Golden Hour
This phase of the trauma evaluation includes fetal heart rate assessment in a pregnant patient?
Secondary Survey
Evaluation of the posterior stomach during trauma laparotomy for epigastric stab wound includes entering what space?
Lesser Sac
26yo M GSW to chest with shotgun, this is the dressing used as initial treatment?
Occlusive, securing 3 of 4 sides
This type of shock may be seen in a 21 yo M in MVC, intubated on scene, extremities warm, multiple abrasions and lacerations, BP 80/40, HR 78, Fast negative. CXR negative.
Neurogenic Shock
How to drape patient in OR after GSW with single hole in the anterior abdomen?
Chest, Abdomen, Neck, Bilateral Thighs
Components to the lethal triad that is to be prevented in the golden hour
Hypothermia, Acidosis, Coagulopathy
This is done to control hepatic bleeding from a grade III liver laceration in a 22 yo M stabbed in the RUQ
Pringle Maneuver
Volume of blood return after 3 hours in a chest tube that would need surgical intervention?
>750cc (aka 250cc/hr for 3 hours)
Decreased blood pressure is a sign of what class of hemorrhagic shock?
Class III
Next Step
22yo M Motorcycle crash, open right femur fracture, pulsatile bleeding, tourniquet in place HR 120, BP 100/65 O2 98%
OR Exploration
Next step in management for 35yo M in a car accident, chest pain with bruising over chest, HR 115, BP 90/50, CXR with sternal fracture, BP still 85/50 after 2L LR.
ECG, Troponin and ECHO
Procedure to repair 60% circumference laceration of thoracic esophagus, secondary to stab, no tissue loss on endoscopy. Hemodynamically stable
Primary repair, 2 layers, tissue coverage,
Next step in the procedure after 25 yo M stab to the chest. Lost pulses, underwent ED thoracotomy that shows tense pericardium.
Longitudinal incision on the pericardium
Vasopressor with renal actions at low doses versus alpha adrenergic effects at high doses?
Dopamine
Next Step
67yoM, morbidly obese stabbed in abdomen, 2cm laceration, lower midline, no bleeding or evisceration, mild pain hemodynamically stable
Wound exploration
GCS is 10 with incomprehensible words, opens eyes to speech. What is the expected motor response?
Withdrawal from pain
Splenic AAST grade for splenic injury after stab wound in the left posterior lower thorax. CT states parenchymal laceration > 3cm deep. No extravasation.
Grade III
Incision to best obtain proximal and distal control for suspected subclavian artery injury?
Trap door - anterolateral thoracotomy, supraclavicular incision connected with median sternotomy
What do you expect the systemic vascular resistance (SVC) on Swan Ganz for 50 F in the SICU after Hartmans secondary to feculent peritonitis who has marginal urine output?
SVC < 800 AKA LOW
Next Step in Management
26 yo obese M stabbed in RUQ. GCS 12, Hemodynamically stable, local tenderness, no peritonitis, soft, wound exploration not clear. CT with trace feee fluid
Diagnostic Laparoscopy
This is the next step after failed endotracheal intubations in a hypoxic trauma patient with expanding neck hematoma?
Cricothyroidotomy
Maneuver done to evaluate suprarenal aorta after suspected penetrating injury based on expanding retroperitoneal hematoma during trauma laparotomy
Mattox
Next step in management of a 32yo pregnant F (30 weeks) in MVC suffers cardiac arrest in trauma bay. CPR initiated and she is rolled to the left side
emergency c- section
This will cause excessive urine output, decreased urine osmolality sometimes associated with traumatic brain injury
Diabetes insipidus
Next step in management of 30yo F struck by a garbage truck, has superior pubic ramus fracture, blood noted at meatus. CT cysto shows contrast extravasation to retroperitoneal space
Foley catheter insertion/decompression 10-14 days