Trauma Management Flashcards

Spinal shock is defined as:

Answer: Transient depression of all spinal cord function below the level of injury, with flaccid paralysis and loss of reflexes

Spinal shock is a temporary physiological phenomenon (hours to weeks) of complete suppression of cord function below the injury level, presenting as flaccid paralysis and areflexia — distinct from the haemodynamic neurogenic shock.

Neurogenic shock following spinal cord injury is characterised by:

Answer: Hypotension WITH bradycardia (warm, dry, vasodilated skin — loss of sympathetic tone)

Neurogenic shock results from loss of sympathetic tone below the injury level — vasodilation causes hypotension but the intact vagal tone produces bradycardia (or prevents compensatory tachycardia) and warm vasodilated skin.

Pre-hospital management of an open femur fracture includes:

Answer: Haemorrhage control, moist sterile dressing over wound, traction splint if applicable, analgesia, and IV access

Open fractures require covering with moist sterile dressings to reduce contamination risk, haemorrhage control, analgesia, IV access, and transport — traction may apply but the wound should not be manipulated.

In a multiple casualty incident, a patient who is breathing only when the airway is manually repositioned is categorised as:

Answer: Immediate (Red) — requires airway intervention and rapid treatment

A patient who breathes only with airway repositioning requires active airway intervention; in START triage, this patient is tagged Immediate (Red) indicating a salvageable life-threatening condition requiring prompt treatment.

Crush syndrome occurs when compressed muscle releases:

Answer: Myoglobin, potassium, and other breakdown products into circulation, causing renal failure and cardiac arrhythmia

Prolonged muscle compression causes rhabdomyolysis; upon release, myoglobin precipitates in renal tubules causing acute kidney injury, while hyperkalaemia from cell breakdown causes life-threatening cardiac arrhythmias.

The ideal pre-hospital endotracheal tube (ETT) depth for an average adult male measured at the incisors is:

Answer: 21-23cm for males, 19-21cm for females

Average adult ETT depth at the teeth/incisors is approximately 21-23cm for males and 19-21cm for females; this places the tube tip 2-4cm above the carina, confirmed with bilateral auscultation and waveform capnography.