Injured what?
Primary, Secondary, and Tertiary
What are the three phases of the trauma survey?
When the patient status changes, start back at the primary survey!
Don't "hold" this unless told to do so.
DVT Chemoprophylaxis. Even for surgery. If you are unsure, verify with the team.
MACE 2
What is the name of the TBI Screening tool used for all trauma patients?
Bonus if you can show me a MACE 2 card
AUDIT-C
What is the alcohol screening tool used for every trauma patient?
Bonus: Who documents this in Genesis?
This tube should be on continuous suction or no suction at all
What is a chest tube?
Bonus: when are chest tubes placed to water seal?
ABCDE
What are the components of the primary survey?
Bonus: What does a secondary survey consist of?
30mg BID SC
What is the dose of lovenox for trauma patients at LRMC?
If you see a trauma patient without lovenox ordered, or with a different dose, review the note and ask the team.
Referral to TBI team
What is a positive MACE 2 exam?
Command Referral to Substance Abuse Program
What is required for every alcohol related incident in active duty service members?
This tube should have low intermittent suction and is two colors
What is an NG tube?
Bonus: Describe how you would troubleshoot an NG tube that is not draining.
24 hours after the patient arrives
When do you do the tertiary survey?
Listen to what you patient complains about, they often tell you what's broken. Be present for the tertiary survey and communicate your findings! You are part of the TRAUMA TEAM.
11-58% and 1.5-6% of trauma patients develop these two problems.
What are rates of DVT and pulmonary embolism? Without DVT prophylaxis 77% of tibial fractures develop DVT.
Deteriorating levels of consciousness
Repeatative emesis
Double vision
Agitated/Combative
What are red flags that may represent acutely worsening injury? Notify trauma team providers for new or worsening findings.
A score of 4-7
Who needs, at minimum, verbal counseling and printed educational sheet about alcohol use?
What else might this patient need?
This tube should have 0.5ml/kg/hour output. For severe injury or burns up to 1ml/kg/hour.
What is a foley catheter?
Bonus: What does low UOP warn you of?
Extremities, axilla, perineum, scalp
What are the most common areas for missed injuries?
Hands On-Eyes On
Unilateral calf swelling; purple swollen limbs
What are acute signs of DVT. Calf may be tender to palpation.
Blow/Jolt to head AND alteration of memory/consciousness
What is MACE 2 definition of concussion?
Peak at 5 days, may be lifethreatening.
Bonus: name commons symptoms of withdrawal
More than 300 mL per hour
New bubbles or abrupt increase in bubbles
What are signs of potential life threatening intrathoracic injuries?
Bonus: Describe how you determine where an air leak is coming from.
15.4% of patients have these documented 24 hours after polytrauma
What are new injuries identified on tertiary exam.
Travis comes by within 24 hours to perform this exam
What is a venous duplex of the bilateral lower extremities.
8 hours // 24 hours
What are the times MACE2 and TBI consult must be completed in?
Folate and B12 // No IV glucose
What are things you should and shouldn't given to patients suspected of alcohol abuse, dependancy?
Bonus: Why?
Suck on this tube to determine if you can discharge
What is incentive spirometry for patients with blunt thoracic trauma?
Bonus: What scoring system should be documented with every vital sign assessment?