FISDAP Trauma Exam With Complete Solution

Complications of spinal cord injuries - Answer loss of sensation or paralysis below injury, incontinent, abdominal excursion, inability to maintain body temperature, priapism Ecchymosis - Answer Produces a characteristic blue or black discoloration as the result of an injury; not a contusion Indications for spinal immobilization - Answer -Motor vehicle crashes -Pedestrian-motor vehicle crashes -Fall >20 ft (A) or >10 ft (P) -Blunt trauma -Penetrating trauma to the head, neck, back, or torso -Rapid deceleration injuries -Hangings -Axial loading injuries (falling from a height and landing on feet) -Diving accidents Indications for tourniquet use - Answer Bleeding is uncontrolled, Direct pressure on wound does not control the bleed. Pt has substantial bleeding from an extremity injury Pathophysiology of Cushing's reflex - Answer Triad of increased systolic bp, decreased pulse rate, and irregular respirations. This signifies an increased ICP Signs and symptoms of chest wall injuries - Answer -Pain at the site of injury -Pain localized at the site of injury that is aggravated by or increased with breathing -Bruising to the chest wall -Crepitus (broken bone ends grinding together) with palpation of the chest -Penetrating injury to the chest -Dyspnea -Hemoptysis -Failure of one or more sides of chest to expand -Rapid, weak pulse, low bp -Cyanosis around lips or fingernails Pneumothorax - Answer Collapsed lung; absent breath sounds, sucking sound from lungs Open pneumothorax (sucking chest wound) - Answer open or penetrating wound to the chest wall Simple pneumothorax - Answer Doesn't result in major changes in the pt cardia physiology; commonly a result of blunt trauma that results in fractured ribs Tension pneumothorax - Answer arises from ongoing air accumulation in the pleural space. The air from the collapsed lung pushes the mediastinum (heart and great vessels) into the opposite pleural cavity. Can cause decreased cardiac output and shock. -may exhibit JVD, shock symptoms, chest pain, severely decreased lung sounds Hemothorax - Answer From blunt or penetrating chest injures, blood can collect in the pleural space from bleeding around the rib cage, lung, or great vessel. -Pt may exhibit signs of shock without external bleeding, decreased breath sounds Cardiac tamponade - Answer Commonly occurs in the prescence of penetrating chest trauma. Pericardial sac fills with blood or fluid, from a lacerated coronary artery or vein. -Pt may exhibit JVD, narrowing pulse pressure, and muffled heart sounds (Beck's triad) Rib fractures - Answer Pt will report localized pain and tenderness when breathing. Will avoid taking deep breaths and will have rapid, shallow breathing instead. May hold affected portion of chest to minimize discomfort. Flail chest - Answer When 3 or more ribs are fractures in 2 or more places, or if the sternum is fractured along several ribs, a segment of the chest wall may detach. -Breathing will be painful and ineffective, and hypoxemia usually will occur. Suspect pulmonary contusion Traumatic asphyxia - Answer Sudden increase in chest pressure. Pt will have distended neck veins, cyanosis in the face and neck, hemorrhage of the sclera Myocardial contusion - Answer Blunt trauma to the chest. Pulse is irregular, signs and symptoms can mimic a heart attack. Commotio Cordis - Answer A blunt chest injury caused by a sudden, direct blow to the chest that occurs only during the critical portion of a person's heartbeat. Can result in immediate cardiac arrest and ventricular fibrillation. -Usually occurs after pt are struck with softballs, baseballs, bats, snowballs, fists, kicks