ATLS FACS
What's ABCDE to trauma assessment? - ANS Airway w/ C-spine protection
Breathing and ventilation
Circulation
Disability- neurological status
Exposure (undress) and Environment (temperature control)
Ortho-related injuries from frontal impact automobile collision? - ANS - C-spine fracture
- Posterior fracture/dislocation of hip/knee
Ortho-related injuries from side-impact automobile collisions? - ANS - C-spine fracture
- Fractured pelvis/acetabulum
Ortho-related injuries from motor impact w/ pedestrian? - ANS Fractured pelvis/lower
extremities
Ortho-related injuries from fall from height? - ANS - Fractured pelvis/acetabulum
- Bilateral lower extremity fractures (including Calc fractures)
What are some physical exam findings that might suggest pelvic fracture? - ANS - Ruptured
urethra (scrotal hematoma or blood at meatus)
- Limb length discrepancy
- Rotational deformity of a leg w/out obvious fracture
* In patients w/ these signs, do NOT manually manipulate pelvis *
What are some pertinent historical points to collect about MVC trauma? - ANS Vehicle speed,
Collision type, Ejection, Restraint type, Air bags, Patient position, Status of other passengers
When should you place pelvic binder in a trauma situation? - ANS If pelvic fractures,
hypotension, and no other source of blood loss
Most common type of pelvic fracture (mechanism)? - ANS - Lateral compression (70%)
- AP (15-20%)
- Highly unstable vertical shear
Total blood loss in an active pelvic hemorrhage is up to ____ liters - ANS 2
, What's the purpose of a pelvic binder in a trauma setting? - ANS Pelvis is a potential space. By
binding the pelvis, there is less volume and therefore less ability for blood loss in the pelvic
potential space
* Specifically recommended for AP/Open book pelvic fractures
4 regions assessed in the FAST exam? - ANS Pericardial sac, hepatorenal fossa, splenorenal
fossa, pelvis
What's a Chance fracture? - ANS Lumbar distraction fracture
Reversal agent for antiplatelet agents like Aspirin and Plavix? - ANS Platelets
Reversal agents for coumadin/warfarin?
What lab do you want to normalize? - ANS FFP, Vitamin K
INR
Reversal agents for heparin?
Lab that you want to normalize? - ANS Protamine Sulfate
PTT
Reversal agent of LMWHeparin (Lovenox)? - ANS Protamine sulfate (monitor PTT)
Reversal agent of direct thrombin inhibitors (like Pradaxa)? - ANS Praxbind (idarucizumab)
Reversal agent for Xarelto (Rivaroxaban)? - ANS N/a... Possibly improved by prothrombin
complex concentrate (Kcentra)
True or False. Many patients w/ C-spine fractures have a second, noncontiguous vertebral
column fracture. - ANS True (10%)
Neurogenic shock is associated with spinal cord injuries above ____. Why? - ANS T6
Due to descending sympathetic fibers from upper thoracic spinal cord that help maintain tone of
vasculature and heart rate
Why are injuries to C-spine below C3 more likely to cause injury to the spinal cord?
What about injuries above C3? - ANS Smaller canal diameter
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