ATLS study cards With Complete Solution

Glasgow Coma Scale Correct AnswerChance fracture Correct Answer- Transverse fracture through vertebra. In children usually associated with enterc disruption. Seen in motor vehicle accidents involving only lap belt. May be associated with retroperitoneal and Abdominal visceral injuries. Anterior hip dislocation Correct Answer- Flexed, abducted, externally rotated. Burst fracture Correct Answer- Associated with vertebral-axial compression injuries Posterior hip dislocation Correct Answer- Flexed, aDDucted, internally rotated Anterior shoulder dislocation Correct Answer- Squared off appearance Posterior shoulder dislocation Correct Answer- Lock in internal rotation. Ankle dislocation Correct Answer- Most are Externally rotated, with a prominent medial malleolus. FULL thickness (3rd degree) burn Correct Answer- Dark or white and leathery. Translucent white as well. Painless and generally "dry" Does not blanch with pressure. Very little swelling of burned tissue. Principle Life saving measures for patients with burn injuries include Correct Answer- -Establishing airway control -Stopping the burning. process -Intravenous access Factors that increase the risk for upper AIRWAY OBSTRUCTION in burns include: Correct Answer- -Burns to the head and face -Burn size and depth -Burns inside the mouth Partial thickness burn Correct Answer- Red remodeled appearance with associated swelling and blister formation. May have weeping or wet appearance and is painfully hypersensitive even to air current. Signs and symptoms and history that suggest INHALATION INJURY include: Correct Answer- These patients should be intubated. Inhalation injury is an indication for transfer to a burn center. Rule of nines - adult Correct Answer- The palm represents 1% of the body total surface area. Symptoms of carbon monoxide poisoning and respective levels Correct Answer- PaO2 does not reliably predict carbon monoxide poisoning because a CO partial pressure of only 1 mmm Hg results in a hemoglobin CO level of 40% or greater. Carbon monoxide has how many times greater affinity for hemoglobin than oxygen Correct Answer- 240 times. It displaces the oxyhemoglobin desaturated curve to the LEFT. Two criteria required for the diagnosis of smoke inhalation injury Correct Answer- -Exposure to a combustible agent -Signs of exposure to smoke in the lower airway, below the vocal cords, by bronchoscopy. Performing this action will help reduce neck and chest wall edema in patients with burn and inhalation injury. Correct Answer- Elevation of the head and chest by 30 degrees. IV fluid administration formula for burn victims Correct Answer- Indicated in burns involving over 20% of the body surface area. *(2-4 mL/kg of LR/NS) (weight in kg) (% area of burn); give 1/2 of this volume in first 8 hours. Remainder in over 16 hours. Large caliber, at least 15 gauge intravenous line should be introduced. Pitfalls for IV fluid requirements for burn victims. Correct Answer- These patients require greater fluid requirements: ~immolation injury ~pediatric burn victims ~concomitant blunt or crush injuries. Basic rules regarding IV fluids administration in burn victims Correct Answer- IV fluid Rate should not be based on the time of actual injury. In very small children, less than 10 kilograms, it may be necessary to add glucose to the IV fluids to avoid hypoglycemia. Any adjustment in IV fluid rate should be based on urine output. In an adult, urine output above 0.5 ml/ kilogram should result in reduction of IV fluid rate. Initial treatment of frostbite/ cold injuries Correct Answer- Place injured part in circulating water and a constant 40 degrees centigrade until pink color and perfusion return, usually within 20 to 30 minutes. Antibiotics are not indicated empirically unless infection develops later. Persisted ACIDEMIA in burn victims may reflect... Correct Answer- Cyanide poisoning. (Cyanide is a naturally occurring toxin that may be inhaled in a confined space fire). Hypothermia Severe hypothermia Correct Answer- Core temperature of 36 degrees centigrade Temperature below 32 degrees centigrade Definition of frostbite. Correct Answer- Freezing of tissue with intracellular ice crystal formation, microvascular occlusion, subsequent tissue anoxia. First degree frostbite Correct Answer- Hyperemia and edema without skin necrosis Second-degree frostbite Correct Answer- Large clear vesicle formation accompanies hyperemia and edema with partial thickness skin necrosis 3rd degree frostbite Correct Answer- Full thickness and subcutaneous necrosis occurs, commonly with hemorrhage and vesicle formation. Although a compartment pressure systolic blood pressure is required to lose a pulse distal to in extremity burn, a pressure of what was in the compartment may lead to muscle necrosis Correct Answer- 30 mm Hg. If a pressure of greater than 30 mm Hg in a burned extremity is present, eschatotomy is indicated. Difference between fasciotomy and eschatotomy Correct Answer- Compartment syndrome is also present with circumferential chest and abdominal burns, which lead to increased peak inspiratory pressures. Eschatotomy in circumferential chest and abdominal burns. Correct Answer- We are generally not needed before the first 6 hours after a burn. Gastric tube placement in burn victims. Correct Answer- Place of burn involves more than 20% of total BSA. Alkali burns to the eyes require how many hours of continuous irrigation Correct Answer- 8 hours. Electrical burns. Correct Answer- Can cause thrombosis and entry to nerves, and digits are especially prone to injury. Patients with electrical injuries frequently require fasciotomies because of the degree of deep tissue injury and should be transferred to a burn center. Immediate ELECTRICAL burn treatment measures. Correct Answer- Attention to airway and breathing, IV line placement, ECG monitoring, and placement of an indwelling Foley catheter. Rhabdomyolysis and subsequent metabolic acidosis are common complications. Criteria for transfer of a burn victim to a burn center. Correct AnswerEstimating WEIGHT in kilograms for a child Correct Answer- (2× AGE) + 10 Infant blood volume estimate Correct Answer- 80 ml/kg Child blood volume estimate Correct Answer- 70 ml/kg. IO needle size: Infant Child Correct Answer- 18 gauge 15 gauge Packed red blood cell volume transfusion for a child Correct Answer- 10 mL/ kilogram Pediatric verbal score Correct Answer