SSM TCAR review Questions and Answers Fully Solved
External Fixation
Interventional Radiology
Open reduction & Internal fixation - AnswersWhat are the definitive options for pelvic fracture
stabilization and hemorrhage control?
Intramedullary nail fixation - AnswersHow are closed mid-shaft femur fractures managed?
The bone is in multiple pieces - AnswersWhat makes a fracture comminuted?
SBP<90
Resp rate <10 or >29
GCS <14 - AnswersPhysiologic criteria for trauma center care?
The process of predicting potential injuries based on analysis of the forces involved - AnswersWhat is
Kinematics?
The nature and amount of force - AnswersDose of energy is?
Type of energy and how it was applied - AnswersCharacteristic of wounding agent?
The dose of energy involved - AnswersForce
Male - AnswersWhich gender is the majority of trauma?
Teens and young adult - AnswersIncidence of trauma peaks at what age?
MVA
Auto vs. pedestrian
Falls
Struck by or against an object - AnswersBlunt trauma Classifications include?
1 organ system failure=4%
2 organ system failures=32%
3 organ system failures=67%
4 organ system failures=90% - AnswersTrauma mortality based on organ system failure?
1. The vehicle
,2. The occupants
3. The internal organs
4. The secondary impacts - AnswersWhat are the four collisions?
Deceleration distance
Energy is dissipated over the distance of the roll and whether or not the occupants are restrained -
AnswersEnergy transmission in a rollover depends on?
Point of contact with the care
Height of hood & bumper
Size & weight of vehicle
Height of patient
Direction patient was facing when struck - AnswersCar vs pedestrian injuries depend on?
Falls - AnswersWhat is the most common mechanism of injury in all age groups?
Fall height (velocity)
Landing surface (deceleration distance)
Point of impact on the body - AnswersFactors predicting fall injuries are?
Cavity is the a function of the size, shape, and characteristic of the missile (mass) - AnswersWound
ballistics- permanent cavity
Speed increases by approximately 20 MPH - AnswersFor every second of fall time, speed increases by?
A state in which cellular oxygen demand exceeds supply
When the cost of tissue oxygen is higher than the body can pay, an oxygen debt develops. -
AnswersDefine Shock?
Pumps-Site of defect heart
Pipes- site of defect is artery, veins or capillaries
Fluid-intravascular, interstitial or intracellular - AnswersTypes of shock per TCAR?
Narrow pulse pressure
Tachycardia
Low CO - AnswersVS in shock?
, 32 ATP molecules - AnswersHow many ATP molecules are produced with oxygen & glucose?
2 ATP molecules - AnswersHow many ATP molecules are produced without oxygen?
Refernce range is 7.35-7.45, but actual normal range is 7.38-7.42 - AnswersNormal pH?
Lactic Acidosis - AnswersWhat is the footprint of shock?
Temperature & pH, which is the oxyhemoglobin dissociation curve - AnswersWhat 2 things affect the
amount of oxygen availalbe to the cells?
Acidosis, elevated temp
More oxygen available to the cells - AnswersOxyhemoglobin dissociation shift to the right?
Hypothermia, alkalosis
Less oxygen available to the cells - AnswersOxyhemoglobin dissociation curve shift to the left?
It is a measure of hemodilution rather than blood loss. - AnswersH & H is a measure of ?
Promote body water retentions by secretion of ADH & activation of RAAS - AnswersWhat are the
hormonal responses to shock?
SIRS
Which is a production of pro-inflammatory mediators, histamine release, and capillary leakage -
AnswersWhat are the inflammatory responses to shock?
Gastric distention,
absent breath sounds,
minimal chest wall movement and
rapid deterioration - AnswersInadvertent esophageal intubation assessment findings include?
Normal is 35-45 mmHg
It is the measurement of ventilation
Clinical assessment- rate, depth, and work of breathing - AnswersWhat is the normal PaCO2 and what
does it measure?
Normal is 80-100 mmHG
It is a measurement of diffusion
External Fixation
Interventional Radiology
Open reduction & Internal fixation - AnswersWhat are the definitive options for pelvic fracture
stabilization and hemorrhage control?
Intramedullary nail fixation - AnswersHow are closed mid-shaft femur fractures managed?
The bone is in multiple pieces - AnswersWhat makes a fracture comminuted?
SBP<90
Resp rate <10 or >29
GCS <14 - AnswersPhysiologic criteria for trauma center care?
The process of predicting potential injuries based on analysis of the forces involved - AnswersWhat is
Kinematics?
The nature and amount of force - AnswersDose of energy is?
Type of energy and how it was applied - AnswersCharacteristic of wounding agent?
The dose of energy involved - AnswersForce
Male - AnswersWhich gender is the majority of trauma?
Teens and young adult - AnswersIncidence of trauma peaks at what age?
MVA
Auto vs. pedestrian
Falls
Struck by or against an object - AnswersBlunt trauma Classifications include?
1 organ system failure=4%
2 organ system failures=32%
3 organ system failures=67%
4 organ system failures=90% - AnswersTrauma mortality based on organ system failure?
1. The vehicle
,2. The occupants
3. The internal organs
4. The secondary impacts - AnswersWhat are the four collisions?
Deceleration distance
Energy is dissipated over the distance of the roll and whether or not the occupants are restrained -
AnswersEnergy transmission in a rollover depends on?
Point of contact with the care
Height of hood & bumper
Size & weight of vehicle
Height of patient
Direction patient was facing when struck - AnswersCar vs pedestrian injuries depend on?
Falls - AnswersWhat is the most common mechanism of injury in all age groups?
Fall height (velocity)
Landing surface (deceleration distance)
Point of impact on the body - AnswersFactors predicting fall injuries are?
Cavity is the a function of the size, shape, and characteristic of the missile (mass) - AnswersWound
ballistics- permanent cavity
Speed increases by approximately 20 MPH - AnswersFor every second of fall time, speed increases by?
A state in which cellular oxygen demand exceeds supply
When the cost of tissue oxygen is higher than the body can pay, an oxygen debt develops. -
AnswersDefine Shock?
Pumps-Site of defect heart
Pipes- site of defect is artery, veins or capillaries
Fluid-intravascular, interstitial or intracellular - AnswersTypes of shock per TCAR?
Narrow pulse pressure
Tachycardia
Low CO - AnswersVS in shock?
, 32 ATP molecules - AnswersHow many ATP molecules are produced with oxygen & glucose?
2 ATP molecules - AnswersHow many ATP molecules are produced without oxygen?
Refernce range is 7.35-7.45, but actual normal range is 7.38-7.42 - AnswersNormal pH?
Lactic Acidosis - AnswersWhat is the footprint of shock?
Temperature & pH, which is the oxyhemoglobin dissociation curve - AnswersWhat 2 things affect the
amount of oxygen availalbe to the cells?
Acidosis, elevated temp
More oxygen available to the cells - AnswersOxyhemoglobin dissociation shift to the right?
Hypothermia, alkalosis
Less oxygen available to the cells - AnswersOxyhemoglobin dissociation curve shift to the left?
It is a measure of hemodilution rather than blood loss. - AnswersH & H is a measure of ?
Promote body water retentions by secretion of ADH & activation of RAAS - AnswersWhat are the
hormonal responses to shock?
SIRS
Which is a production of pro-inflammatory mediators, histamine release, and capillary leakage -
AnswersWhat are the inflammatory responses to shock?
Gastric distention,
absent breath sounds,
minimal chest wall movement and
rapid deterioration - AnswersInadvertent esophageal intubation assessment findings include?
Normal is 35-45 mmHg
It is the measurement of ventilation
Clinical assessment- rate, depth, and work of breathing - AnswersWhat is the normal PaCO2 and what
does it measure?
Normal is 80-100 mmHG
It is a measurement of diffusion
