Exam (elaborations)
TCRN PRACTICE QUESTIONS WITH CORRECT ANSWERS
- Course
- Institution
TCRN PRACTICE QUESTIONS WITH CORRECT ANSWERS
[Show more]
Content preview
TCRN QUESTIONS AND ANSWERSMost sscommon ssmechanism ssof ssinjury ss- ssans✔✔Falls
Forms ssof ssenergy ss- ssans✔✔-mechanical
-gravitational
-thermal
-chemical
Types ssof sstrauma ss- ssans✔✔-blunt
-penetrating
-burn
-other
Blunt sstrauma ss- ssans✔✔accounts ssmost ssinjuries sssustained
frontal ssimpact
ss-aortic ss& sscardiac ssinjury, ssrib ssfxs, ssliver ss& ssspleen
ss-dash ssboard ssposterior sship ssfx/dislocation, ssfemur, ssknee ssinjury
lateral ssimpact
ss-head/facial, ssc ssspine, ssclavicle, sspelvic, ssliver/spleen
rear ssend
ss-low ssvelocity, ssneck sshyperextension/hyperflexn ss
rollover
ss-DAI ss
ejection
ss-risk ssof ssdeath ss4x ssgreater
pedestrian ssvs sscar ss
ss-tib/fib ssfx, sstruncal, sshead ssinjury
bicycle
ss-head ssand ssabdominal ssinjury ssfrom sshandlebar
falls
ss-4 ssstories ss50% sswill ssdie
ss-calcaneous, sspelvis, ssspine, ssarm ssfx
Penetrating ssTrauma ss- ssans✔✔lower ssincidence sshigher ssmortality
GSW
Stab: sslow ssvelocity sshigher ssdirect ssdamage ssto ssorgans
Burn: ssthermal ssor ssinhalation
Other: ssHanging, ssstrangulation ss, sssuffocation, ssdrowning
Waddell's ssTriad ss- ssans✔✔-femoral ssshaft ssfx ss
-intrathoracic ssand ssabdominal ssinjury
-contralateral sshead ssinjury
,Newton's ssthree sslaws ssof ssmotion ss- ssans✔✔1. ssobject ssat ssrest sswill ssstay ssat ssrest,
ssobject ssin ssmotion sswill ssstay ssin ssmotion
2. ssForce: ssF=ma ssapplying ssforce ssproduces ssacceleration ss(think ssseatbelt sssign) ss
3. ssAction ss& ssRxn: ssEvery ssaction ssthere ssis ssan ssequal ssand ssopposite ssreaction
ABCDE ss"do ssyour ssjob" ssPrimary ssSurvey ss- ssans✔✔Airway ssobstruction ssis ssmajor
sscause ssof sspreventable sstrauma ssdeaths ss
Hemorrhage ssis ssthe ssmost sscommon sscause ssof ssmortality ssin sstrauma ss
Airway-get ssdefinitive ssairway
Circulation-IV ssaccess ssand ssIVF ss
Disability-assess ssLOC ssGCS ssscale ss
Exposure-get ssyour sspt ssnaked! sstemperature sscontrol
ss-hypothermia=acidosis, sscoagulopathy, sslow ssO2
Hemorrhage ssControl-STOP ssTHE ssBLEED ssreplace ssvolume ssloss, ssuse sstourniquet-
note sstourniquet sstime
ss-<6yo ssIO ssaccess sspreferred ssover sscentral ssline
MTP
ss-1:1:1 sspRBC:plasma:platelet
ss-pt ssreceiving ss>10 ssunits sspRBC ssw/in ss24 sshrs ssadmit
When ssis ssa ssdefinitive ssairway ssneeded? ss- ssans✔✔Edema, sshemorrhage, ssfracture ssto
ssobstruct ssairway ssand ssan ssET/NT sscannot ssbe ssplaced ss
-closed sshead ssinjury ssw/ ssGCS ss<8
-unresponsive ss
-neuromuscular ssparalysis ss
-apnea
-sustained ssseizure ssactivity
-inability ssto ssprotect sslower ssairway ssfrom ssblood/secretion
Breathing ssAssessment ss- ssans✔✔-rate
-depth
-effort
-symmetry
-watch ssfor sstension sspneumothorax!!
Open sspneumothorax ssdressing ss- ssans✔✔3 sssided ssdressing
Confirm ssairway ssplacement ss- ssans✔✔-cords ssvisualized
-chest ssrise ssand ssfall
-auscultate
-CO2 ssdetector
-pulse ssox
-CXR
Adult ssIVF ssbolus ss- ssans✔✔1-2 ssliters ssif ssno sscontraindication
,Pediatric ssIVF ssbolus ss- ssans✔✔20ml/kg
Secondary ssSurvey ss- ssans✔✔a sshead-to-toe ssphysical ssassessment; ssan ssadditional
ssassessment ssof ssa sspatient ssto ssdetermine ssthe ssexistence ssof ssany ssinjuries ssother ssthan
ssthose ssfound ssin ssthe ssprimary sssurvey, sshistory ssor ssscene ssdetail
Cardiac ssOutput ss(L/min) ss- ssans✔✔HR ss(beats/min) ssx ssSV ss(cc/beat)
Shock ssDefinition ss- ssans✔✔State ssin sswhich ssperfusion ssis sscompromised ss@ sscellular
sslevel ssd/t: ss
-insufficient ssoxygen ssdelivery
-increased ssoxygen ssconsumption
-ineffective ssoxygen ssutilization
Hypovolemic ssShock ss- ssans✔✔most sscommon sstype ssshock: sssignificant ssloss
sscirculating ssvolume ssmost sscommon sssource ssacute ssblood ssloss ss(hemorrhage) ss
-AMS ssfirst sssign ssof ssshock
-Tachycardia ss>120 ssvery ssconcerning-one ssof ss1st sssigns
-Cool ssclammy ssskin ssd/t ssvasoconstriction
-prolonged ssCRT ss
-Narrowed sspulse sspressure ss(40-50mm)
-Hypotension
-Decreased ssUO
ss-adult ss0.5mL/kg/hr
ss-child ss1mL/kghr
ss-toddler ss1.5 ssmL/kg/hr
ss-Infant ss2mL/kg/hr
Hemorrhagic ssShock ssGoals ss- ssans✔✔Goal: ssSTOP ssTHE ssBLEED ss& ssdefinitive
sscontrol ssof sshemorrhage ssand ssrestoration ssof ssadequate sscirculating ssvolume
Hemorrhagic ssShock ss- ssans✔✔Look ss@ sschest, ssabdomen, sspelvis
Class ssI ssHemorrhage ss- ssans✔✔up ssto ss15% ssblood ssloss, ssminimal sstachycardia, ssno
ssmeasurable sschanges ssin ssBP, ssHR, ssRR ss
ex. sssomeone sswho ssdonated ssblood
Class ssII ssHemorrhage ss- ssans✔✔15-30%, ssuncomplicated sshemorrhage, ss1-2 ssL ssof
sscrystalloid ss
increased ssHR, ssnarrowed sspulse sspressure
Class ssIII ssHemorrhage ss- ssans✔✔30-40%, sscomplicated ssstate sswhere ssblood
ssreplacement ssessential, ssno sslonger ssable ssto sscompensate ssfor ssvolume ssloss,
sshypotension ssoccurs, ssHR ss>120 ssBPM, ssRR ss30-40, sssevere ssanxiety ssor ssconfusion
, Class ssIV ssHemorrhage ss- ssans✔✔Blood ssloss: ss>40%
Pre-terminal ssevent ss
Aggressive ssmeasures ssnecessary ssactivate ssMTP
BP: ssprofound ssdecrease
HR: ss>140
RR: ss>35
Urine ssoutput: ss<5cc/h
CNS ssstatus: ssobtunded
Capillary ssrefill: sssignificant ssdelay/cold
ABG ssvalues ss- ssans✔✔pH ss7.35-7.45
pCO2 ss39-55
PO2 ss30-55
Base ssexcess ss-3 ssto ss3 ss
Bicarb ss20-28
INR ss- ssans✔✔>1.5=coagulopathy
Male ssTrauma ssPatient ssBlood ssProduct ss- ssans✔✔O ssPositive
Female ssTrauma ssPatient ssBlood ssProduct ss- ssans✔✔O ssNegative
TEG ss- ssans✔✔TEG ssmonitors sswhole ssdynamic ssprocess ssof sshemostasis ssfrom ssclot
ssformation ssto ssclot ssdissolution
pH ss<7.20 sstreatment ss- ssans✔✔Indicates ssmyocardial ssdepression
Fix ssthe ssunderlying ssinjury
The ssLethal ssTriad/Bloody ssViscous ssCycle/Trauma ssTriad ssof ssDeath ss-
ssans✔✔hypothermia, ssacidosis, sscoagulopathy
hypoxia=hypothermia=hypoperfusion=coagulopathy ss(stops ssblood ssclotting)=anaerobic
ssenergy=increased sslactate=acidosis
Permissive ssHypotension ss- ssans✔✔Non ssTBI sspatients: ss80-90 ss
TBI sspatients: ss>90
Evaluating ssOrgan ssPerfusion ssin ssShock ss- ssans✔✔Vigilant ssmonitoring ssof ssurine
ssoutput ssand sscore sstemperature
Obstructive ssShock ss- ssans✔✔Heart ssis ssimpeded ssas ssa ssresult ssof ssobstructed ssvenous
ssfilling ssor ssdirect sscompression ssof ssthe ssheart ss
Ex. sspericardial sstamponade ss(most ssw/ sspenetrating ssinjury), sstension sspneumothorax ss
*Life ssthreatening* ssand ssshould ssbe ssseen sson ssprimary sssurvey ss*
Tension ssPneumothorax ss- ssans✔✔ABSENT ssbreath sssounds
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller AGRADEPROMASTER. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
77858 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now