trauma wk 3 vocab

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deb1316
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288591
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trauma wk 3 vocab
Updated:
2014-11-08 18:28:09
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trauma
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trauma
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  1. primary survey
    • A= Airway with cervical spine stabilization and/or immobilization, possible jaw thrust manuever
    • B= breathing
    • C= circulation
    • D= disability+ neuro assess, ROM
    • E= exposure and environmental control, prevent hypothermia
  2. Secondary survey
    • F= full set of vitals, Fahrenheit- treat hypothermia
    • G= get vitals, give comfort measures
    • H=history and head to toe, AMPLE
  3. Jaw thrust manuever
    • used to open airway
    • avoid hyperextension of neck when doing this
  4. AMPLE
    • Allergies to drugs, food, environment
    • Medication history
    • Past health history
    • Last meal
    • Events leading up to illness/injury
  5. Triage
    • meaning to sort
    • 4 or 5 levels 
    • 5: 1-immediate attention, 5= no resources needed
    • 4: 1-immediately seen, 4- not needing immediate attention
  6. Respiratory acidosis
    • increased CO2, more than 45 
    • Manis:
    • neuro: drowsy, disoriented, dizzy, headache, coma
    • Cardio: decrease BP, ventricular fib, warm and flushed skin
    • GI: no significant findings
    • Neuromuscular: seizures
    • Respiratory: hypoventilation with hypoxia
  7. Respiratory alkalosis
    • decreased CO2 less than 35 
    • Manis: 
    • Neuro: lethargy, light-headedness, confusion
    • Cardio: tachycardia, dysrhythmias
    • GI: nausea, vomiting, epigastric pain
    • Neuromuscular: tetany, numbness, tingling, hyperreflexia, seizures
    • Respiratory: hyperventilation
  8. Basilar skull fracture
    • linear fracture occurs when fracture involves base of the skull
    • Nursing care: 
    • high risk for infection: insure free flow of CSF, no NG tubes, no dressing in ears or nose, elevate HOB
    • Prevent infectious material from entering: cleanliness, nothing to clean nares
  9. Rhinorrhea
    • mani of basilar skull fracture
    • CSF leakage from nose
  10. Otorrhea
    • mani of basilar skull fracture
    • CSF leakage from ear
  11. Halo sign
    • used to determine whether fluid leaking from nose or ear is CSF
    • Positive halo: within a few minutes: blood coalesces into center, yellowish ring encircles blood if CSF is present
  12. Battle's sign
    postauricular ecchymosis (behind ear brusing)
  13. Raccoon eyes
    periorbital ecchymosis (bruising around eyes)
  14. Coup-contracoup
    • coup: direct impact of brain on the skull (forward)
    • Contracoup: damage on opposite side away from the injury
  15. Subdural hematoma
    • occurs from bleeding between dura mater and arachnoid layer of meninges
    • venous in origin, slower to develop
  16. Epidural hematoma
    • bleeding between dura and inner surface of skull
    • arterial faster to develop
  17. GCS- Glascow coma scale
    • assess 3 areas: opening of eyes, best verbal response and best motor response 
    • below 9 usually coma
    • 15 fully alert person 3 lowest possible
  18. Decorticate posturing
    • flexion of arms, wrists, and fingers with adduction in UE
    • LE: extension, internal rotation and plantar flexion
  19. Decerbrate posturing
    all 4 extremities in rigid extension, with hyperpronation of forearms and plantar flexion of feet
  20. CCP- cerebral perfusion pressure
    • CPP=MAP-ICP
    • CPP>60= adequate brain perfusion
  21. Intracranial pressure monitor
    • gold standard: ventriculostomy
    • specialized catheter is inserted into lateral ventricle and coupled to an external transducer
    • measures pressure within ventricles
  22. Fiberoptic catheter
    • alternative technology
    • uses a sensor transducer located within catheter tip
  23. Subarachnoid bolt or screw
    • placed just thru the skull between arachnoid membrane and cerebral cortex
    • doesn't allow for CSF drainage but ideal for patients with mild or moderate head injury
  24. A waves
    • most clinically significant ICP waveforms
    • may come and go
  25. osmotic diuretic
    • Mannitol
    • used for increased ICP
  26. Antipyretics
    • for temp control- when increased ICP 
    • cools body temp
  27. Blunt trauma
    falls, MVA, many organs involved, more injuries-some hidden
  28. Penetrating trauma
    bullets, knives, usually specific site affected
  29. Flail chest
    • fracture of 2 or more ribs in 2 or more places with loss of chest wall stability 
    • Manis:
    • paradoxical chest movement 
    • respiratory distress
  30. Tension pneumothorax
    • air in pleural space that doesn't escape
    • Manis
    • Cyanosis
    • air hunger
    • violent agitation
    • tracheal deviation away from affected side
    • Neck vein distension
  31. Mediastinal shift
    mediastinum shifts toward affected side, which compresses the other lung
  32. CIWA score
    for ETOH withdrawal

    if total>15 pt at risk for withdrawal
  33. Rhabdomyolysis causes
    • direct muscle injury: trauma, bites, burns
    • excessive physical exertion: tonic-clonic
    • muscle ischemia: localized compression, immobility, arterial/venous occlusions
    • temp extremes
    • Electrolyte and osmolarity abnormalities: chronic hypokalemia
    • genetic and autoimmune disorders
    • infections
    • drugs, toxins, venoms: ethanol, recreational drugs, stimulants, pharmaceuticals
  34. Myoglubinuria
    • release of myoglobin from muscle cells is often assoc with increase in CK aldolase, LDH, SGPT and other enzymes
    • causes tubular obstruction and AKI 
    • most common causes: trauma, alcohol and drug use
  35. Hypovolemic shock
    • increased hr, decreased BP
    • cool and clammy skin
    • decreased CO, decreased preload, increased SVR
  36. Spinal shock (above T6)
    • decreased hr, Decrease BP
    • skin warm below level of injury
    • decreased CO, decreased preload, decrease SVR
  37. Septic shock
    • increase HR, decrease BP, increase temp
    • all skin warm
    • increased CO, decreased preload, decreased SVR
  38. LeFort fracture
    • fracture of front of the face
    • destabilizes the mandible
    • Airway is major issue: edema and bleeding
    • Also worry about aspiration
  39. Retroperitoneal bleeding
    • or retroperitoneal hemorrhage
    • refers to accumulation of blood found in retroperitoneal space (in ABD cavity behind peritoneum)
    • can present with Grey Turner's sign (flank bruising
  40. Autonomic dysreflexia
    • spinal cord lesions above T6 
    • Manis: pounding headache, HTN, flushing and perspiration above level of injury, cold below level of injury

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