asdfasdf

One of the main tenants of trauma care

to maintain or restore perfusion

Perfusion

the supply of oxygen to and removal of of wastes from the body's cells and tissues as a result of the flow of blood through the capillaries.

Hypoperfusion

the body's inability to adequately circulate blood to the body's cells to supply them with oxygen and nutrients. Shock

PVC

Pump, Volume, Container

Arteries

Carry oxygenated blood away from the heart

Capillaries

Oxygen rich blood is emptied from the arteries into microscopically small _, which supply every cell in the body.

Veins

Capillaries empty into veins, which carry blood back to the heart. Contain one-way valves that prevent the blood from flowing the wrong direction.

Hemorrhage

Bleeding, especially severe bleeding

Arterial bleeding

Bleeding from an artery, which is characterized by bright red blood that is rapid, profuse, and difficult to control. Spurting, pulsating flow.

Venous bleeding

Bleeding from a vein, which is dark red or maroon. Steady, easy to control flow.

Junctional Hemorrhage

occurs where appendages of the body connect to the trunk. Neck, both armpits, and both sides of the groin are sites where massive bleeding is likely.

Capillary Bleeding

Characterized by slow, oozing flow of blood. Typically ceases without intervention. Sometimes occurs over large areas making infection a high risk.

Atrial Fibrillation

Irregular heartbeat

Exsanguination

is the process of blood loss, to a degree sufficient to cause death. One does not have to lose all of one's blood to cause death.

External Bleeding

1. Direct Pressure

2. Elevation of a limb

3. Hemostatic Agent

4. Tourniquet

Direct Pressure

Can be done with gloved hand, a dressing, or by pressure dressing and bandage.

Pressure Dressing

a bulky dressing held in position with a tightly wrapped bandage, which applies pressure to help control bleeding.

Hemostatic Agents

Substances applied as powders, dressings, gauze, or bandages to open wounds to stop bleeding.

Tourniquet

a device used for bleeding control that constricts all blood flow to and from extremity. Applied 2 inches above the bleeding wound.

ICP

Internal Cranial Pressure

CSF

Cerebral Spinal Fluid

Epistaxis

Nose bleed

Mechanisms of Blunt Trauma

Falls, motor-vehicle crashes, auto-pedestrian crashes, blast injuries.

Mechanisms of Penetrating Trauma

Gunshot wounds, stab wounds (knife, ice pick, screwdriver), impaled objects

Circulatory System

Heart, blood vessels, blood

Compensated Shock

When the patient is developing shock but the body is still able to maintain perfusion.

Decompensated Shock

when the body can no longer compensate for low blood volume or lack of perfusion. Late signs such as decreasing blood pressure become evident. (Shock)

Hypovolemic Shock

shock resulting from blood or fluid loss.

Hemorrhagic shock

Shock resulting from blood loss.

Cardiogenic shock

shock, or lack of perfusion, brought on not by blood loss but by the heart's inadequate pumping action. It is often the result of a heart attack (Myocardial Infarction) or congestive heart failure.

Neurogenic shock

hypoperfusion due to nerve paralysis (sometimes caused by spinal cord injuries) resulting in the dilation of blood vessels that increase the volume of the circulatory system beyond the point where it can be filled.

Septic Shock

When an infection spreads throughout the body via the bloodstream, sepsis is present. Toxins produced by this condition can lead to dilation of the blood vessels and loss of integrity ("leakiness") of the blood vessels.

Signs of Sepsis

Temp high OR low, tachycardia, tachypnea, hypotension

Platinum 10 minutes

goal for on-scene time when caring for a trauma or shock patient.

Acidosis

a condition that occurs when cells receive insufficient oxygen and generate acidic waste products that accumulate in the blood.

coagulopathy

impaired ability to clot

Functions of Skin

Protection, water balance, temperature regulation, excretion, shock (impact) absorption

Epidermis

the outer layer of skin

Dermis

the inner (second) layer of the skin found beneath the epidermis. It is rich in blood vessels and nerves.

Subcutaneous Layers

The layers of fat and soft tissues found below the dermis

Closed Wound

an internal injury with no open pathway from the outside

Contusion

a bruise

Hematomas

a swelling caused by the collection of blood under the skin or in damaged tissues as a result of an injured or broken blood vessel

Crush Injury

an injury caused when force is transmitted from the body's exterior to its internal structures. Bones can be broken; muscles, nerves, and tissues damaged; and internal organs ruptured, causing internal bleeding.

Open Wound

an injury in which the skin is interrupted, exposing the tissue beneath,

Abrasion

a scratch or scrape

Lacerations

a cut

Puncture Wound

an open wound that tears through the skin and destroys underlying tissues. A penetrating puncture wound can be shallow or deep. A perforating puncture wound has both an entrance and an exit

Avulsion

the tearing away or tearing off of a piece of flap of skin or other soft tissue. This term also may be used for an eye pulled from its socket or a tooth dislodged from its socket.

Amputation

the surgical removal or traumatic severing of a body part, usually an extremity.

Blast Injury

a) pressure wave/primary injury; b) blast wave/secondary injury; c) patient displacement/tertiary injury; d) patient exposed to hazardous material or structural collapse/quaternary injury

Stab Wounds

ALL should be considered serious

Sympathetic (eyes)

both eyes move together

Burn Assessments

By agent and source, by depth, by severity (body surface area, rule of 9s)

Superficial Burn

Involves only the epidermis, the outer layer of the skin. It is characterized by reddening of the skin and perhaps some swelling. A common example is a sunburn. Also called a first degree burn.

Partial Thickness Burn

a burn in which the epidermis (first layer) is burned through an the dermis (second layer) is damaged. Burns of this type cause reddening, blistering, and a mottled appearance. Also called a second degree burn.

Mottled

spotted

Full Thickness Burn

a burn in which all the layers of the skin are damaged. There are usually areas that are charred black or areas that are dry and white. Also called a third degree burn.

Rule of Palm

a method of estimating the extent of a burn. The palm and fingers of a patient's own hand, which equals about 1 percent of the body's surface area, is compared withe the patient's burn to estimate it's size.

Rule of Nines

a method for estimating the extent of a burn. For an adult, each of the following areas represents 9 percent of the body surface: the head and neck, each upper extremity, the chest, the abdomen, the upper back, the lower back and buttocks, the front of each lower extremity, the back of each lower extremity. The remaining 1 percent is assigned to the genital region. For an infant or child, the percentages are modified so 18 percent is assigned to the head, 15 percent to each lower extremity.

circumferential

pertaining to a circumference; encircling; peripheral.

Dressing

any material (preferably sterile) used to cover a wound that will help control bleeding and prevent additional contamination

Bandage

any material used to hold a dressing in place

Universal Dressing

a bulky dressing (profuse bleeding, large wounds, stabilizing impaled objects)

Pressure Dressing

a dressing applied tightly to control bleeding

Occlusive Dressing

any dressing that forms an airtight seal

Flail Chest

fracture of two or more adjacent ribs in two or more places that allows for free movement of the fractured segment

paradoxical motion

movement of ribs in a flail segment that is opposite to the direction of movement of the rest of the chest cavity.

Sucking chest wound

an open wound in which air is "sucked" into the chest cavity.

Burping the wound

cleaning out an open chest wound and occlusive dressing, relieving tension pneumothorax

pneumothorax

air in the chest cavity

tension pneumothorax

a type of pneumothorax in which air that enters the chest cavity is prevented from escaping.

Hemothorax

blood fills chest cavity (usually present with signs of shock)

hemopneumothorax

blood and air fill chest caivty

Traumatic Asphyxia

Sudden compression of the lungs - blood being forced into the head and neck.

Cardiac Tamponade

Injury to heart causes blood to flow into the surrounding pericardial sac.

pericardial

pertaining to the area around the heart.

Becks Triad

Increase in Jugular Vein Distention, Muffled heart sounds, equalizing of systolic and diastolic blood pressure. Signs of cardiac tamponade

Commotio Cordis

disturbance of the heart - when someone gets hit in the chest resulting in ventricular fibrillation. Do NOT treat as trauma, begin CPR and defibrillation.

Evisceration

an intestine or other internal organ protruding through a wound in the abdomen. Insides come out.

Peritonitis

is an inflammation of the membrane which lines the inside of the abdomen and all of the internal organs. This membrane is called the peritoneum.

Aortic Injury and dissection

damage to the aorta causes massive, often fatal bleeding.

Extremities

the portions of the skeleton that include the clavicles, scapulae, arms, wrists, and hands (upper extremities) and the pelvis, thighs, legs, ankles, and feet (lower extremities)

Bones

hard but flexible living structures that provide support for the body and protection to vital organs. Long, short, or flat

Joints

places where bones articulate, or meet

Periosteum

what cover bones. Strong, white, fibrous material. Blood vessels and nerves pass through this membrane as they enter and leave the bone.

Muscles

tissues or fibers that cause movement of body parts and organs

cartilage

tough tissues that covers the joint ends of bones and helps to form certain body parts such as the ear

tendons

tissues that connect muscle to bone. muscle-tendon-bone MTB

ligaments

tissues that connect bone to bone. bone-ligament-bone BLB

MTB

Muscle-tendon-bone

BLB

bone-ligament-bone

Direct force

ie. a person being struck by an auto

Twisting or rotation force

can cause tearing or stretching of muscles and ligaments, as well as broken bones

Indirect force

ie. when people fall from heights and land on their feet.

traction splint

a splint that applies constant pull along the length of a lower extremity to help stabilize the fractured bone and to reduce muscle spasm in the limb. Traction splints are used primarily on femoral shaft fractures. Amount of traction applied should be roughly 10 of pt's body weight, not to exceed 15 lbs.