TCRN Exam Study Guide with 100% Correct Answers
Kehr's sign - ️️ Referred left shoulder pain, usually indicates a splenic injury
Base deficit - ️️ Base deficit more than -6 indicates the need for agressive
resuscitation and determination of the etiology
CXR - ️️ Most important tool ...
Ultrasound abd exam - ✔️✔️Not useful to detect injuries to the diaphragm, intestine and
pancreas. In patients with obesity, ascites and/or subQ emphysema the accuracy is
reduced.
CT scan - ✔️✔️Hemodynamically stable patients may be taken to CT
Angiography - ✔️✔️Embolization is useful in treating patient with unstable pelvic
fractures, liver and splenic hemorrhage. Use of hybrid OR suites to allow for surgical
and interventional radiology methods of treatment simultaneously.
Diagnostic laparoscopy - ✔️✔️Can be used to detect or exclude finding so f
hemoperitoneum, organ injury, intestinal spillage or peritoneal penetration. Most useful
in evaluating possible diaphragmatic injuries, espectially in penetrating
thoracoabdominal injuries on the left site
Diaphragmatic injuries - ✔️✔️Usually resultant of penetrating throacoabdominal injuries
on the left side, including 11-12 rib fractures on the left.
Small intestine injuries - ✔️✔️Result from shearing forces in MVC or direct blows that
crush intestine between force and the vertebrae. Most commonly intra-abd injury in
penetrating trauma. Occurs often with spinal injury. Pancreatic/solid organ injury are
predictive of increased risk for hollow viscus injury. Signs of peritonitis develop. Any
blow to the abd/penetrating injury to the lower chest/abd should increase suspicion of
injury
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