Scale (GCS) in trauma patients?
What is the purpose of assessing the Glasgow Coma Scale (GCS) in trauma patients?
Signup and view all the answers
What does a total Glasgow Coma Scale (tGCS) score consist of?
What does a total Glasgow Coma Scale (tGCS) score consist of?
Signup and view all the answers
In what situation may some systems use only the motor component of the GCS (mGCS) to triage patients?
In what situation may some systems use only the motor component of the GCS (mGCS) to triage patients?
Signup and view all the answers
What does a score of 15 on the Glasgow Coma Scale (GCS) indicate?
What does a score of 15 on the Glasgow Coma Scale (GCS) indicate?
Signup and view all the answers
What components make up the Glasgow Coma Scale (GCS)?
What components make up the Glasgow Coma Scale (GCS)?
Signup and view all the answers
What should not be simply attributed to altered mental status in trauma patients?
What should not be simply attributed to altered mental status in trauma patients?
Signup and view all the answers
What score on the Glasgow Coma Scale (GCS) does not exclude the presence of traumatic brain injury?
What score on the Glasgow Coma Scale (GCS) does not exclude the presence of traumatic brain injury?
Signup and view all the answers
In some systems, what component of the GCS is used to triage trauma patients?
In some systems, what component of the GCS is used to triage trauma patients?
Signup and view all the answers
What is a high-risk factor that mandates radiography according to the Canadian Cervical Spine Rule?
What is a high-risk factor that mandates radiography according to the Canadian Cervical Spine Rule?
Signup and view all the answers
Which low-risk factor allows safe assessment of range of motion according to the Canadian Cervical Spine Rule?
Which low-risk factor allows safe assessment of range of motion according to the Canadian Cervical Spine Rule?
Signup and view all the answers
What indicates the need for radiography according to the Canadian Cervical Spine Rule?
What indicates the need for radiography according to the Canadian Cervical Spine Rule?
Signup and view all the answers
What is the GCS motor response point for extension to pain?
What is the GCS motor response point for extension to pain?
Signup and view all the answers
At what GCS motor response point does the patient exhibit withdrawal to pain?
At what GCS motor response point does the patient exhibit withdrawal to pain?
Signup and view all the answers
Which GCS motor response point indicates the patient's ability to obey commands?
Which GCS motor response point indicates the patient's ability to obey commands?
Signup and view all the answers
What does a GCS Verbal response point of 2 indicate?
What does a GCS Verbal response point of 2 indicate?
Signup and view all the answers
What is the GCS Verbal response point for being oriented?
What is the GCS Verbal response point for being oriented?
Signup and view all the answers
What is the GCS Verbal response point for using inappropriate words?
What is the GCS Verbal response point for using inappropriate words?
Signup and view all the answers
At what GCS motor response point does the patient exhibit extension to pain?
At what GCS motor response point does the patient exhibit extension to pain?
Signup and view all the answers
What GCS eye opening point represents no response?
What GCS eye opening point represents no response?
Signup and view all the answers
At what GCS verbal response point does the patient exhibit incomprehensible sounds?
At what GCS verbal response point does the patient exhibit incomprehensible sounds?
Signup and view all the answers
What intervention should be performed immediately if tension pneumothorax is clinically suspected during trauma resuscitation?
What intervention should be performed immediately if tension pneumothorax is clinically suspected during trauma resuscitation?
Signup and view all the answers
In patients requiring intubation during trauma resuscitation, what should be provided when the cervical collar is removed?
In patients requiring intubation during trauma resuscitation, what should be provided when the cervical collar is removed?
Signup and view all the answers
What should be obtained to assess endotracheal tube placement and exclude pneumothorax during trauma resuscitation?
What should be obtained to assess endotracheal tube placement and exclude pneumothorax during trauma resuscitation?
Signup and view all the answers
What should be performed to quickly identify patients with intracranial injuries who may benefit from operative treatment during the primary survey in trauma resuscitation?
What should be performed to quickly identify patients with intracranial injuries who may benefit from operative treatment during the primary survey in trauma resuscitation?
Signup and view all the answers
What should be done if tension pneumothorax is clinically suspected during the primary survey?
What should be done if tension pneumothorax is clinically suspected during the primary survey?
Signup and view all the answers
What is the recommended approach for patients requiring intubation with suspected traumatic brain injury?
What is the recommended approach for patients requiring intubation with suspected traumatic brain injury?
Signup and view all the answers
In equivocal cases, what can confirm the presence of pneumothorax and prompt emergent intervention?
In equivocal cases, what can confirm the presence of pneumothorax and prompt emergent intervention?
Signup and view all the answers
What should be obtained to assess endotracheal tube placement and exclude pneumothorax in trauma patients?
What should be obtained to assess endotracheal tube placement and exclude pneumothorax in trauma patients?
Signup and view all the answers
What indicates the emergent need for exploratory laparotomy in a patient with penetrating abdominal injury?
What indicates the emergent need for exploratory laparotomy in a patient with penetrating abdominal injury?
Signup and view all the answers
What is the recommended intervention for patients with penetrating chest trauma and witnessed signs of life during transport to or in the ED, and at least cardiac electrical activity upon arrival?
What is the recommended intervention for patients with penetrating chest trauma and witnessed signs of life during transport to or in the ED, and at least cardiac electrical activity upon arrival?
Signup and view all the answers
What should be done if a patient with a penetrating gunshot wound to the abdomen requires emergent exploratory laparotomy?
What should be done if a patient with a penetrating gunshot wound to the abdomen requires emergent exploratory laparotomy?
Signup and view all the answers
What is the best course of action for objects deeply impaled in the chest and abdomen?
What is the best course of action for objects deeply impaled in the chest and abdomen?
Signup and view all the answers
What is indicated for patients in traumatic arrest upon arrival to the ED?
What is indicated for patients in traumatic arrest upon arrival to the ED?
Signup and view all the answers
What did one study analyzing 862 patients undergoing ED thoracotomy reveal about neurologically intact survivors?
What did one study analyzing 862 patients undergoing ED thoracotomy reveal about neurologically intact survivors?
Signup and view all the answers
What was observed regarding survival rates among thoracic stab wound victims who showed breathing or pulse in the field?
What was observed regarding survival rates among thoracic stab wound victims who showed breathing or pulse in the field?
Signup and view all the answers
What is recommended for patients with blunt trauma and no respiration or pulse in the field?
What is recommended for patients with blunt trauma and no respiration or pulse in the field?
Signup and view all the answers
When should ED thoracotomy be performed according to recommendations?
When should ED thoracotomy be performed according to recommendations?
Signup and view all the answers
What should any recommendation for termination or escalation of resuscitative efforts be based on?
What should any recommendation for termination or escalation of resuscitative efforts be based on?
Signup and view all the answers
What should be performed if tension pneumothorax is clinically suspected?
What should be performed if tension pneumothorax is clinically suspected?
Signup and view all the answers
What should be deferred until after head CT is performed in patients with suspected traumatic brain injury?
What should be deferred until after head CT is performed in patients with suspected traumatic brain injury?
Signup and view all the answers
What should be provided when the cervical collar is removed during intubation in patients requiring intubation?
What should be provided when the cervical collar is removed during intubation in patients requiring intubation?
Signup and view all the answers
What can confirm the presence of pneumothorax and prompt emergent intervention in equivocal cases?
What can confirm the presence of pneumothorax and prompt emergent intervention in equivocal cases?
Signup and view all the answers
What is the recommended action for patients with penetrating abdominal injury showing abdominal tenderness, distention, and hypotension?
What is the recommended action for patients with penetrating abdominal injury showing abdominal tenderness, distention, and hypotension?
Signup and view all the answers
In the context of a penetrating gunshot wound to the abdomen, what should be done if emergent exploratory laparotomy is required?
In the context of a penetrating gunshot wound to the abdomen, what should be done if emergent exploratory laparotomy is required?
Signup and view all the answers
What is the recommended approach for impaled objects deeply lodged in the chest and abdomen?
What is the recommended approach for impaled objects deeply lodged in the chest and abdomen?
Signup and view all the answers
In cases of traumatic cardiac arrest, what justifies performing an emergency department (ED) thoracotomy?
In cases of traumatic cardiac arrest, what justifies performing an emergency department (ED) thoracotomy?
Signup and view all the answers
What does one study analyzing 862 patients undergoing ED thoracotomy reveal about neurologically intact survivors?
What does one study analyzing 862 patients undergoing ED thoracotomy reveal about neurologically intact survivors?
Signup and view all the answers
What is indicated if there are no survivors among patients with blunt trauma and no respiration or pulse in the field?
What is indicated if there are no survivors among patients with blunt trauma and no respiration or pulse in the field?
Signup and view all the answers
When should the secondary survey be initiated in trauma assessment?
When should the secondary survey be initiated in trauma assessment?
Signup and view all the answers
How can bleeding from scalp lacerations be controlled?
How can bleeding from scalp lacerations be controlled?
Signup and view all the answers
What should be inspected for in a trauma patient with suspected basilar skull fracture?
What should be inspected for in a trauma patient with suspected basilar skull fracture?
Signup and view all the answers
When is rectal examination no longer routinely performed in alert trauma patients?
When is rectal examination no longer routinely performed in alert trauma patients?
Signup and view all the answers
What imaging technique is recommended for definitive imaging of the chest and abdomen-pelvis?
What imaging technique is recommended for definitive imaging of the chest and abdomen-pelvis?
Signup and view all the answers
Which examination is a rapid screening tool for identifying major intraperitoneal bleeding, pericardial tamponade, pneumothorax, and hemothorax?
Which examination is a rapid screening tool for identifying major intraperitoneal bleeding, pericardial tamponade, pneumothorax, and hemothorax?
Signup and view all the answers
What type of injuries may require further imaging and hospital observation due to being undiagnosed initially?
What type of injuries may require further imaging and hospital observation due to being undiagnosed initially?
Signup and view all the answers
For patients not rapidly transported to the operating room or CT suite, what radiographic imaging is recommended?
For patients not rapidly transported to the operating room or CT suite, what radiographic imaging is recommended?
Signup and view all the answers
What is essential for patients without clear indications for surgery?
What is essential for patients without clear indications for surgery?
Signup and view all the answers
What should be performed to exclude fractures in trauma patients?
What should be performed to exclude fractures in trauma patients?
Signup and view all the answers
What is a rapid screening tool for identifying major intraperitoneal bleeding?
What is a rapid screening tool for identifying major intraperitoneal bleeding?
Signup and view all the answers
What should be performed alongside head CT in certain cases?
What should be performed alongside head CT in certain cases?
Signup and view all the answers
What can quickly detect injuries not clinically apparent but comes with increased ionizing radiation exposure?
What can quickly detect injuries not clinically apparent but comes with increased ionizing radiation exposure?
Signup and view all the answers
What laboratory study includes urine dipstick testing for blood?
What laboratory study includes urine dipstick testing for blood?
Signup and view all the answers
What should be provided when the cervical collar is removed during intubation in patients requiring intubation?
What should be provided when the cervical collar is removed during intubation in patients requiring intubation?
Signup and view all the answers
What should be assessed during the secondary survey of a trauma patient?
What should be assessed during the secondary survey of a trauma patient?
Signup and view all the answers
What is the recommended action when there is facial trauma or evidence of basilar skull fracture?
What is the recommended action when there is facial trauma or evidence of basilar skull fracture?
Signup and view all the answers
How can bleeding from scalp lacerations be controlled?
How can bleeding from scalp lacerations be controlled?
Signup and view all the answers
Under what circumstance is a rectal examination no longer routinely performed in alert trauma patients?
Under what circumstance is a rectal examination no longer routinely performed in alert trauma patients?
Signup and view all the answers
What is the recommended imaging protocol for patients not rapidly transported to the operating room or CT suite?
What is the recommended imaging protocol for patients not rapidly transported to the operating room or CT suite?
Signup and view all the answers
What is the purpose of the extended FAST examination in trauma assessment?
What is the purpose of the extended FAST examination in trauma assessment?
Signup and view all the answers
What is the initial imaging modality recommended for excluding fractures in extremities?
What is the initial imaging modality recommended for excluding fractures in extremities?
Signup and view all the answers
When should a chest radiograph be obtained for trauma patients?
When should a chest radiograph be obtained for trauma patients?
Signup and view all the answers
What should be considered for patients with head, cervical spine, and chest injuries?
What should be considered for patients with head, cervical spine, and chest injuries?
Signup and view all the answers
What is a concern associated with a liberal approach to CT scanning in trauma patients?
What is a concern associated with a liberal approach to CT scanning in trauma patients?
Signup and view all the answers
What are routine laboratory studies recommended for trauma patients older than 55?
What are routine laboratory studies recommended for trauma patients older than 55?
Signup and view all the answers
What is the recommended course of action for patients with hemodynamic instability and ongoing bleeding?
What is the recommended course of action for patients with hemodynamic instability and ongoing bleeding?
Signup and view all the answers
When may blunt abdominal injuries become clinically apparent despite initial CT findings?
When may blunt abdominal injuries become clinically apparent despite initial CT findings?
Signup and view all the answers
What is the estimated blood loss for Class III hemorrhage in mL?
What is the estimated blood loss for Class III hemorrhage in mL?
Signup and view all the answers
In Class IV hemorrhage, what is the approximate percentage of blood volume lost?
In Class IV hemorrhage, what is the approximate percentage of blood volume lost?
Signup and view all the answers
In Class II hemorrhage, what is the expected pulse rate (beats/min)?
In Class II hemorrhage, what is the expected pulse rate (beats/min)?
Signup and view all the answers
What is the estimated blood loss for a Class III hemorrhage?
What is the estimated blood loss for a Class III hemorrhage?
Signup and view all the answers
What is the pulse rate for a Class I hemorrhage?
What is the pulse rate for a Class I hemorrhage?
Signup and view all the answers
What is the pulse pressure for a Class II hemorrhage?
What is the pulse pressure for a Class II hemorrhage?
Signup and view all the answers
Study Notes
-
Perform retrograde urethrography before inserting a Foley catheter if there is meatal blood or prostate displacement, indicating a urethral injury.
-
Perform a manual and speculum examination for vaginal bleeding and possible vaginal lacerations in the presence of a pelvic fracture.
-
Evaluate extremities for fracture and soft tissue injuries, checking peripheral pulses.
-
Perform a more thorough neurologic examination, checking motor and sensory function.
-
Undiagnosed injuries, such as esophageal, diaphragm, and small bowel injuries, may require further imaging and hospital observation.
-
Standard radiographic imaging for patients not rapidly transported to the operating room or CT suite includes cervical spine, chest, and pelvic radiographs.
-
A chest radiograph is required for gunshot wounds to the torso, with or without abdominal films, depending on the site of injury.
-
The extended FAST examination is a rapid screening tool for identifying major intraperitoneal bleeding, pericardial tamponade, pneumothorax, and hemothorax.
-
CT scan with IV contrast is for definitive imaging of the chest and abdomen-pelvis.
-
Obtain appropriate extremity radiographs to exclude fractures.
-
Consider imaging of the entire spine, especially in patients with head, cervical spine, and chest injuries.
-
Cervical spine CT is often performed alongside head CT.
-
Liberal approach to CT scanning can quickly detect injuries not clinically apparent but comes with increased ionizing radiation exposure.
-
Routine laboratory studies include blood type and screen, hemoglobin level, urine dipstick testing for blood, ethanol level, pregnancy test, capillary blood glucose level, and ECG with troponin I levels for patients older than 55.
-
Patients with hemodynamic instability and ongoing bleeding should be expeditiously transported to the operating room, and personnel capable of performing ongoing resuscitation should accompany the patient.
-
Serial examinations are essential for patients without clear indications for surgery.
-
Blunt abdominal injuries may not be readily apparent on initial CT and may become clinically apparent upon serial examinations.
-
Consider admission or observation for patients with closed head trauma, normal levels of consciousness, and requiring repeat neurologic examinations, as well as patients at risk for delayed pneumothorax or pulmonary contusion.
-
Perform retrograde urethrography before inserting a Foley catheter if there is meatal blood or prostate displacement, indicating a urethral injury.
-
Perform a manual and speculum examination for vaginal bleeding and possible vaginal lacerations in the presence of a pelvic fracture.
-
Evaluate extremities for fracture and soft tissue injuries, checking peripheral pulses.
-
Perform a more thorough neurologic examination, checking motor and sensory function.
-
Undiagnosed injuries, such as esophageal, diaphragm, and small bowel injuries, may require further imaging and hospital observation.
-
Standard radiographic imaging for patients not rapidly transported to the operating room or CT suite includes cervical spine, chest, and pelvic radiographs.
-
A chest radiograph is required for gunshot wounds to the torso, with or without abdominal films, depending on the site of injury.
-
The extended FAST examination is a rapid screening tool for identifying major intraperitoneal bleeding, pericardial tamponade, pneumothorax, and hemothorax.
-
CT scan with IV contrast is for definitive imaging of the chest and abdomen-pelvis.
-
Obtain appropriate extremity radiographs to exclude fractures.
-
Consider imaging of the entire spine, especially in patients with head, cervical spine, and chest injuries.
-
Cervical spine CT is often performed alongside head CT.
-
Liberal approach to CT scanning can quickly detect injuries not clinically apparent but comes with increased ionizing radiation exposure.
-
Routine laboratory studies include blood type and screen, hemoglobin level, urine dipstick testing for blood, ethanol level, pregnancy test, capillary blood glucose level, and ECG with troponin I levels for patients older than 55.
-
Patients with hemodynamic instability and ongoing bleeding should be expeditiously transported to the operating room, and personnel capable of performing ongoing resuscitation should accompany the patient.
-
Serial examinations are essential for patients without clear indications for surgery.
-
Blunt abdominal injuries may not be readily apparent on initial CT and may become clinically apparent upon serial examinations.
-
Consider admission or observation for patients with closed head trauma, normal levels of consciousness, and requiring repeat neurologic examinations, as well as patients at risk for delayed pneumothorax or pulmonary contusion.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Learn about the impact of traumatic injury on public health, including statistics on ED visits, mortality rates, and leading causes of trauma-related deaths. Understand the significance of trauma as the leading cause of death among children and adults under the age of 46.
