TRAUMA Notes Verified 100% Correct 2025
-Deteriorating neurological state
and inability to access neurosurgical assistance within 2 hours
•Pupillary dilation must be present
•Ipsilateral pupillary dilation better than motor signs in localising the side of the lesion
•site of extradural collection often indicated by bogginess over scalp or fracture.
- ANSWER-Angio-pros/cons
- ANSWER-Base of skull # signs
Kernohan's notch syndrome* false localizing of motor findings due to contralateral
cerebral peduncle compression (midbrain) by the tentorium cerebelli.
i. It is a FALSE localizing sign: ie. the patient has a left SDH causing an uncal herniation
to the right, producing decreased LOC and LEFT (rather than right) sided hemiparesis.
- ANSWER-C Spine injury complications
- ANSWER-Central cord syndrome-
MUD-E- capes
- ANSWER-CT VS FAST (IMP)
- ANSWER-CT vs FAST Vs DPL
DPL- cons
-can't decide if surgery indicated
-False +ve,Invasive
-Low sensitivity for diaphgram injury
-Pros
High sensitivity ,can be done on multiple patients
- ANSWER-Diff B/W Flexion & Extension tear drop Fracture
Flexion tear drop is a larger fragment.
Flexion involves the anterior and posterior columns usually.
They are unstable, often assx with complete and incomplete spinal cord injuries and
they need surgery.
Extension tear drop fracture is an avulsion fracture of the anterior endplate.
Extension tear drop fractures are stable and treated with a collar.
- ANSWER-Injuries not picked well by CT Abdo (monash 2021.2Q)
-Mesentric injuries
-Small bowel injury
,-Diaphragmatic rupture
-Retroperitoneal -e.g Pancreas
- ANSWER-pelvic # -associated. injuries
- ANSWER-Pelvic # -Rx
Angioembolisation vs surgery
Angio pros/cons(see dunn)
Complications of Agioembolisation
•impotence
•bladder / gluteal necrosis
•neuropathy
- ANSWER-Post traumatic arrest- Care
- ANSWER-Urethral injury
Geelong SAQ 6-Q6
Abdo Trauma RX - ANSWER-In the haemodynamically stable patient(Dunn)
If > 1L /hr required—(unstable)
(gas)Angio Blush, free gas, Peritonism without free gas
-->Laprotomy
(Fluid)-Small fluid without tenderness->observe, With tenderness--.Laparotomy
(No gas or fluid)-Negative imaging,no pain, no intoxication or altered sensorium,& HD
stable -->DC
12-24 hrs observe if Dangerous mechanism, Altered conscious, Abdo pain, limited
resource
Burn -Transfer Criteria(Cameron) - ANSWER-Large, deep, sensitive areas, electric,
preexisting injuries
-Full-thickness burns>5% in any age group
>10% in the under 10 and over 50 age groups
-Partial-thickness burns>20% in all age groups, or
-Burns involving face, eyes, ears, hands, feet, genitalia, perineum or a major joint
-Inhalation burns
-Electrical burns, including lightning injury
-Burns associated with other significant injuries
, -Smaller burns in patients with pre-existing disease that could complicate management
-Extremes of age-Children & elderly
-Pregnant
-Suspicion of NAI, Parents not coping
Burn Depth - ANSWER-Superficial-(Epidermal)- or 1st Degree
Pink, tender, normal cap refill & nicolsky -ve)
Dermal
-Dermal also called 2nd degrees
- Both superficial & deep are Nikolsky +ve)
Dermal -Superficial
Papillary dermis-->Painful, Blisters, Cap refill present, Base of blister has cap return
+sensation
Dermal -deep
Reticular dermis-->Dry, blotchy, red, Absent cap refill, doesn't bleed, variable pain
Full-thickness-3rd degree
Dermal & epidermal tissue destruction, Sub cut tissue exposed, No sensation
Burn Percentage (Different in Children)-Lund Bowler chart - ANSWER--Head(A),Thigh
(B) & Leg (C) -change with age *
-Torso (Chest +Abdomen ) 13 % front & 13 % back
-Buttock - 2.5% each
ARM
Overall whole arm total = 10% = 9.5 % for adult
-Upper arm ( Shoulder to elbow) 2% front & 2% back (same as adult =4.5% total of front
& back))
-Lower arm (Elbow to wrist ) 1.5 % font & 1.5 % back
-Palm 1.5 % font & 1.5 % back
Forearm + palm = 3 % each side ,total of 6 % front & back ----adults 4.5% total of front
& back
Arm=2% ,forearm=1.5%,hand =1.5% =anterior & same %age posteriotly
*Head surface area decreases with age.
Thigh & leg surface increases with age
At Age 10-
Head =5% each side ( infants (10% each side) & at Age 15-Adult
Thigh - 4.25% & leg =3%
-Deteriorating neurological state
and inability to access neurosurgical assistance within 2 hours
•Pupillary dilation must be present
•Ipsilateral pupillary dilation better than motor signs in localising the side of the lesion
•site of extradural collection often indicated by bogginess over scalp or fracture.
- ANSWER-Angio-pros/cons
- ANSWER-Base of skull # signs
Kernohan's notch syndrome* false localizing of motor findings due to contralateral
cerebral peduncle compression (midbrain) by the tentorium cerebelli.
i. It is a FALSE localizing sign: ie. the patient has a left SDH causing an uncal herniation
to the right, producing decreased LOC and LEFT (rather than right) sided hemiparesis.
- ANSWER-C Spine injury complications
- ANSWER-Central cord syndrome-
MUD-E- capes
- ANSWER-CT VS FAST (IMP)
- ANSWER-CT vs FAST Vs DPL
DPL- cons
-can't decide if surgery indicated
-False +ve,Invasive
-Low sensitivity for diaphgram injury
-Pros
High sensitivity ,can be done on multiple patients
- ANSWER-Diff B/W Flexion & Extension tear drop Fracture
Flexion tear drop is a larger fragment.
Flexion involves the anterior and posterior columns usually.
They are unstable, often assx with complete and incomplete spinal cord injuries and
they need surgery.
Extension tear drop fracture is an avulsion fracture of the anterior endplate.
Extension tear drop fractures are stable and treated with a collar.
- ANSWER-Injuries not picked well by CT Abdo (monash 2021.2Q)
-Mesentric injuries
-Small bowel injury
,-Diaphragmatic rupture
-Retroperitoneal -e.g Pancreas
- ANSWER-pelvic # -associated. injuries
- ANSWER-Pelvic # -Rx
Angioembolisation vs surgery
Angio pros/cons(see dunn)
Complications of Agioembolisation
•impotence
•bladder / gluteal necrosis
•neuropathy
- ANSWER-Post traumatic arrest- Care
- ANSWER-Urethral injury
Geelong SAQ 6-Q6
Abdo Trauma RX - ANSWER-In the haemodynamically stable patient(Dunn)
If > 1L /hr required—(unstable)
(gas)Angio Blush, free gas, Peritonism without free gas
-->Laprotomy
(Fluid)-Small fluid without tenderness->observe, With tenderness--.Laparotomy
(No gas or fluid)-Negative imaging,no pain, no intoxication or altered sensorium,& HD
stable -->DC
12-24 hrs observe if Dangerous mechanism, Altered conscious, Abdo pain, limited
resource
Burn -Transfer Criteria(Cameron) - ANSWER-Large, deep, sensitive areas, electric,
preexisting injuries
-Full-thickness burns>5% in any age group
>10% in the under 10 and over 50 age groups
-Partial-thickness burns>20% in all age groups, or
-Burns involving face, eyes, ears, hands, feet, genitalia, perineum or a major joint
-Inhalation burns
-Electrical burns, including lightning injury
-Burns associated with other significant injuries
, -Smaller burns in patients with pre-existing disease that could complicate management
-Extremes of age-Children & elderly
-Pregnant
-Suspicion of NAI, Parents not coping
Burn Depth - ANSWER-Superficial-(Epidermal)- or 1st Degree
Pink, tender, normal cap refill & nicolsky -ve)
Dermal
-Dermal also called 2nd degrees
- Both superficial & deep are Nikolsky +ve)
Dermal -Superficial
Papillary dermis-->Painful, Blisters, Cap refill present, Base of blister has cap return
+sensation
Dermal -deep
Reticular dermis-->Dry, blotchy, red, Absent cap refill, doesn't bleed, variable pain
Full-thickness-3rd degree
Dermal & epidermal tissue destruction, Sub cut tissue exposed, No sensation
Burn Percentage (Different in Children)-Lund Bowler chart - ANSWER--Head(A),Thigh
(B) & Leg (C) -change with age *
-Torso (Chest +Abdomen ) 13 % front & 13 % back
-Buttock - 2.5% each
ARM
Overall whole arm total = 10% = 9.5 % for adult
-Upper arm ( Shoulder to elbow) 2% front & 2% back (same as adult =4.5% total of front
& back))
-Lower arm (Elbow to wrist ) 1.5 % font & 1.5 % back
-Palm 1.5 % font & 1.5 % back
Forearm + palm = 3 % each side ,total of 6 % front & back ----adults 4.5% total of front
& back
Arm=2% ,forearm=1.5%,hand =1.5% =anterior & same %age posteriotly
*Head surface area decreases with age.
Thigh & leg surface increases with age
At Age 10-
Head =5% each side ( infants (10% each side) & at Age 15-Adult
Thigh - 4.25% & leg =3%
