Traumatic Injuries

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1
Pediatric Assessment Triangle (PAT) is your ___________ or _________ assessment & includes 3 sections: ______, _____, ______
- General Impression
- Doorway assessment
- Appearance, WOB, skin circulation
2
Broselow Tape is the most common method for _________ based on the pt. ________
- weight estimation
- height
3
There are 3 methods for estimating a pt. weight including _____, _____, & _____. The most common method is the _________
- Broselow Tape--> Most common
- Leffler formula
- Theron formula
4
______ airways cannot be used if the patient is conscious, but a _______ airway can
- oral
- nasal trumpet
5
Infants/small children(toddlers) are __________ breathers, so __________ breathing may be normal for them
- diaphragmatic
- Belly breathing
6
GCS < 12 = _________
Head injury
7
GCS < 8 = _________
Intubate
8
GCS < 6 = _________
ICP monitoring
9
Pediatric trauma score <____ = significant risk of morbidity and mortality
8
10
M.I.V.T is the detailed hx you need from prehospital providers for your secondary survey. MIVT=
- Mechanism of Injury
- Injuries Sustained
- Vital signs
- Treatment
11
_______ is used as a marker to tell if abdominal compartment syndrome is getting worse or getting better
Bladder Pressure
12
In abdominal trauma the _____ nerve of the diaphragm can also be injured causing ______ breathing
- Phrenic
- Seesaw
13
Cardiothoracic trauma is generally rare and usually related to _______ to the chest
blunt force trauma
14
Children's chest wall compliance is ______ than in adults; as a result severe thoracic injury (i.e pneumothorax) can occur w/o _______
- >
- Rib fractures
15
Pulmonary contusions are areas of ________ and are very common. Mainstay tx is ________ & providing ________ therapy
- Injury to the lung
- Monitoring closely
- Oxygen
16
Flail chest is when the ribs move _______ bc they're ______; This is seen with _______
- Opposite the direction they should
- not attached to one another anymore
- Rib fractures
17
Salter Harris fractures classification determines _______ vs. ______and has to do with fractures around the _________
- who gets casted/splinted
- who needs surgery
- growth plate
18
Salter Harris Type 1 fracture is a __________. Management is ______
- Complete separation of the growth plate without fracture
- Closed reduction and cast
19
Salter Harris Type 2 fracture is the _______ type and is a ________. Management is ______
- Most Common
- Separation of plate with fracture
- Closed reduction and cast
20
Salter Harris Type 3 fracture is a __________. Management is ______
- Fracture through part of plate extending to lower joint
- Open reduction and internal fixation (PIN or Screw)
21
Salter Harris Type 4 fracture is __________. Management is ______
- Fracture completely through everything
- Open reduction and internal fixation (PIN or Screw)
22
Salter Harris Type 5 fracture is a __________. Management is ______
- Crush injury to area of plate that is nondisplaced with no fx line visible on xray
- immobilization and non‐weight bearing for a min of 3 weeks
23
Le Fort I is a ______fracture through the ______ including the _____ process, portion of the ______, the ______, and the lower aspect of the _____ plates. Teeth are usually contained in the detached portion of the maxilla
- transverse maxillary
- lower maxilla
- maxillary aleolar
- maxillary sinus
- hard palate
- pterygoid
24
Le Fort II is a ___ fracture that passes through the ____ & ______ bones, ______, ____ margin; across the _______ line, ___ sinus, & _____ plate; along the ____ wall; into the _____ fossa.
- pyramidal
- nasal & lacrimal
- floor of the orbit
- infraorbital
- upper zygomatic-maxillary suture
- maxillary
- pterygoid
- lateral maxilla
- pterygopalatine
25
The Le Fort II facture results in a floating ____ & ___ with possible ______ plate fracture
- maxilla and nose
- cribiform
26
any time a child has facial trauma, you wanna get ________ involved
ophthalmology
27
Pt. with a C- spine injury will have very little use of their ____ or _____. This is considered ______
- Arms or legs
- Quadraplegia
28
Pt. with a T, L, or S spine injury can lead to ______
- Paraplegia
29
An incomplete lesion is anything that has residual motor or sensory function more than _______ the level of injury
three segments below
30
A spinal cord injury without radiographic evidence (SCIWORA) result from the normally ________ of the ________ and ______ tissue in younger children
- Increased elasticity
- spinous ligamentous
- paravertebral soft
31
Children with SCIWORA may have a _____ between ______ and the onset of _________ from minutes to days
- delay
- injury
- objective sensorimotor dysfunction
32
The age range for children with SCIWORA is _____ to _______, with a higher incidence in children younger than _______
- 1.5 to 16 years
- 9 y.o
33
There is an increased risk of SCIWORA in children with _______ or ________
Chiari I malformation or Down syndrome
34
Spinal shock is a ____ loss of _______ that lasts up to ________ but then recover
- Temporary
- Sensory motor function
- Several days
35
In neurogenic shock there is impairment of the _______ system ______ the level of injury, r/in unopossed _______ of the heart , resulting in a triad of ________, ________, & ________. The peripheries are _______, and pulses are ______
- Sympathetic nervous
- Below
- Vagal stimulation
- vasodilation (hypotension), hypothermia, and bradycardia
- Warm
- Present
36
Neurogenic shock is unlikely to occur with SCI below the level of ______
T6
37
When managing SCI, ______ have been shown to improve outcomes, especially when given early
High dose IV steroids
38
We manage neurogenic shock with _____ and ______
Fluids and Alpha-adrenergic agonist
39
How is the cerebral perfusion pressure (CPP) calculated?
CPP= MAP-ICP
40
In most kids we want their CPP greater than _____ and ICP less than _____
- 50
- 20
41
Signs of impending herniation triad include ______ pupils, _______ and ______, and then ________
- Dilated and fixed
- HTN & bradycardia
- Extensor posturing
42
Impending herniation means the brain is about to push through the ______ and that leads to brain death
Foramen Magnum
43
Acute Post Traumatic Stress Disorder is when the stress of the trauma continues to impact their daily lives immediately ________
After going home
44
Phase 1 of spinal shock includes loss of ____ faciliation that presents as _____ & happens ____ days following SCI
- Descending
- Areflexia
- 0-1
45
Phase 2 of spinal shock includes denervation _____ that presents as ______ & happens ____ days following SCI
- Supersensitivity
- Initial reflex return
- 1-3
46
Phase 3 of spinal shock includes _____ synapse growth presenting as _____ & happens ____ weeks following SCI
- Axon-supported
- Hyperreflexia
- 1-4
47
Phase 4 of spinal shock includes _______ synapse growth presenting as _____ & happens ____ months following SCI
- Soma- supported
- Hyperreflexia & spasticity
- 1-12 months
48
Normal AST & ALT range
< 55
49
Normal Amylase level
< 140
50
Normal Lipase level
< 160
51
Normal Lipase level
7-30
52
Normal creatnine level
0.7-1.2
53
Formaula for calculating MAP
MAP= (2(DP) + SBP)/3
54
CO2 ______ in brain and _______ in lungs
- vasodilates
- vasoconstricts
55
Cardiac tamponade definitively diagnosed by
US
56
SCI: Younger children are at higher risk of ____ spinal fracture and older ______
- C1-C3
- C5-C7
57
Spinal Cord Injury w/o Radiograph Abnormality (SCIWORA) More common in ______ d/t ______ Can stretch up to ______
- younger children
- flexibility of spine/ligaments
- 5cm d/t flexibility
58
Atlanto-occipital dislocation is a ______ injury to the _______.
Ligamentous injury to the cranio-cervical junction (CCJ) -> spinal column separates completely from the base of the skull
59
Abd. trauma: Pain in the left shoulder may signify _______
splenic trauma
60
A seat belt mark across the abdomen raises concern for _______
bowel or mesentery injury
61
Association between ____ & ______ w/ intraabdominal injuries
lumbar spinal fractures and femur fractures
62
Blunt cardiac trauma: Cardiac injury is most likely when the ventricles are ______
maximally distended at the end of diastole
63
Commotio cordis is _______. usually seen in ________... its suspected that ______ occurs
- sudden death due to cardiac arrest from BCI with no obvious injury to the heart
- young male athlete
- ventricular fibrillation occurs as a complication of impact during ventricular repolarization.
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