[PART 2] SHOCK- CSI/ STI/MFT

cervical spine injury

are injuries to the cervical spine due csto crushing, stretching, and rotational shear forces exerted on the cord at the time of trauma that canproduce severeneurologic deficits.

Edema and cord swelling

this contribute further to the loss of aspinal cord function

True

T or F in assessing for cervical and spine injury, weakness or paralysis of the diaphragm may occur with lesion at or above C4

priaprism

persistent erection of penis

Hoffman’s sign

this is define in the action of flicking of the middle finger induces flexion of the ipsilateral thumb or index finger

done nasally

if the pt is experiencing CSI, he may b e intubated and should be done what way of ventilation

Methylprednisolone (30 mg/kg IV loading dose over 15 mins— 5.4 mg/kg/hr initiated 45 mins later and continue infusion for 23 hours—> reassess if there is improvement)

In CSI oatients what are the medications:

HIgh dose steroids

This med is given to decrease the inflammation and restore the functioning of the nerves

hypertension, hypothermia, and bradycardia

what are the indicative of spinal shock

MAXILLOFACIAL TRAUMA

Injuries to the head frequently result in facial lacerations and fractures to the facial bones (nasal, orbital, maxillary and mandibular fracture

Paralysis of the upward gaze (Inferioir rectuis muscle, inferior oblique muscle and infraorbital nerve affected)

Assessment (Maxillo): it is indicative of inferior orbit fracture (blowout fracture)

Crepitus (grating, crackling, or popping sensation) on palpation around the nose

assessment (maxillo): indicative of nasal fracture

malocclussion of teeth

ass of (maxillo): indicative of maxilla or mandible fracture

Palpable flattening of the cheek and loss of sensation below the orbit

ass (maxillo): - indicative of zygomatic (cheekbone) fracture

Trismus and mobility of the jaw

assess (maxillo): -indicative of maxillary fracture

Rhinorrhea and otorrhea

assess (Maxillo): indicative of CSF leak

opthalmologist

If maxillofacial trauma, if there is obvious optha, eye injury, we refer them to?

apply loose and bulky dressing

in controlling bleeding how will you do it as a nurse?

FALSE. no ice to eyes

Apply ice to eyes if injury is present, TRUE OR FALSE (maxillo)

Pain relievers and sedative

Drugs for maxillofacial trauma

meningitis and encephalititis

what are the possible complications when the brain become infected by the bacteria thru csf leaks by coughing, sneezing

CLOSED WOUND

an injury to the soft tissue without a break in the skin

CONTUSION

bleeding beneath the skin into the soft tissue (usually muscles)

Hematoma

well-defined pocket of blood and fluid beneath the skin

Blunt trauma

caused by a sudden force over the chest and abdomen, there is possible internal bleeding

Bruises, ecchymosis, hematoma

What you should assess to know if there is presence of blunt trauma?

closed wound

These patients have potential to develop shock, and may also present with other medical emergencies, what is the related trauma

open wound

an injury to the soft tissue with a break in the skin

abrasion (gas-gas)

superficial loss of skin resulting from rubbing or scraping the skin over a rough or uneven surface.

Laceration

tear in the skin; can be partial or full thickness cut. Can be defined as incisional (clean cut) or jagged

Puncture

occurs when the skin is penetrated by a pointed object. Can be penetrating or perforating. Don’t cause serious external bleeding but significant internal bleeding. (tusok

Avulsion

involves a tearing off or loss of a f lap of the skin. (wak-wak

Amputation

traumatic cutting or tearing off of a finger, toe, arm, or leg.

No

WHAT TO DO IN STI: if the dressing becomes saturated during direct pressure, will you remove the dressing?

above the level of the heart

Mgt in STI : if possible the injured area should be elevated how high?

Pressure points

These points are used when direct pressure and elevation cannot control bleeding alone or when direct pressure cannot be applied to a bleeding site due to protruding bone or an embedded object.

On the artery (proximal) to lessen flow to injury (distal)

In dealing with pressure points where will you put the pressure

1. temporal

2. Facial

3. carotid

4. subclavian

5. brachial

6. radial and ulnar

7. femoral

name the arteries: or the pressure points to stop hemorrhage

the site of injury and the heart

pressure points are located between

50 mL

As general rule in STI, irrigate wound with how many ml per inch of wound per hour of age of wound?

regional nerve block and wound margins

In managing wound preparation, through injection of anesthetic intradermally through what areas of wound?

True by Closure by primary Intent

T or F: Wound thst id repaired without delay after the injury; yields teh fastest healing may be by sutures, skin staples, or tissue adhesives

closure by secondary intent

Closure by what intent wherein the wound is allowed to granulate on its own without surgical closure

closure by secondary intent with delayed closure

closure by intent wherein the wound is cleaned and dressed, then the patient returns 3-4 days for definitive closure;

Hayaan muna mag-evaporate lahat ng debris, mag-nana or kung too much swelling. And then after 3-4 days, ire-reassess ang sugat, saka isasara

contact layer

wound dressing which is first layer, consist of a non absorbent hydrophilic dressing that will allow exudates to pass through to the second layer without wetting the contact layer4

non-absorbent hydrophilic dressing

dressing that will allow exudates to pass through to the second layer without wetting the contact laye

Absorbent layer

wound dressing which is the second layer, usually constructed of surgical dressing pads

outer wrap

wound dressing which is the : third layer, holds the dressing in place. consist of rolled gauze and tape.

surgical dressing pads

what consists the second layer or the absorbent layer of wound dressing which absorbs the pus

hydrophilic dressing

which dressing already has antibiotic with it

mefenamic acid

celecoxib

Tramadol (too much pain)

IV (paracetamol, diclofenac, tramadol)

Pain meds that is usually prescribed to patients: