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Exam (elaborations)

ATLS study cards With Complete Solution

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Glasgow Coma Scale Chance fracture Correct ans - 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 ans - Flexed, abducted, externally rotated. Burst fracture Correct ans - Associated with vertebral-axial compression injuries Posterior hip dislocation Correct ans - Flexed, aDDucted, internally rotated Anterior shoulder dislocation Correct ans - Squared off appearance Posterior shoulder dislocation Correct ans - Lock in internal rotation. Ankle dislocation Correct ans - Most are Externally rotated, with a prominent medial malleolus. FULL thickness (3rd degree) burn Correct ans - 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 ans - -Establishing airway control -Stopping the burning. process -Intravenous access Factors that increase the risk for upper AIRWAY OBSTRUCTION in burns include: Correct ans - -Burns to the head and face -Burn size and depth -Burns inside the mouth Partial thickness burn Correct ans - 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 ans - These patients should be intubated. Inhalation injury is an indication for transfer to a burn center. Rule of nines - adult Correct ans - The palm represents 1% of the body total surface area. Symptoms of carbon monoxide poisoning and respective levels Correct ans - 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 ans - 240 times. It displaces the oxyhemoglobin desaturated curve to the LEFT. Two criteria required for the diagnosis of smoke inhalation injury Correct ans - -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 ans - Elevation of the head and chest by 30 degrees. IV fluid administration formula for burn victims Correct ans - 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 ans - These patients require greater fluid requirements: ~immolation injury ~pediatric burn victims ~concomitant blunt or crush injuries.

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