Chapter 18 Trauma Surgery
Traumatic deaths may occur in three phases, or time frames. The first phase occurs
immediately after the injury, the second phase within the first 1 to 2 hours after the injury, and
the third phase occurs days to weeks after the injury. Approximately 30% of total fatalities from
trauma could be prevented with definitive trauma care, including appropriate and aggressive
resuscitation with rapid transport to an appropriate facility. Which phase, or timeframe, of
potential for trauma death, does this group represent? - ANS-Phase II
Pressure on the heart causing restriction and damage to the conduction system - ANS-Cardia
tamponade
Injury that results in air in the pleural space causing displacement or collapse of the respiratory
structures - ANS-Pneumothorax
Bruising - ANS-Contusion
Trauma that results in deep tissue injury without rupture of the skin - ANS-Blunt injury
A protocol of ATLS in which ultrasound is used in a focus area to diagnose severe trauma -
ANS-Focused Assessment with Ultrasound for Trauma (FAST)
Tissue damage that occurs when an object enters the body through the skin, or the body is
propelled against an object, breaking the skin - ANS-Penetrating injury
Condition in which the body's normal blood clotting mechanism ceases to function,
characteristic im severe multitrauma - ANS-Coagulopathy
Tearing of the atria or ventricles as a result of trauma - ANS-Cardiac rupture
A potentially lethal physiological condition occurring in shock, characterized by abnormally low
blood pH - ANS-Metabolic acidosis
Evidence-based diagnosis of a medical problem using normal investigative procedures such as
imaging studies - ANS-Definitive diagnosis
A type of shock characterized by vascular failure due to severe bleeding - ANS-Hemorrhagic
shock
Hemorrhage with the potential to deplete the patient's total blood volume - ANS-Exsanguinating
, Surgery whose objective is to stop hemorrhage and prevent sepsis without attempting
reconstruction or anatomical continuity - ANS-Damage control surgery
Increase pressure in any compartment of the body such as the cranium, abdominal cavity, or a
limb caused by trauma - ANS-Compartment syndrome
An injury that is not detected in normal assessment procedures - ANS-Occult injury
A planned surgical procedure, usually with specific objectives for reconstruction or restoring
continuity of anatomical structures - ANS-Definitive procedure
Rib fracture in at least three adjacent ribs in two locations each. This condition requires
immediate surgery - ANS-Flail chest
Bleeding into a pleural space - ANS-Hemothorax
Trauma that results in deep tissue injury without rupture of the skin - ANS-Blount injury
In trauma medicine, the process of restoring physiological balance following severe trauma. -
ANS-Resuscitation
What statement regarding level I and level II trauma centers best describes the difference
between the two types of centers? - ANS-A level I trauma center provides care for every type of
injury, while a level II lacks some specialized resources.
When the patient arrives in the ED, the trauma team initiates a primary assessment. This is a
logical, orderly process of patient assessment for potential life threats. These assessment
activities are based on established protocols for advanced trauma life support (ATLS). The
mnemonic "ABCDE" is used, representing assessment of the following: Airway, Breathing,
Circulation, Disability, and Exposure. The D and E represent what degree of investigation? -
ANS-D = a brief neurologic examination; E = exposure to reveal all life-threatening injuries
If cervical spine precautions were not implemented before arrival at the hospital, the emergency
department team initiates them before performing any other procedures on the patient. A
trauma team member can stabilize the head and neck, if necessary, until a cervical collar is
placed. What event needs to take place before the team removes the cervical collar and
continues care? - ANS-A cervical radiograph is obtained to rule out injury to the neck.
Blunt trauma injuries may not fully reveal the degree or depth of injury. What noninvasive
diagnostic test is critical to diagnosis in potential traumatic brain injury? - ANS-CT scan of the
head
Traumatic deaths may occur in three phases, or time frames. The first phase occurs
immediately after the injury, the second phase within the first 1 to 2 hours after the injury, and
the third phase occurs days to weeks after the injury. Approximately 30% of total fatalities from
trauma could be prevented with definitive trauma care, including appropriate and aggressive
resuscitation with rapid transport to an appropriate facility. Which phase, or timeframe, of
potential for trauma death, does this group represent? - ANS-Phase II
Pressure on the heart causing restriction and damage to the conduction system - ANS-Cardia
tamponade
Injury that results in air in the pleural space causing displacement or collapse of the respiratory
structures - ANS-Pneumothorax
Bruising - ANS-Contusion
Trauma that results in deep tissue injury without rupture of the skin - ANS-Blunt injury
A protocol of ATLS in which ultrasound is used in a focus area to diagnose severe trauma -
ANS-Focused Assessment with Ultrasound for Trauma (FAST)
Tissue damage that occurs when an object enters the body through the skin, or the body is
propelled against an object, breaking the skin - ANS-Penetrating injury
Condition in which the body's normal blood clotting mechanism ceases to function,
characteristic im severe multitrauma - ANS-Coagulopathy
Tearing of the atria or ventricles as a result of trauma - ANS-Cardiac rupture
A potentially lethal physiological condition occurring in shock, characterized by abnormally low
blood pH - ANS-Metabolic acidosis
Evidence-based diagnosis of a medical problem using normal investigative procedures such as
imaging studies - ANS-Definitive diagnosis
A type of shock characterized by vascular failure due to severe bleeding - ANS-Hemorrhagic
shock
Hemorrhage with the potential to deplete the patient's total blood volume - ANS-Exsanguinating
, Surgery whose objective is to stop hemorrhage and prevent sepsis without attempting
reconstruction or anatomical continuity - ANS-Damage control surgery
Increase pressure in any compartment of the body such as the cranium, abdominal cavity, or a
limb caused by trauma - ANS-Compartment syndrome
An injury that is not detected in normal assessment procedures - ANS-Occult injury
A planned surgical procedure, usually with specific objectives for reconstruction or restoring
continuity of anatomical structures - ANS-Definitive procedure
Rib fracture in at least three adjacent ribs in two locations each. This condition requires
immediate surgery - ANS-Flail chest
Bleeding into a pleural space - ANS-Hemothorax
Trauma that results in deep tissue injury without rupture of the skin - ANS-Blount injury
In trauma medicine, the process of restoring physiological balance following severe trauma. -
ANS-Resuscitation
What statement regarding level I and level II trauma centers best describes the difference
between the two types of centers? - ANS-A level I trauma center provides care for every type of
injury, while a level II lacks some specialized resources.
When the patient arrives in the ED, the trauma team initiates a primary assessment. This is a
logical, orderly process of patient assessment for potential life threats. These assessment
activities are based on established protocols for advanced trauma life support (ATLS). The
mnemonic "ABCDE" is used, representing assessment of the following: Airway, Breathing,
Circulation, Disability, and Exposure. The D and E represent what degree of investigation? -
ANS-D = a brief neurologic examination; E = exposure to reveal all life-threatening injuries
If cervical spine precautions were not implemented before arrival at the hospital, the emergency
department team initiates them before performing any other procedures on the patient. A
trauma team member can stabilize the head and neck, if necessary, until a cervical collar is
placed. What event needs to take place before the team removes the cervical collar and
continues care? - ANS-A cervical radiograph is obtained to rule out injury to the neck.
Blunt trauma injuries may not fully reveal the degree or depth of injury. What noninvasive
diagnostic test is critical to diagnosis in potential traumatic brain injury? - ANS-CT scan of the
head
