PHTLS EXAM PREP

what are the (5) major areas of blood loss? -Answer- - external - chest - abdomen - pelvis - long bones what are the (3) types of blast injuries? -Answer- Primary injuries are caused by the effect of transmitted blast waves on gas-containing structures; secondary injuries, by the impact of airborne debris; tertiary injury, by the transposition of the entire body because of blast wind or structural collapse; and quaternary injuries, by all other forces what 3 collisions are involved with an MVA? -Answer- 1. vehicle collides with an object 2. unrestrained occupant collides with inside of car 3. internal organs collide with one another or with the wall of the cavity that contains them what is o'donohue's triad? -Answer- adult pedestrian vs car accident - adults tend to protect themselves by turning away 1 - bumper vs lower legs; tib/fib#, knee tear 2 - falls towards bonnet; intra-abdominal/thoracic injury, #femur/pelvis/thorax/spine. 3 - strikes ground; deceleration/compression forces, head injuries what is waddell's triad? -Answer- child vs car - children tend to face the oncoming vehicle 1 - bumper vs fermur/pelvis 2 - bonet vs thorax; head/neck flexes forward; head/face/neck may collide with bonnet. 3 - strikes ground/dragged under car. what is the munro-kellie doctrine? -Answer- 1. The total intracranial volume if fixed because of the inelastic nature of the skull 2. Inside the skull is the brain, blood & CSF 3. If ICP is increased (via haematoma, swelling or tumour) the skull cannot expand to accommodate this 4. As a result some other structure must be forced out 5. First the CSF & Blood are forced out 6. The only way out is through the foramen magnum 7. Once the ability to force out CSF & blood has been exhausted, the ICP rises rapidly & the next structure to be forced out of the vault is the brain 8. One of the first parts of the brain to be forced out is the medulla oblongata causing an alteration in respirations what is major trauma? -Answer- any trauma that requires p1 transport under what conditions should a patient with major trauma NOT be taken to the major trauma centre? -Answer- - diversion to nearest ED for stabilisation is required what considerations should be remembered in major trauma and burns? -AnswerBurns patients with burns should be taken to fiona stanley. Should major trauma be present, they should be taken to RPH. what are 4 signs to assist determination of death? -Answer- persons in cardiac arrest - obvious signs of death - rigor mortis, with or without decomposition/ putrification - palliative care - advanced directive