TCRN QUESTIONS WITH CORRECT
ANSWERS
Kehr's ssign s- sans--Referred sleft sshoulder spain, susually sindicates sa ssplenic sinjury
Base sdeficit s- sans--Base sdeficit smore sthan s-6 sindicates sthe sneed sfor sagressive
sresuscitation sand sdetermination sof sthe setiology
CXR s- sans--Most simportant stool sproviding suseful sinformation sin sthe searly sminutes. sCan
sidentify smajor ssources sof sblood sloss sfrom sinjuries sin sthe schest sor selevated sdiaphragm
swith sdisplacement sof sabdominal sorgans
Tracheobronchial sinjury s- sans--Should sbe ssuspected sif safter schest stube splacement sa
ssignificant sair sleak sis spresent
Diagnostic sPeritoneal sLavage s- sans--Alternative sto sFAST sscan sto sdetect sabd sbleeding.
sA surinary scatheter sand sgastric stube sshould sbe sin splace sprior sto sprocedure.
FAST s- sans--Focused sAssessment swith sSonography sin sTrauma. sUsed sto sdetect sfree
sfluid sin speritoneum sor shemoperitoneum. sFree sfluid sappears s"black" son sthe sscreen.
sHas sreplaced sDPL swhen savailable.
Positive sFAST sscan s- sans--Hemodynamically sunstable strauma spatient swith sa spositive
sfast sare staken sdirectly sto sthe sOR sfor slaparotomy
Ultrasound sabd sexam s- sans--Not suseful sto sdetect sinjuries sto sthe sdiaphragm, sintestine
sand spancreas. sIn spatients swith sobesity, sascites sand/or ssubQ semphysema sthe
saccuracy sis sreduced.
CT sscan s- sans--Hemodynamically sstable spatients smay sbe staken sto sCT
Angiography s- sans--Embolization sis suseful sin streating spatient swith sunstable spelvic
sfractures, sliver sand ssplenic shemorrhage. sUse sof shybrid sOR ssuites sto sallow sfor ssurgical
sand sinterventional sradiology smethods sof streatment ssimultaneously.
Diagnostic slaparoscopy s- sans--Can sbe sused sto sdetect sor sexclude sfinding sso sf
shemoperitoneum, sorgan sinjury, sintestinal sspillage sor speritoneal spenetration. sMost
suseful sin sevaluating spossible sdiaphragmatic sinjuries, sespectially sin spenetrating
sthoracoabdominal sinjuries son sthe sleft ssite
, Diaphragmatic sinjuries s- sans--Usually sresultant sof spenetrating sthroacoabdominal
sinjuries son sthe sleft sside, sincluding s11-12 srib sfractures son sthe sleft.
Small sintestine sinjuries s- sans--Result sfrom sshearing sforces sin sMVC sor sdirect sblows
sthat scrush sintestine sbetween sforce sand sthe svertebrae. sMost scommonly sintra-abd sinjury
sin spenetrating strauma. sOccurs soften swith sspinal sinjury. sPancreatic/solid sorgan sinjury
sare spredictive sof sincreased srisk sfor shollow sviscus sinjury. sSigns sof speritonitis sdevelop.
sAny sblow sto sthe sabd/penetrating sinjury sto sthe slower schest/abd sshould sincrease
ssuspicion sof sinjury
Treatment sof ssmall sintestine sinjury s- sans--Control sbleeding sprior sto sexploration.
sDebridement sand sclosure sand sligation sof sbleeders. sResection sfor smultiple sdefects.
sObserve sfor swound sinfection/abscess sdevelopment
Cause sof sduodenum sinjuries s- sans--Penetrating strauma smost sfrequent scause. sUsually
sconconcurrent smult-organ sinjuries. sUsually sfound sintraoperatively, scommonly smissed
sduring sexlap. sBlunt sforce sinjury scause sby svetebral scompression.
Duodenal sinjury streatment s- sans--Identification swith sCT sscan. sCommonly spatients shave
smidepigastric sor sback spain swith sevolving speritoneal ssigns s6-24 shrs safter sinjury.
sPrimary sclosure sin sOR, sclosed sdrainage ssystem. sGoals sare sto scontrol shemorrhage,
sdebride sdevitalized stissue sand sprovide sdrainage. sNon soperative smanagement srequires
sclose sobservation sfor sexpanding sor sruptured shematomas scausing sbleeding sor
speritoneal scontamination.
Jejunum sand sileum sinjuries s- sans--Jejunum slies sin sumbilical sregion, sileum slies sin sthe
shypogastric/pelvice sregions. sLap sbelt scan scause sbowel sto sbe scrushed sbetween sthe
svertebrae sand sa ssolid sobject. sIncorrect swearing sof sseatbelt sincreases schance sfor
sinjury
Stomach sinjury s- sans--Rare, smore scommon sin schildren. sPenetrating strauma smost
scommon scause. sMay sfind sfree sair son scxr/fua. sPain sto sepigastric/abd sarea, stenderness,
ssigns sof speritonitis. sBloody soutput sfrom sgastric stube. sSurgical sintervention, sis sgastric
scontent sleakage, scopious speritoneal sirrigation sand sdelayed sprimary sclosure
Large sintestine s- sans--Rectal sinjuries smay sbe sassociated swith ssevere spelvic sfracture.
sLethal sdue sto ssepsis srelated sto sfecal scontamination. sMost sare sdue sto spenetrating
strauma. sTransverse scolon smost soften sinjured. sMost sinjuries sare scontusions.
sLaparotomy swith sprimary srepair sand scolostomy sis sperformed swhen sperforation sto sthe
scolon sor srectum sis ssuspected. sAbscesses scan sbe spercutaneously sdrained.
Liver sinjuries s- sans--Commonly sinjured sdue sto ssize sand slocation. sCause sof sinjury sis
sblunt sand spenetrating strauma. sMVC smost scommon scause. sGreatest smortality srisk sis
shemorrhage.
High svelocity sGSW scause smore swidespread sdamage sthat screates smassive
shemorrhage. sSuspect sliver sinjury sin sany spatient swith sblunt sinjury sto sright sside. sFAST
ANSWERS
Kehr's ssign s- sans--Referred sleft sshoulder spain, susually sindicates sa ssplenic sinjury
Base sdeficit s- sans--Base sdeficit smore sthan s-6 sindicates sthe sneed sfor sagressive
sresuscitation sand sdetermination sof sthe setiology
CXR s- sans--Most simportant stool sproviding suseful sinformation sin sthe searly sminutes. sCan
sidentify smajor ssources sof sblood sloss sfrom sinjuries sin sthe schest sor selevated sdiaphragm
swith sdisplacement sof sabdominal sorgans
Tracheobronchial sinjury s- sans--Should sbe ssuspected sif safter schest stube splacement sa
ssignificant sair sleak sis spresent
Diagnostic sPeritoneal sLavage s- sans--Alternative sto sFAST sscan sto sdetect sabd sbleeding.
sA surinary scatheter sand sgastric stube sshould sbe sin splace sprior sto sprocedure.
FAST s- sans--Focused sAssessment swith sSonography sin sTrauma. sUsed sto sdetect sfree
sfluid sin speritoneum sor shemoperitoneum. sFree sfluid sappears s"black" son sthe sscreen.
sHas sreplaced sDPL swhen savailable.
Positive sFAST sscan s- sans--Hemodynamically sunstable strauma spatient swith sa spositive
sfast sare staken sdirectly sto sthe sOR sfor slaparotomy
Ultrasound sabd sexam s- sans--Not suseful sto sdetect sinjuries sto sthe sdiaphragm, sintestine
sand spancreas. sIn spatients swith sobesity, sascites sand/or ssubQ semphysema sthe
saccuracy sis sreduced.
CT sscan s- sans--Hemodynamically sstable spatients smay sbe staken sto sCT
Angiography s- sans--Embolization sis suseful sin streating spatient swith sunstable spelvic
sfractures, sliver sand ssplenic shemorrhage. sUse sof shybrid sOR ssuites sto sallow sfor ssurgical
sand sinterventional sradiology smethods sof streatment ssimultaneously.
Diagnostic slaparoscopy s- sans--Can sbe sused sto sdetect sor sexclude sfinding sso sf
shemoperitoneum, sorgan sinjury, sintestinal sspillage sor speritoneal spenetration. sMost
suseful sin sevaluating spossible sdiaphragmatic sinjuries, sespectially sin spenetrating
sthoracoabdominal sinjuries son sthe sleft ssite
, Diaphragmatic sinjuries s- sans--Usually sresultant sof spenetrating sthroacoabdominal
sinjuries son sthe sleft sside, sincluding s11-12 srib sfractures son sthe sleft.
Small sintestine sinjuries s- sans--Result sfrom sshearing sforces sin sMVC sor sdirect sblows
sthat scrush sintestine sbetween sforce sand sthe svertebrae. sMost scommonly sintra-abd sinjury
sin spenetrating strauma. sOccurs soften swith sspinal sinjury. sPancreatic/solid sorgan sinjury
sare spredictive sof sincreased srisk sfor shollow sviscus sinjury. sSigns sof speritonitis sdevelop.
sAny sblow sto sthe sabd/penetrating sinjury sto sthe slower schest/abd sshould sincrease
ssuspicion sof sinjury
Treatment sof ssmall sintestine sinjury s- sans--Control sbleeding sprior sto sexploration.
sDebridement sand sclosure sand sligation sof sbleeders. sResection sfor smultiple sdefects.
sObserve sfor swound sinfection/abscess sdevelopment
Cause sof sduodenum sinjuries s- sans--Penetrating strauma smost sfrequent scause. sUsually
sconconcurrent smult-organ sinjuries. sUsually sfound sintraoperatively, scommonly smissed
sduring sexlap. sBlunt sforce sinjury scause sby svetebral scompression.
Duodenal sinjury streatment s- sans--Identification swith sCT sscan. sCommonly spatients shave
smidepigastric sor sback spain swith sevolving speritoneal ssigns s6-24 shrs safter sinjury.
sPrimary sclosure sin sOR, sclosed sdrainage ssystem. sGoals sare sto scontrol shemorrhage,
sdebride sdevitalized stissue sand sprovide sdrainage. sNon soperative smanagement srequires
sclose sobservation sfor sexpanding sor sruptured shematomas scausing sbleeding sor
speritoneal scontamination.
Jejunum sand sileum sinjuries s- sans--Jejunum slies sin sumbilical sregion, sileum slies sin sthe
shypogastric/pelvice sregions. sLap sbelt scan scause sbowel sto sbe scrushed sbetween sthe
svertebrae sand sa ssolid sobject. sIncorrect swearing sof sseatbelt sincreases schance sfor
sinjury
Stomach sinjury s- sans--Rare, smore scommon sin schildren. sPenetrating strauma smost
scommon scause. sMay sfind sfree sair son scxr/fua. sPain sto sepigastric/abd sarea, stenderness,
ssigns sof speritonitis. sBloody soutput sfrom sgastric stube. sSurgical sintervention, sis sgastric
scontent sleakage, scopious speritoneal sirrigation sand sdelayed sprimary sclosure
Large sintestine s- sans--Rectal sinjuries smay sbe sassociated swith ssevere spelvic sfracture.
sLethal sdue sto ssepsis srelated sto sfecal scontamination. sMost sare sdue sto spenetrating
strauma. sTransverse scolon smost soften sinjured. sMost sinjuries sare scontusions.
sLaparotomy swith sprimary srepair sand scolostomy sis sperformed swhen sperforation sto sthe
scolon sor srectum sis ssuspected. sAbscesses scan sbe spercutaneously sdrained.
Liver sinjuries s- sans--Commonly sinjured sdue sto ssize sand slocation. sCause sof sinjury sis
sblunt sand spenetrating strauma. sMVC smost scommon scause. sGreatest smortality srisk sis
shemorrhage.
High svelocity sGSW scause smore swidespread sdamage sthat screates smassive
shemorrhage. sSuspect sliver sinjury sin sany spatient swith sblunt sinjury sto sright sside. sFAST
