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A review of trauma care concepts and protocols for the TNCC 9th edition, featuring questions and answers on hemorrhage control, airway management, respiratory support, circulation, head injury and hypothermia management. It covers assessment techniques like AVPU and LACE, urinary catheterization contraindications, and ventilator alarm troubleshooting. Also addresses rapid sequence intubation (RSI), cerebral perfusion pressure (CPP), intracranial pressure (ICP), and management of corneal injuries, orbital fractures, neck injuries, and thoracic skeletal fractures. Key signs like Beck's triad, Kehr's sign, Cullen's sign, and Grey Turner's sign are highlighted, along with musculoskeletal injury and electrical burn classifications. This serves as a quick reference for healthcare professionals in trauma care, offering a structured overview of critical procedures and assessments.
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Thexaveragexbloodxpressurexinxaxsinglexcardiacxcycle,xroughlyxcalculatedxasxthexSBPx+x 2 xxxthexDBP/ Avoidxhypoxemiaxinxthexpatientxwithxheadxtraumax-xCORRECTxANSWER- Axsinglexepisodexofxhypoxemiax(PaO2x<60mmHg)xcanxbexdetrimentalxtoxthexpatient'sxoutcome.xMain tainxpulsexoxxatx95%xorxgreaterxandxobtainxABGxmeasurementxasapxforxpatientxwithxseverexTBI. MaintainxETCO2xbetweenx 35 - 45 xmmHg
ManagexICPxinxthexpatientxwithxheadxtraumax-xCORRECTxANSWER- AnxICPxsustainedxatxgreaterxthanx 22 xmmHgxandxunresponsivextoxtreatmentxisxassociatedxwithxpoorx outcomes IncreasedxICPxAssessmentxFindingsx-xCORRECTxANSWER- Early:xHeadache;xn/v;xamnesia;xbehaviorxchangesx(restlessness,ximpairedxjudgement;xdrowsiness) ;xalteredxlevelxofxconsciousnessx(hyperarousabilityxandxhypoarousability) Late:xDilated,xnonreactivexpupils;xunresponsivextoxverbalxorxpainfulxstimuli;xabnormalxmotorxpostur ingx(flexion,xextension,xflaccidity);xCushingxresponse:xWideningxpulsexpressure,xreflexxbradycardia ,xandxdecreasedxrespiratoryxeffort. CornealxInjuryx-xCORRECTxANSWER- AssessmentxFindings:xPhotophobia,xpain,xeyexredness,xlidxswelling,xFBxsensation Treatment:xTopicalxanesthesia,xtopicalxophthalmicxNSAID,xnoxeyexpatch,xremovexFB,xmayxneedxtopi calxabxxforxlaceration. Followxup:xwithxophthalmologistxinx 24 - 48 xhours;xophthalmologyxconsultationxforxdeepxandxlargexFB OrbitalxFracturex-xCORRECTxANSWER- AssessmentxFindings:xPeriorbitalxecchymosis,xfacialxswelling,xdoublexvision,xenophthalmosx(poste riorxdisplacementxofxeyeballxwithinxorbit,xptosis. Treatment:xNasalx decongestant,xicexpacksxtoxthexorbitx forx 48 xhours,x oralxabxx Followxup:xMayxr equirexsurgery,xophthalmology.xAvoidxblowingxnose,xsneezing,xandxValsalvaxmaneuver Retrobulbarxhematomax-xCORRECTxANSWER- AssessmentxFindings:xSeverexpain,xdecreasedxvisionxorxlossxofxvision,xreducedxeyexmovement,xdou blexvision,xIOP
40mmHg Treatment:xAdministerxmedicationsxtoxdecreasexIOP,xemergencyxdecompressionxviaxlateralxcantho tomy Followxup:xEmergentxconsultationxwithxophthalmology GlobexRupturex-xCORRECTxANSWER-AssessmentxFindings:xIrregularxorxteardrop- xshapedxpupils,xperiorbitalxecchymosis,xdecreasedxvisualxacuityxandxEOM,xseverexsubconjunctivalx
Followxup:xOphthalmologyxconsultationxandxclosexfollowxup. NeckxInjuriesx-xCORRECTxANSWER- 3 xzones. Mortalityxisxthexhighestxwithxinjuriesxtoxzonex 1 xandxpatientsxwhoxhavexdysphonia,xdysphagia,xsubcut aneousxemphysema,xorxhematomasxtoxthexneckxregionxindicatingxvascularxtrauma,xairwayxinjuries,x orxesophagealxinjuriesxthatxmayxnotxbexdiagnosedxonximagingxstudies. Penetratingxthoracicxwoundxbelowxthexfourthxintercostalxspacex-xCORRECTxANSWER- xPenetrationxintoxthexabdominalxcavityxisxsuspectedxuntilxprovenxotherwise ThoracicxSkeletalxFracturesxandxAssociatedxInjuriesx-xCORRECTxANSWER- Sternal:xBluntxcardiacxinjury;xpneumothorax Firstxandxsecondxrib:xGreatxvesselxinjuries,xbrachialxplexusxinjuries,xheadxandxspinalxcordxinjuries Multiplexribsxandxflailxchest:xpulmonaryxcontusion;xpneumothorax;xhemothoraxxLowerxrib sx 7 - 12:xLiverxforxrightxsided;xspleenxforxleftxsided Beck'sxTriadx-xCORRECTxANSWER-Threexsignsxofxacutexcardiacxtamponade:
maximizingxoxygenationxandxpainxmanagement.xJudiciousxusexofxfluidsxshouldxbexconsideredxtoxprev entxincreasexinxintraparenchymalxhemorrhage,xatelectasis,xorxconsolidationxbyxinfusingxfluidsxintoxth exinjuredxregionxofxthexlung. Pulsusxparadoxusx-xCORRECTxANSWER- decreasexinxsystolicxBPxofxmorexthanx10mmHgxwithxnormalxinspiration.xItxisxcausedxbyxaxfallxinxcardi acxoutputxasxaxresultxofxincreasedxnegativexintrathoracicxpressurexduringxinhalation.xAsxpressurexwi thinxthexthoraxxfalls,xbloodxpoolsxinxthexlargexveinsxofxthexlungsxandxthorax,xandxstrokexvolumexisxdec reased. **NeverxclampxthexCT,xotherwisexaxtensionxpneumothoraxxmayxdevelop
nyxcortexxisxnotxcompletelyxinterruptedxComminuted:xbonexisxspli nteredxintoxfragmentsxGreenstick:xbonexbendsxorxisxbuckled Impacted:xbonexisxwedgedxintoxdistalxandxproximalxfracturexsitesxDisplace d:xbonexfracturexsitesxarexnotxaligned CompartmentxSyndomex-xCORRECTxANSWER-PainxPressure Pulses
ParesthesiaxPar alysisxPallorxPoi kilothermia Hyperkalemiax 12 - 36 xhoursxafterxinjuryxevent ElectricalxBurnsx-xCORRECTxANSWER-Doxnotxlabelxasx'exit'xorx'entrance',xbutxasx'contactxpoint' DisseminatedxIntravascularxCoagulopathyx-xCORRECTxANSWER- Decreasedxplateletxcount,xdecreasedxfibrinogen,xelevatedxfibrinxdegradationxproduct,xelevatedxd- dimer,xprolongedxprothrombinxtime,xprolongedxpartialxthromboplastinxtime