TCAR Exam Questions With Correct
Answers
3 questions to ask in trauma - answer-what was the dose of energy?
-where did it go?
-what injuries are likely?
2 q's to ask in GSW - answercaliber
type of gun
# of entrance/exit wounds
high/low velocity
1st question to ask in any traumatic injury? ...
TCAR Exam Questions With Correct
Answers
3 questions to ask in trauma - answer✔✔-what was the dose of energy?
-where did it go?
-what injuries are likely?
2 q's to ask in GSW - answer✔✔caliber
type of gun
# of entrance/exit wounds
high/low velocity
1st question to ask in any traumatic injury? - answer✔✔what was the dose of energy involved?
(was it high or low?)
what is the caliber of a bullet? - answer✔✔diameter
aka diameter of a bullet - answer✔✔caliber
what happens to projectiles when they enter the body - answer✔✔projectiles don't travel in a
straight line
consider temporary cavity wound
what should you consider about tissue a projectile enounters - answer✔✔temporary cavitation
primary goal of GSW surgery - answer✔✔usually damage repair & not bullet removal
-if superficial, it may migrate the surface with time
important thing to remember about retained projectiles - answer✔✔they may migrate over time.
bullett migration might explain unexplained clinical findings
(VP Cheney accidentally shot his friend while hunting in 2006. ICU and did great. moved to an
inpatient unit. had a silent MI bc a shot gun pellets migrated into a canary artery causing an
infract. so had a MI but fibrinolytic not the answer in this case b/c it was a "projectile embolus"
what breaks thoracic bones - answer✔✔significant force
-1-2nd ribs, posterior ribs, sternum, scapulae, T2-10
gives us info about the force aka "dose" of energy received
consider injury to internal structures b/c force
ribs that are the most frequently broken - answer✔✔ribs 4-9 b/c long, thin, and poorly protecte
it is harder to break a short pencil (T1-2) and easier to break a longer one
*ask how many and where to understand the force involved
what is the significance of posterior rib fractures - answer✔✔unusual direction of injury
shorter stubby ribs
good muscle profection
**posterior rib fractures have a lot of force so need a high dose.
***PRF need a lot of force so high dose of energy. big red flag for t-spine injury
indication of c-spine injury - answer✔✔to injure c-spine, you don't need a big energy blow. all it
takes is shaking around.
c spine versus t spine fractures - answer✔✔c-spine doesn't need a big energy blow. just some
shaking around
t-spine needs a great strong direct blow (not just a shock_
treatment for rib fractures - answer✔✔largely supportive nursing care like pulmonary toilet
CXR and rib fractures - answer✔✔simple rib fractures are difficult to see on CXR and can be
commonly missed
(1/2 of all rib fractures aren't identified at the POI CXR)
identify a previous rib fracture on CXR - answer✔✔once healed, rib fractures form bony
callouses and become more visible on CXR
how to tell a pt has a pneumonia from a CXR - answer✔✔dark spot that is not equal to the
opposite side
consider if a pt has a lower rib fracture - answer✔✔liver & spleen injury
s/s of flail chest - answer✔✔paradoxical chest wall movement
where on the tissue oxygenation cascade is thoracic cage fractures a problem -
answer✔✔ventilation
parameters to assess ventilation - answer✔✔ETCO2, PaCO2, clinical assessment
what are considered "great vessels" - answer✔✔
thorax - answer✔✔
what type of injuries occur when the lungs are subjected to force? - answer✔✔bruise = contusion
tear = lacerations
pop = punctures
inhalation injury
bruise on the lungs - answer✔✔pulmonary contusion
causes of pulmonary contusions - answer✔✔high speed blunt or penetrating injury
what happens to the lungs in pulmonary contusions - answer✔✔big boggy bruise on the lungs
diffusion problems
when it becomes contused & edematous, it becomes difficult for oxygen to move from the
alveoli into the capillaries
all contusions over time - answer✔✔all contusions "blossom" over time. the full extent of the
injury is not initially apparent
important thing to remember when you are evaluating a patient for pulmonary contusions -
answer✔✔70% of pulmonary contusions aren't initial on the initial CXR
what should you monitor when a pt has trauma to the throax - answer✔✔closely monitor for
pulmonary contustiobs = 70% not present on the initial CXR and "blossom" over time
-monitor for progress e deterioration in hours/days post injury
*might look ok in ER
best parameter of serial monitoring for pt's who have risk factors for pulmonary contusions -
answer✔✔anticipate "blossoming" over time b/c 70% of pulmonary contusions aren't present on
the initial CXR
P:F ratio
problem of using CXR as a definitive clinical dx tool - answer✔✔CXR may lag behind clinical
status
*b/c 70% of pulmonary contusions aren't present on initial CXR. they "blossom" over time
tear in lung tissue - answer✔✔pulmonary laceration
problem of pulmonary lacerations - answer✔✔risk of massive hemothoax b/c those vessels are
very vascular
simple v. tension v. open v. closed. v. hemothorax v. hemopneumothorax - answer✔✔
what is a simple pneumothorax - answer✔✔any air that enters the pleural cavity can also leave at
the same rate. lungs deflated but no increase in intrathroacic pressure. air in/out exits at the same
rate. pt might be able to tolerate a simple pneumothraox
causes a problem at the ventilation point at the tissue oxygen cascade
intrathroacic pressure in simple pneumothorax - answer✔✔air that enters the pleural cavity
leaves at the same rate
lungs are deflated but no increase in pressure
air in/out at the same rate
where is the problem in the tissue oxygenation cascade in simple pneumothroax -
answer✔✔ventilation
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 Brightstars. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.49. You're not tied to anything after your purchase.
