Trauma Management Flashcards

The ABCDE approach in trauma places haemorrhage control at which priority level?

Answer: C (Circulation) — simultaneous with or immediately after Airway and Breathing

In trauma, catastrophic external haemorrhage control (using the ABCDE mnemonic, or 'C' in ABCDE) is treated as a simultaneous priority with airway, as uncontrolled haemorrhage is the leading preventable cause of trauma death.

The 'Lethal Triad' in trauma refers to:

Answer: Hypothermia, acidosis, and coagulopathy — three mutually reinforcing killers in haemorrhagic shock

The lethal triad: hypothermia (impairs clotting and cardiac function), acidosis (from tissue hypoperfusion), and coagulopathy (failure of clotting mechanisms) — each worsens the others in a deadly cycle.

Tourniquet application for extremity haemorrhage should be placed:

Answer: 5-8cm proximal to the wound on the mid-shaft of the affected limb

Tourniquets are applied 5-8cm proximal to the wound, mid-shaft (not over a joint), tightened until bleeding stops, time documented, and left in place until surgical haemostasis in hospital.

In the trauma patient, haemothorax is suspected when:

Answer: Absent breath sounds, dull percussion, and signs of hypovolaemic shock after chest trauma

Haemothorax presents with decreased/absent breath sounds and dullness to percussion (blood in pleural space) combined with signs of haemodynamic compromise; tracheal deviation occurs in tension pneumothorax, not simple haemothorax.

Damage Control Surgery (DCS) focuses on:

Answer: Rapid control of haemorrhage and contamination, temporary closure, and ICU resuscitation before definitive repair

DCS limits initial surgery to abbreviated haemorrhage and contamination control, then resuscitates the patient in ICU to correct the lethal triad before returning for definitive repair when physiologically optimised.

The preferred initial fluid for haemorrhagic shock in modern damage control resuscitation is:

Answer: Blood products in a 1:1:1 ratio (packed red cells : plasma : platelets) where available

Modern damage control resuscitation prioritises blood products in balanced ratios to replace haemorrhage losses while preserving coagulation, avoiding the dilutional coagulopathy caused by large volumes of crystalloid.