Trauma Management Flashcards

The 'MARCH' algorithm used in tactical/military pre-hospital care stands for:

Answer: Massive haemorrhage, Airway, Respirations, Circulation, Hypothermia/Hyperthermia prevention

MARCH prioritises Massive haemorrhage control (tourniquet, haemostatic dressings), Airway management, Respiratory interventions (tension pneumothorax, sucking wounds), Circulation (IV fluids, shock management), and Hypothermia prevention.

In blunt abdominal trauma, which organ is most commonly injured?

Answer: Spleen

The spleen is the most commonly injured abdominal organ in blunt trauma due to its fixed, fragile, and highly vascular structure; splenic injury can cause significant haemorrhage ranging from minor lacerations to complete rupture.

The 'Damage Control Resuscitation' (DCR) approach replaces traditional ATLS resuscitation by:

Answer: Permissive hypotension, early blood products, and haemostatic resuscitation instead of large crystalloid volumes

DCR uses permissive hypotension to avoid worsening coagulopathy, early blood product administration in balanced ratios to replace haemorrhage losses, and haemostatic resuscitation — avoiding the crystalloid dilution that worsens the lethal triad.

When assessing a patient with suspected pelvis fracture, which physical examination manoeuvre should be avoided?

Answer: Repeated manual pelvic compression tests (springing the pelvis)

Repeated manual pelvic compression (springing) can disrupt forming blood clots and worsen haemorrhage; one assessment is performed if clinically indicated, then a pelvic binder is applied without further manipulation.

The 'Walking Blood Bank' concept in mass casualty incidents refers to:

Answer: Using pre-screened volunteer donors with known compatible blood types to provide fresh whole blood

In mass casualty or military settings where stored blood products are unavailable, walking blood banks use pre-screened volunteers with known ABO/Rh type as on-demand whole blood donors, providing the most physiologically complete haemorrhage replacement.

Pre-hospital hypothermia prevention in trauma patients includes all of the following EXCEPT:

Answer: Active cooling with ice packs to prevent fever

Hypothermia prevention involves removing wet clothing, warming IV fluids, covering with insulating blankets, and warming the ambulance environment; ice packs would cause or worsen hypothermia and are contraindicated in trauma.