Chance fracture
Answer - Transverse fracture through vertebra.
In children usually associated with enterc disruption. Seen in motor vehicle accidents involving
only lap belt.
May be associated with retroperitoneal and Abdominal visceral injuries.
Anterior hip dislocation
Answer - Flexed, abducted, externally rotated.
Burst fracture
Answer - Associated with vertebral-axial compression injuries
Posterior hip dislocation
Answer - Flexed, aDDucted, internally rotated
Anterior shoulder dislocation
Answer - Squared off appearance
Posterior shoulder dislocation
Answer - Lock in internal rotation.
Ankle dislocation
Answer - Most are Externally rotated, with a prominent medial malleolus.
FULL thickness (3rd degree) burn
Answer - Dark or white and leathery. Translucent white as well. Painless and generally "dry"
Does not blanch with pressure. Very little swelling of burned tissue.
Principle Life saving measures for patients with burn injuries include
Answer - -Establishing airway control
-Stopping the burning. process
-Intravenous access
,Factors that increase the risk for upper AIRWAY OBSTRUCTION in burns include:
Answer - -Burns to the head and face
-Burn size and depth
-Burns inside the mouth
Partial thickness burn
Answer - Red remodeled appearance with associated swelling and blister formation. May have
weeping or wet appearance and is painfully hypersensitive even to air current.
Signs and symptoms and history that suggest INHALATION INJURY include:
Answer - These patients should be intubated. Inhalation injury is an indication for transfer to a
burn center.
Rule of nines – adult
Answer - The palm represents 1% of the body total surface area.
Symptoms of carbon monoxide poisoning and respective levels
Answer - PaO2 does not reliably predict carbon monoxide poisoning because a CO partial
pressure of only 1 mmm Hg results in a hemoglobin CO level of 40% or greater.
Carbon monoxide has how many times greater affinity for hemoglobin than oxygen
Answer - 240 times.
It displaces the oxyhemoglobin desaturated curve to the LEFT.
Two criteria required for the diagnosis of smoke inhalation injury
Answer - -Exposure to a combustible agent
-Signs of exposure to smoke in the lower airway, below the vocal cords, by bronchoscopy.
Performing this action will help reduce neck and chest wall edema in patients with burn and
inhalation injury.
Answer - Elevation of the head and chest by 30 degrees.
IV fluid administration formula for burn victims
Answer - Indicated in burns involving over 20% of the body surface area.
*(2-4 mL/kg of LR/NS) (weight in kg) (% area of burn); give 1/2 of this volume in first 8 hours.
Remainder in over 16 hours.
Large caliber, at least 15 gauge intravenous line should be introduced.
Pitfalls for IV fluid requirements for burn victims.
Answer - These patients require greater fluid requirements: ~immolation injury
, ~pediatric burn victims
~concomitant blunt or crush
injuries.
Basic rules regarding IV fluids administration in burn victims
Answer - IV fluid Rate should not be based on the time of actual injury.
In very small children, less than 10 kilograms, it may be necessary to add glucose to the IV fluids
to avoid hypoglycemia.
Any adjustment in IV fluid rate should be based on urine output. In an adult, urine output above
0.5 ml/ kilogram should result in reduction of IV fluid rate.
Initial treatment of frostbite/ cold injuries
Answer - Place injured part in circulating water and a constant 40 degrees centigrade until pink
color and perfusion return, usually within 20 to 30 minutes.
Antibiotics are not indicated empirically unless infection develops later.
Persisted ACIDEMIA in burn victims may reflect...
Answer - Cyanide poisoning. (Cyanide is a naturally occurring toxin that may be inhaled in a
confined space fire).
Hypothermia
Severe hypothermia
Answer - Core temperature of 36 degrees centigrade
Temperature below 32 degrees centigrade
Definition of frostbite.
Answer - Freezing of tissue with intracellular ice crystal formation, microvascular occlusion,
subsequent tissue anoxia.
First degree frostbite
Answer - Hyperemia and edema without skin necrosis
Second-degree frostbite
Answer - Large clear vesicle formation accompanies hyperemia and edema with partial
thickness skin necrosis
3rd degree frostbite
Answer - Full thickness and subcutaneous necrosis occurs, commonly with hemorrhage and
vesicle formation.
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