ATCN review exam questions and
answers verified 100%
The approach to trauma care typically begins with what? - notification that a trauma
patient is arriving
When preparing to receive a trauma patient, what should you keep in mind? - safe
practice, safe care
What does "Safe practice" mean when receiving trauma patients? - take into
consideration the protection of the team (universal precautions/PPE/preparing
equipment prior to patient arrival)
What does "Safe care" mean when receiving trauma patients? - that the patient is
going to the right hospital, in the right time, for the right care
Trauma primary survey for "A"? - airway and alertness with simultaneous cervical
spinal stabilization
Trauma primary survey for "B"? - breathing and ventilation
Trauma primary survey for "C"? - circulation and hemorrhage control
Trauma primary survey for "D"? - disability (neurological status: AVPU/GCS)
Trauma primary survey for "E"? - exposure and environmental control
Trauma primary survey for "F"? - full set of vital signs and family presence
Trauma primary survey for "G"? - get resuscitation adjuncts (LMNOP)
Which resuscitation adjunct under the "G" primary assessment is this?
-"L" - laboratory studies (ABG's/Type and cross)
Which resuscitation adjunct under the "G" primary assessment is this?
-"M" - monitor for continuous cardiac rhythm and rate assessment
Which resuscitation adjunct under the "G" primary assessment is this?
-"N" - naso/orogastric tube consideration
Which resuscitation adjunct under the "G" primary assessment is this?
-"O" - oxygenation and ventilation analysis (pulse oximetry/ETCO2/capnography)
Which resuscitation adjunct under the "G" primary assessment is this?
-"P" - pain assessment and management
Trauma primary survey for "H"? - history and head to toe assessment
Trauma primary survey for "I"? - inspect posterior surfaces
1.chest pain
2.air hunger
3.respiratory distress
4.tachycardia
5.hypotension
6.tracheal deviation away from injury
7.unilateral absence of breath sounds
8.elevated hemithorax w/out respiratory movement
9.neck vein distention
10.cyanosis (late sign) - 10 Signs and sx of tension pneumothorax
, 1. Becks Triad= increased venous pressure(distended neck veins), decreased arterial
pressure(hypotension), muffled heart tones
2. PEA
3. JVD &/or Kussmauls sign
4. Use FAST to dx - Signs and sx of cardiac tamponade
Careful assessment of the pt's breath sounds is paramount to differentiate the two -
tension pneumothorax can often be confused with cardiac tamponade, how do you
differentiate?
1. Needle decompression- large bore needle 2nd intercostal space midclavicular line 2.
chest tube 4 or 5th intercostal space mid axillary - Tx of tension pneumothorax
-Acidosis
- Hypothermia
- Coagulopathy (blood can't clot resulting in continued bleeding) - triad of death
Head = 9%
Chest (front) = 9%
Abdomen (front) = 9%
Upper/mid/low back and buttocks = 18%
Each arm = 9% (front = 4.5%, back = 4.5%)
Groin = 1%
Each leg = 18% total (front = 9%, back = 9%) - rule of 9's adult
Anterior/Posterior Head - 9% Each
Anterior/Posterior Torson - 18% Each
Anterior/Posterior Arms - 4.5% Each
Anterior/Posterior Legs - 7% Each - Rule of 9's - Pediatric
Early signs and sx
1. increased pain, greater than expected and out of proportion to the injury
2. Palpable tenseness of the compartment
3. asymmetry of the muscle compartment
4. pain on passive stretch
5.altered sensation
Note: Absent distal pulses and poor cap refill are not reliable in dx compartment
syndrome. May be a very late sign of C.S. possibility of proximal vascular injury should
be considered - signs and symptoms of compartment syndrome
thoracotomy is indicated when output exceeds 1500 mL within 24 hours, THE
INDICATIONS for thoracotomy after traumatic injury typically include shock, arrest at
presentation, diagnosis of specific injuries (such as blunt aortic injury), or ongoing
thoracic hemorrhage. - Indications for thoracotomy
sx can be slow and gradual and silent. hypotension, tachycardia, arrhythmias and
dysrhythmias, visible trauma, distended neck veins, muffled heart sounds, and other
signs of shock.
Note: rapid deceleration - blunt cardiac injury s and sx
1.Metabolic acidosis is corrected by control of hemorrhage and admin of fluids and
blood
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