Practice, 6th Edition, Volume 5 by Bledsoe
Discuss the following?
Haddon matrix - ANSWER:a three-by-three matrix that identifies host, agent, and
environmental factors affecting the incidence and seriousness of disease (or trauma)
during the pre-event, event, and post-event time frames.
Golden Period - ANSWER:the concept that it is important to hasten care and delivery
to a trauma center for the seriously injured trauma patient; replaces the former term
Golden Hour, which was not supported by scientific evidence, and the understanding
that some patients need to reach surgery in less than an hour from the time of injury
while others do not.
mechanism of injury - ANSWER:Circumstances and events by which an injury occurs.
As you assess the scene, try to mentally re-create the incident from available
evidence. Attempt to identify the strength and direction of the forces involved in the
accident. Try to determine the area or areas of the patient's body most likely to have
been affected by these forces. Current research suggests that MOI alone is no as
good a trauma severity predictor as was once thought. At best, the MOI is only an
indirect indicator of injury severity.
index of suspicion - ANSWER:the anticipation of injury to a body region, organ, or
structure based on analysis of the mechanism of injury. This index is a mental
summation of suspected injuries based on your event analysis.
Preload - ANSWER:The amount of blood returned to the heart to be pumped out and
directly affects the afterload.
Afterload - ANSWER:The resistance a contraction of the heart must overcome in
order to eject blood; in cardiac physiology, defined as the tension of cardiac muscle
during systole (contraction). Also called peripheral vascular resistance.
rule of nines - ANSWER:Method of estimating amount of body surface area burned
by a division of the body into regions, each of which represents approximately 9
percent of total BSA (plus 1 percent for the genital region).
rule of palms - ANSWER:Method of estimating the amount of body surface area
burned that sizes the area burned in comparison to the patient's palmar surface.
What is the best choice of pain medication for burn victims? - ANSWER:Provide
patients in severe pain with narcotic analgesia. Fentanyl or morphine should be
, administered as needed Consider Morphine in 2 to 5 mg increments every 5 minutes
until suffering is relieved. Use morphine with caution, though, as it may depress the
respiratory drive and increase any existing hypovolemia. With fentanyl, start with
loading dose of 25 to 50 mcg IV and administer repeat doses of 25 mcg IV as needed.
Describe the rule of 9's for an infant. - ANSWER:Head - 18
Chest - 18
Back - 18
Legs - 13.5
Arms - 9
Genitalia - 1
Describe the rule of 9's for an adult. - ANSWER:Head - 9
Chest - 18
Back - 18
Arms - 9
Legs - 18
Genitalia - 1
Who is a scald burn most commonly seen in? - ANSWER:Children and handicapped
adults
What is hemorrhagic shock? - ANSWER:Shock caused by blood loss
*4 classes
Types of Bleeding - ANSWER:Venous- flowing, darker red. Arterial- fast, spurting,
bright red. Capillary- oozes, slow bleed.
What are the 4 classes of hemorragic shock - ANSWER:Class I - <15%
-tolerable
Class 2 - 15%-30%
-HR increases, but weakens
-RR increases, but shallower
Class 3 - 30%-40%
-HR very high, barely palpable
-RR increases, volume decreases
-Pale, cool, clammy
-AMS - unconcious
Class 4 - >40%
-Losing more than 2000mL
-Usually unconcious
What is cardiogenic shock? - ANSWER:Shock caused by cellular death that weakens
the heart muscle and decreases cardiac output
What is neurogenic shock? - ANSWER:Results from an interruption in the
communication pathway between the central nervous system and the body. A spinal