Final Surgical Procedures

PP and Notes

What are the primary objectives of emergency care?

To preserve life, prevent further deterioration, and restore the patient to their previous lifestyle.

What is the first priority in any emergency situation?

To check for and provide a patent airway.

What should be maintained or restored after ensuring a patent airway?

Cardiovascular status.

List three treatments provided after ensuring airway and cardiovascular status.

Shock, fractures, and chest injuries.

What should be monitored in emergency care?

Vital signs.

What is the role of reassurance in emergency care?

To provide comfort for the conscious patient.

What is CPR?

Cardiopulmonary resuscitation, a lifesaving technique used in emergencies.

What should every healthcare provider (HCP) be familiar with?

The techniques of cardiopulmonary resuscitation (CPR).

What is the recommended response to sudden cardiac arrest?

Early CPR and defibrillation.

How quickly must CPR be initiated after clinical death?

Within 4 to 6 minutes.

What should an HCP check for in an unresponsive person?

A pulse for no longer than 10 seconds.

What maneuver should be used to open the airway if no spinal injury is suspected?

The head tilt-chin maneuver.

What is the recommended depth for chest compressions during CPR?

At least 2 inches (5 cm).

What is the ideal rate for chest compressions?

100 to 120 compressions per minute.

What should be done before defibrillation pads are placed?

Remove clothing and jewelry touching the chest.

What is the first priority for a pregnant woman in cardiac arrest?

Immediate CPR and relief of aortocaval compression through left lateral uterine displacement.

What is DIC?

Disseminated intravascular coagulation, a pathological process where blood coagulates throughout the body.

What are common causes of DIC?

Severe liver disease, leukemia, obstetric complications, and severe tissue trauma.

What is the first-line treatment for a severe anaphylactic reaction?

Epinephrine.

What should be done during an anaphylactic reaction?

Maintain the airway and provide supplemental oxygen.

What does a Green Tag indicate in an all-hazards event?

Minor injuries; the patient is physiologically stable and can self-care.

What does a Red Tag indicate in an all-hazards event?

Immediate treatment is needed to stabilize the patient.

What does a Black Tag indicate in an all-hazards event?

The patient is not expected to survive, and resources should be preserved for others.

What is the significance of the 'golden hour' in emergency care?

Treatment must be given within 1 hour for the victim to survive.

What is the recommended action for a patient with suspected spinal injury?

Use the jaw thrust maneuver to open the airway.

What is the role of the CST during a cardiac arrest in the surgical setting?

To protect the sterile field and assist with resuscitation efforts.

What is malignant hyperthermia?

A rapid increase in body temperature and other symptoms during anesthesia.

What should be done if a patient exhibits symptoms of DIC?

Determine the underlying cause and provide appropriate treatment.

What is the purpose of providing reassurance in emergency situations?

To comfort the conscious patient and reduce anxiety.

What is the leading cause of death among individuals aged 1 to 45?

Trauma

What is the role of a Surgical Technologist in trauma surgery?

To apply familiar skills with a focus on task prioritization and accuracy.

What are common errors that increase patient risk during surgery?

Passing instruments incorrectly, using inappropriate retractors, misidentifying medications, and poor communication.

How are trauma centers designated?

By a numerical system from Levels I to V, with Level I having the greatest capacity.

What must Level I trauma centers have?

State-of-the-art equipment and real-time communication with trauma specialists.

What is the purpose of the ATLS course?

To achieve physician certification in trauma care, focusing on treatment guidelines and protocols.

What types of unintentional trauma are commonly studied?

Automobile accidents, falls, bicycle accidents, and industrial accidents.

What is a blunt injury?

An injury where the skin is unbroken, typically from motor vehicle accidents or falls.

What is a penetrating injury?

An injury caused by an object that creates an open wound, such as gunshot or knife attacks.

What is the Lethal Triangle in trauma assessment?

Hypothermia, metabolic acidosis, and coagulopathy.

What is hemorrhagic shock?

Vascular failure caused by prolonged, severe blood loss, the most common cause of mortality in trauma.

What physiological condition is characterized by subnormal core body temperature?

Hypothermia.

What is coagulopathy?

A disorder of the normal blood-clotting system that can be lethal.

What triggers disseminated intravascular coagulation (DIC)?

Fluid shifts and continued hypothermia during shock.

What is metabolic acidosis?

An abnormally low blood pH caused by lack of oxygen supply during shock.

What is compartment syndrome?

Tissue swelling within a closed area, requiring emergency surgery if acute.

What are the objectives of ATLS trauma management?

Treat the most lethal clinical problem first, initiate treatment without a definitive diagnosis, and start treatment without detailed history.

What is The Golden Hour in trauma care?

The first critical hour following injury where timely intervention is crucial.

What percentage of victims with aorta, heart, spinal cord, or brainstem injuries die within minutes?

About 50%.

What is the primary cause of death in traumatic injury?

Hemorrhage.

What is included in the primary survey of field care?

Airway control, breathing, circulation, disability assessment, exposure of injuries, and resuscitation.

What is the purpose of the secondary survey in hospital care?

To perform a head-to-toe examination for less obvious injuries once the patient is stable.

What is the second leading cause of mortality in the United States?

Death from firearms.

What is important when handling firearms as forensic evidence in surgery?

Use techniques that maintain specimens correctly and protect instruments from ballistic items.

How should ballistic fragments be stored for evidence?

In separate containers labeled according to their exact location.

What should be done with projectiles before submitting them to pathology?

Send them in a dry container without washing.

What should not be done before submitting an item to pathology?

Do not wash the item.

What must be preserved as specimens from a wound?

Fragments of cloth or other debris.

What is the primary goal of damage control surgery?

To focus solely on lifesaving maneuvers.

What are the key components of damage control surgery?

Control of hemorrhage, control of fecal spillage, packing a body cavity, delayed closure of the wound, relief of compartment syndrome, and splinting.

What is the typical timeframe for returning a stabilized patient to surgery?

12 to 48 hours.

What types of injuries are most commonly associated with damage control surgery?

Thoracic, abdominal, retroperitoneal, cranial, and orthopedic injuries.

What is the priority during preoperative care of the patient?

Maintaining the patient's airway.

Why is maintaining stability of the spine important during surgery?

Sudden movement can cause blood clots to shift and tear through blood vessels and nerves.

What should be done if there is little time before surgery begins?

The CST may be gowning and gloving simultaneously with the surgeon.

What does the American College of Surgeons state about standardized counting procedures in emergencies?

They may be suspended in life-threatening situations.

What is critical for managing the sterile field during surgery?

Controlling hemorrhage and minimizing contamination.

What is the leading cause of trauma morbidity and mortality?

Abdominal injury.

What is abdominal compartment syndrome (ACS)?

Severe edema of any closed compartment of the body, including the abdomen.

What is the treatment for abdominal compartment syndrome?

Immediate surgical opening of the abdominal cavity.

What is the most common method of damage control orthopedic surgery?

External fixation.

What is a common cause of blunt thoracic injury?

Motor vehicle accidents.

What are life-threatening injuries associated with thoracic injury?

Mechanical impingement on respiratory and cardiac function, pulmonary injuries, and soft tissue injuries.

What is indicated for immediate surgery in thoracic injuries?

Tension pneumothorax, open pneumothorax, flail chest, massive hemothorax, and pericardial tamponade.

What are the priorities for case planning in thoracic injury?

Management of hemorrhage and cardiac function, and restoring respiratory function.

What is the objective of urgent damage control surgery of the skeletal system?

To prevent further injury, decrease risk of sepsis, prevent or treat compartment syndrome, and decrease blood loss.

What must be done with laparotomy sponges during emergency trauma surgery?

At least 40 lap sponges should be available as soon as the procedure begins.

What is the role of suction in thoracic injury management?

To ensure good exposure and clear blood and clots from the wound.

What should be done with the viscera in damage control surgery?

Enclose them in a plastic pouch or bag secured to the skin.

What is the purpose of using a closed vacuum suction (wound VAC)?

To manage the open abdomen in damage control surgery.

What is a common complication of pelvic fractures?

High mortality due to instability of the pelvic ring and multiple venous injuries.

What is the significance of tracking sponges during emergency trauma surgery?

It can be problematic due to the urgency of the procedure.

What is the role of debridement and irrigation in trauma surgery?

To prevent sepsis.

What is the common cause of penetrating wounds?

Knife or gunshot injuries.

What must remain intact for normal respiration?

The chest wall

What is a common method for sealing an open chest wound?

Application of petrolatum gauze over the wound

What is a critical condition involving three or more adjacent ribs?

Flail chest

What is the most lethal complication of a penetrating cardiac wound?

Exsanguinating hemorrhage into the pleural cavity resulting in cardiac tamponade

What is the most common cause of blunt cardiac rupture?

Motor vehicle accidents (MVA)

What is the mortality rate for complete rupture of the aorta?

60% - 90% die at the scene or shortly after arrival

What type of trauma is most often associated with femoral artery and vein injuries?

Hip fractures

What are the two major categories of vascular injury?

Penetrating and blunt trauma

What is the leading cause of death in 15-34 year-olds related to trauma?

Gunshot wounds

What surgical treatment is used for major peripheral vascular trauma?

Hemorrhage control by clamping or direct pressure followed by direct repair or temporary graft

What is the objective in treating traumatic brain injury?

To avert secondary injuries related to increased cranial pressure

What are the two effects of blunt trauma to the brain?

Shearing injury of neural tissue and blood vessels, and physical impact of the brain against the cranium

What is a common emergency neurosurgical procedure for subdural hematoma?

Drilling a burr hole in the cranium

What type of hematoma arises between the dura and the brain?

Subdural hematoma

What classification of spinal cord injury results in complete loss of function?

Complete lesions

What is a potential consequence of primary spinal cord injury during transport?

Worsening of the injury if the spinal column is unsupported

What are the three classifications of neck trauma?

Blunt trauma, penetrating injury, and strangulating injury