Chapter 18 Trauma Surgery
________ in trauma is a non-invasive scan that can be used to determine the presence of free
fluid in the chest or abdomen. This skin consists of chest, pelvic, and four abdominal scan. -
ANS-Focused assessment with sonography (FAST)
2 ways in which a stable patient is diagnosed with abdominal injury: - ANS-computerized
tomography (CT)
focused assessment with ultrasound for trauma (FAST)
A 26-year-old woman is rushed to the operating room after a primary and secondary survey in
the emergency department. She was hit by a small truck as she was riding her bicycle through a
busy intersection. She has sustained rib fractures and several fractured transverse vertebral
processes. Renal injury is suspected. As the circulator prepares to insert a urinary catheter, she
notices blood at the urinary meatus. What should the circulator's next action be? -
ANS-Discontinue the catheter insertion.
A planned surgical procedure, usually with specific objectives for reconstruction or restoring
continuity of anatomical structures - ANS-Definitive procedure
A potentially lethal physiological condition occurring in shock, characterized by abnormally low
blood pH - ANS-Metabolic acidosis
A protocol of ATLS in which ultrasound is used in a focus area to diagnose severe trauma -
ANS-Focused Assessment with Ultrasound for Trauma (FAST)
A trauma patient is rushed to the OR after a primary survey is completed in the emergency
department. He is a 36-year-old male with multiple penetrating gunshot and knife wounds to the
abdomen. He is bleeding profusely. What appropriate actions are critical in the rapid preparation
for this procedure? - ANS-Prep the patient from the suprasternal notch to the mid-thigh.
A type of shock characterized by vascular failure due to severe bleeding - ANS-Hemorrhagic
shock
An injury that is not detected in normal assessment procedures - ANS-Occult injury
Autotransfusion can present a vital asset in trauma care, when considering the high blood loss
associated with many traumatic injuries. This process provides immediate volume replacement,
decreases the amount of bank blood used, and reduces the possibility of transfusion reactions
or risk of transfusion with bloodborne pathogens. What are the contraindications to using
autotransfusion as a blood replacement source? - ANS-Blood contaminated with food, bowel
contents, or antibiotic irrigation
, Bleeding into a pleural space - ANS-Hemothorax
Blunt force to the larynx can result in a fracture and impose immediate airway obstruction.
These patients are at risk for a lost airway and may require immediate tracheotomy followed by
repair of the fracture when the fracture is unstable or displaced. It is also important to consider
that a trauma patient is assumed to have a full stomach; thus these patients are at high risk for
aspiration and resultant pneumonia. What is an appropriate action in the event of a lost airway
after anesthesia induction and before intubation? - ANS-Assist the anesthesia provider with
securing the airway while applying cricoid pressure.
Blunt trauma injuries may not fully reveal the degree or depth of injury. What noninvasive
diagnostic test is critical to diagnosis in potential traumatic brain injury? - ANS-CT scan of the
head
Bruising - ANS-Contusion
Cervical Spine Precautions:
A trauma team member can stabilize the ________ and ________, if necessary, until a cervical
collar is placed. Once placed, the team does not remove it until a ________ clears the neck of
injury. - ANS-head
neck
cervical radiograph
Condition in which the body's normal blood clotting mechanism ceases to function,
characteristic im severe multitrauma - ANS-Coagulopathy
Diagnostic Procedures (Focused assessment with sonography/ FAST)-
-The chest scan examines right and left chest views and can determine the presence of
_________.
-The upper right abdominal skin evaluates the _________ area, the first area that shows the
presence of air.
-The left upper scan examines the ________ area.
-The pelvic scan assesses for ________ near the ________. - ANS-pericardial fluid
hepatorenal
splenorenal
free fluid, bladder
Diagnostic Procedures-
________ maybe performed to determine the presence of abdominal injury. This tool is of
particular benefit when evaluation in the abdomen is difficult, such as when the patient is
intoxicated, unconscious, or hemodynamically unstable. - ANS-Diagnostic peritoneal lavage
(DPL)
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