PHTLS & exam prep
what are newton's 1st & second laws? - ANS1: a body at rest will remain at rest, and a body in
motion will remain in motion until acted upon by an outside force
2: force = mass x accelleration
what are the rule of 9's? - ANSADULT
9% = entire head
9% = entire arm
9% =chest
9% =abdomen
18% = entire back
18% = entire leg
1% perineum
CHILD
18% = entire head
9% =entire arm
9% = chest
9% = abdomen
18% = entire back
14% = entire leg
1% = perineum
what are the signs/symptoms of spinal injury? - ANSneurologic function above the injury is intact
and function below the injury is absent or markedly diminished. Specific manifestations will
depend on the exact level of injury.
what are the (5) major areas of blood loss? - ANS- external
- chest
- abdomen
- pelvis
- long bones
what are the (3) types of blast injuries? - ANSPrimary injuries are caused by the effect of
transmitted blast waves on gas-containing structures;
secondary injuries, by the impact of airborne debris;
tertiary injury, by the transposition of the entire body because of blast wind or structural collapse;
and
quaternary injuries, by all other forces
, what 3 collisions are involved with an MVA? - ANS1. vehicle collides with an object
2. unrestrained occupant collides with inside of car
3. internal organs collide with one another or with the wall of the cavity that contains them
what is o'donohue's triad? - ANSadult pedestrian vs car accident
- adults tend to protect themselves by turning away
1 - bumper vs lower legs; tib/fib#, knee tear
2 - falls towards bonnet; intra-abdominal/thoracic injury, #femur/pelvis/thorax/spine.
3 - strikes ground; deceleration/compression forces, head injuries
what is waddell's triad? - ANSchild vs car
- children tend to face the oncoming vehicle
1 - bumper vs fermur/pelvis
2 - bonet vs thorax; head/neck flexes forward; head/face/neck may collide with bonnet.
3 - strikes ground/dragged under car.
what is the munro-kellie doctrine? - ANS1. The total intracranial volume if fixed because of the
inelastic nature of the skull
2. Inside the skull is the brain, blood & CSF
3. If ICP is increased (via haematoma, swelling or tumour) the skull cannot expand to
accommodate this
4. As a result some other structure must be forced out
5. First the CSF & Blood are forced out
6. The only way out is through the foramen magnum
7. Once the ability to force out CSF & blood has been exhausted, the ICP rises rapidly & the
next structure to be forced out of the vault is the brain
8. One of the first parts of the brain to be forced out is the medulla oblongata causing an
alteration in respirations
what is major trauma? - ANSany trauma that requires p1 transport
under what conditions should a patient with major trauma NOT be taken to the major trauma
centre? - ANS- diversion to nearest ED for stabilisation is required
what considerations should be remembered in major trauma and burns? - ANSBurns patients
with burns should be taken to fiona stanley. Should major trauma be present, they should be
taken to RPH.
what are 4 signs to assist determination of death? - ANSpersons in cardiac arrest
- obvious signs of death
- rigor mortis, with or without decomposition/putrification
- palliative care
- advanced directive
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