Trauma Management Flashcards

A tension pneumothorax causes tracheal deviation toward which side?

Answer: Away from the affected side (tension side)

As air accumulates under tension, the affected side's pressure pushes mediastinal structures — including the trachea — toward the contralateral (unaffected) side; this is a late and unreliable sign.

Massive haemothorax is defined as initial drainage of more than:

Answer: 1500ml of blood from the chest on tube thoracostomy

Massive haemothorax is defined by drainage of ≥1500ml immediately on chest tube insertion, or ongoing haemorrhage >200ml/hour — indicating injury to major vessels requiring surgical intervention.

In a penetrating abdominal trauma with evisceration, pre-hospital management includes:

Answer: Covering eviscerated organs with moist dressing without attempting to replace them, and rapid transport

Eviscerated organs should be covered with a moist sterile dressing to prevent desiccation, not pushed back (risk of contamination and injury), and the patient transported urgently to surgery.

Spinal cord injury management in the pre-hospital setting focuses on:

Answer: Preventing secondary cord injury through maintaining perfusion, oxygenation, and avoiding hypotension

Secondary spinal cord injury from hypotension, hypoxia, and excessive movement can worsen outcomes; maintaining MAP ≥85-90 mmHg (in suspected spinal cord injury) and adequate oxygenation are the key pre-hospital interventions.

Pre-hospital wound packing with haemostatic dressings (e.g., Combat Gauze) is indicated for:

Answer: Junctional haemorrhage (groin, axilla, neck) where tourniquets cannot be applied

Junctional areas (groin, axillary, and neck) cannot be controlled with conventional tourniquets; haemostatic gauze packed firmly into the wound with direct manual pressure for 3-5 minutes controls these life-threatening bleeds.

The abdominal trauma assessment tool used in hospitals (FAST exam) evaluates:

Answer: Focused Assessment with Sonography in Trauma — looking for free fluid in pericardium, Morrison's pouch, splenorenal space, and pelvis

FAST uses bedside ultrasound to detect haemoperitoneum and haemopericardium, identifying free fluid (blood) in four standard views — pericardial, hepatorenal, splenorenal, and pelvic — guiding urgent surgical intervention.