Trauma Management Flashcards

Traumatic brain injury (TBI) secondary injury is caused by:

Answer: Hypoxia, hypotension, hypercapnia, hyperthermia, and seizures after the initial impact

Secondary brain injury occurs after the initial impact through preventable physiological insults — hypoxia, hypotension, hypercapnia (vasodilatation increasing ICP), fever, and seizures — all of which paramedics can actively prevent.

The classic Cushing's Triad, indicating raised intracranial pressure, consists of:

Answer: Hypertension (wide pulse pressure), bradycardia, and irregular respirations

Cushing's Triad is a late, ominous sign of severely raised ICP causing brainstem compression: hypertension with widened pulse pressure, reflex bradycardia, and irregular (Cheyne-Stokes) respirations — indicating imminent herniation.

In traumatic cardiac arrest, which reversible cause should be addressed first?

Answer: Tension pneumothorax — bilateral thoracostomy should be performed immediately

Bilateral thoracostomy for presumed bilateral tension pneumothorax is the first priority in traumatic cardiac arrest as it is rapidly reversible in the field; tamponade may require resuscitative thoracotomy depending on the setting.

Open chest wounds ('sucking chest wounds') are treated with:

Answer: 3-sided occlusive dressing (or vented chest seal) to allow air out but not in

A 3-sided (or vented) dressing allows air to exit the pleural space during expiration while preventing air entrainment during inspiration, treating the open pneumothorax without converting it to a tension pneumothorax.

The 'Zone of injury' concept in blast trauma describes:

Answer: Three zones: the blast wave (primary), projectile fragmentation (secondary), and thrown victim (tertiary)

Blast injuries are classified by mechanism: primary (blast overpressure wave — hollow organ injuries), secondary (fragmentation — penetrating injuries), tertiary (victim displacement — blunt trauma), and quaternary (burns, toxic inhalation).

Traction splints are specifically indicated for:

Answer: Isolated mid-shaft femur fractures

Traction splints are indicated for isolated mid-shaft femur fractures to reduce pain, blood loss (the thigh can hold 1-2L of blood), and the risk of fat embolism by realigning the fracture under longitudinal traction.