Effective communication
•Skilled communication, cooperation, and coordination are the cornerstones of high-performance
teams and high-quality trauma care - ✔✔What is the key to a high-performance trauma team?
Reprioritize circulation before airway or breathing.
•The across-the-room observation is done at the beginning of the primary survey to rapidly assess
the need to reprioritize circulation before airway or breathing. This is done if uncontrolled external
hemorrhage is identified - ✔✔The across-the-room observation step in the initial assessment
provides the opportunity to
Evaluating and anticipating the types of injury that may be present
•Mechanism of injury and energy transfer can assist the provider in evaluating and anticipating
damage - ✔✔When obtaining a history for an injured patient, understanding the kinematic concepts
associated with the mechanism of injury and energy transfer can initially assist the trauma provider
in:
Uncontrolled hemorrhage
•Uncontrolled hemorrhage is the major cause of preventable death after injury, so assessment to
identify uncontrolled hemorrhage is key to the initial assessment process - ✔✔The major
preventable cause of death in the trauma patient is:
Ventilate at a rate of 10 to 12 breaths/minute
•If ventilation is ineffective, assist ventilations at 10 to 12 breaths/minute or one every 5 to 6
seconds - ✔✔ventilation principles associated with a bag-mask device?
Base deficit
, •Base deficit serves as an endpoint measurement of the adequacy of cellular perfusion and when
used in conjunction with serum lactate helps predict the success of the resuscitation - ✔✔best
measure of the adequacy of cellular perfusion and helps to predict the outcome
of resuscitation?
Intercostal nerve blocks
•Continuous intercostal nerve blocks use long-acting anesthetics and can provide safe and effective
pain management for the anticoagulated patient - ✔✔What is a safe pharmacological alternative to
opioids for rib fracture pain management in the anticoagulated patient?
Cerebral vasoconstriction
•Hypocapnia, or low levels of carbon dioxide, will cause vasoconstriction, especially in the cerebral
vasculature - ✔✔In a patient with severe traumatic brain injury, hypocapnia causes:
Damage to the spinal cord
*Penetrating neck trauma may include concurrent injuries to the spinal cord, airway, or vascular neck
structures. With an intact airway and hemodynamic stability, the other common concurrent injury is
to the spinal cord - ✔✔A patient with a knife injury to the neck has an intact airway and is
hemodynamically stable. He complains of difficulty swallowing and speaking. Further assessment is
indicated next for which of the following conditions?
Apply gentle pressure over the iliac crests downward and medially
*To assess for pelvic instability, gentle pressure is applied over the iliac crests downward and
medially - ✔✔What is the appropriate technique for palpating the pelvis for stability?
Maintain adequate respiratory status
*Spinal cord injuries at C3 to C5 can cause the loss of phrenic nerve function, resulting in a paralyzed
diaphragm and inability to breathe - ✔✔A patient with a spinal cord injury at C5 is being cared for in
the emergency department while awaiting transport to a trauma center. Which of the following
represents the highest priority for ongoing assessment and management?