ADVANCED TRAUMA LIFE SUPPORT (ATLS) 10TH EDITION/STUDY GUIDE, Study Guides, Projects, Research of Nursing

Download ADVANCED TRAUMA LIFE SUPPORT (ATLS) 10TH EDITION/STUDY GUIDE and more Study Guides, Projects, Research Nursing in PDF only on Docsity!

ADVANCED TRAUMA LIFE SUPPORT (ATLS) 10TH

EDITION/STUDY GUIDE

1. MIST Pneumonic [10.1]: Mechanism (and time) of Injury Injuries found and suspected Symptoms and signs Treatment Initiated
2. Primary Survey (ABCDE) [10.1]: A-airway/cervical spine, B-breathing, c-circulation with hemorrhage control d-disability (assess Neuro status) e-exposure/environmental control
3. DOPE [Ultimate ATLS Prep]: Reasons for deterioration in an intubated patient Dislodgement Obstruction Pneumothorax Equipment Failure

4.Shock index calculation [Ultimate ATLS Prep]: HR/SBP

Normal = 0.5=0. Volume Loss = >0.

5. AMPLE [10.1]: (Allergies, Medications, Past Illnesses/Pregnancy, Last Meal, Events/Environment related to injury)
6. Definitive airway definition: Tube placed in trachea with cuff inflated below vocal cords, tube connected to a form of oxygen enriched assisted ventilation and the airway secured in place with an appropriate stabilizing method. [10.2, pg24]

7. Laryngeal Trauma Triad of Signs: Hoarseness (dysphonia) Subcutaneous Emphysema Palpable fracture Tx: flexible endoscopic intubation Dx : CT scan [10.2, pg25]

8."abdominal breathing" or "diaphragmatic breathing" could be

caused by: -

Injury to below C3. These maintain diaphragmatic function, but lose intercostal and abdominal muscle contribution to respiration. These patients display a seesaw pattern of breathing. [10.2, pg26]

9. LEMON pneumonic: Assessment for Difficult Intubation Look Externally - small mouth, overbite, facial trauma Evaluate the 3-3-2 Rule - evaluates alignment of pharyngeal, laryngeal, and oral aes. 3FB between teeth, 3FB between hyoid bone and chin(tip of mentum), 2FB between throid notch and floor of mouth. Mallampati (PUSH) Opstruction Neck mobility [10.2, pg28]

10.Pulse Oximetry that correllates with PaO2 of >70mmHg: 95%

100% = >90mmHg

90% = >60mmHg [10.2, pg38]

11. Shock definition: an abnormality of the circulatory system that results in inad- equate organ perfusion and tissue oxygenation [10.3, pg44]
12. Types of shock: Hypovolemic - blood and fluid loss Cardiogenic - HF Obstructive - Tension pneumo, cardiac tamponade, PE Distributive - Septic, anaphylactic, neurogenic(injury to cervical or upper thoracic spine) [10.3, pg44]
13. Stroke volume determined by: preload (venous capacitance, volume status, mean venous systemic pressure - RAP) afterload (aka PVR) contractility [10.3, pg44]

14.Earlies measurable circulatory sign of shock: Tachycardia

[10.3, pg

15.SBP can be maintained until up to % of blood volume is lost.:

Therefore is unreliable early. [10.3, pg46]

16. Cardiac Tamponade s/s: JVD, narrow pulse pressure, hypotension ( Becks Triad) Tachycardia

insufficient response to fluid therapy [10.3, pg47]

17.Failure of fluid resuscitation to restore organ perfusion and

tissue oxy- genation suggests (2) reasons: continuing

hemmorrhage

neurogenic shock [10.3, pg48]

18. normal adult blood volume: 7% of ideal body weight in kg. So 70kg person has about 5 liters [10.3, pg48]
19. Classes of hemorrhagic shock and their signs and symptoms chart: Class 1 - like a person that donated 1 unit of blood. ~750ml Class 2 - crystalloid is required. 1500ml Class 3 - perhaps blood. 2000ml Class 4 - Blood transfusion is required.

2000ml [10.3, pg49]

20. Fractured Tibia or humerus can lose up to ml of blood: 750ml Causing Class 1 hypovolemic shock [10.3, pg51]

21.A fractured femur can result in the loss of or more of blood into

the soft tissues of the thigh.: 1500ml

Causing Class 2 hypovolemic shock [10.3, pg51]

22. Initial fluid amount given to adults and peds: 1L to adults 20ml/kg for peds <40kg

[10.3, pg52]

23.Adequate urinary output :

Adults Peds <1yo: Adults - 0.5ml/kg/hr Peds - 1ml/kg/hr <1yo - 2ml/kg/hr "urinary output is one of the prime indicators of resuscitation and patient response" [10.3, pg54]

24. Types of Responses to Initial Fluid Resuscitation: Rapid Response : <15% EBL, Type and cross, low need for blood, class 1 hemorrage. Transient response : 15-40% EBL, Type, mod-high need for blood, class 2or3 hemorrhage, theyre still bleeding Minimal or No response : >40%EBL, Emergency blood release, class 4 hemor- rhageimmediate need for blood MTP, [10.3, pg53]

25.Before infusing crystalloid should be heated to: 39C (102.2F

[10.3, pg55]

26. Massive Transfusion Definition: >10units PRBCS in 24hrs or

4units PRBC in 1hour [10.3, pg55]

27. The goal of resuscitation is to: restore organ perfusion and tissue oxygenation [10.3, pg58]
28. Most common cause of tension pneumothorax: Mechanical ventilation with positive pressure ventilation in patients with visceral pleural injury

[10.4, pg66]

29. needle chest decompression: 8cm (3.1inches) over the needle catheter in the 5th interspace slightly anterior to midaxillary line [10.4, pg66]
30. Massive hemothorax definition: > 1500 milliliters of blood or one third or more of the patient's total blood volume in the chest cavity. Most commonly caused by penetrating wound that disrupts the systemic or hilar vessels. Suspeced when shock is associated with absence of breath sounds or dullness to percussion. Tx : chest tube 28-32fr. Immediate return of >1500ml of blood indicates need for urgent thoracotomy. [10.4, pg68]
31. Cardiac Tamponade s/s: JVD, narrow pulse pressure, hypotension ( Becks Triad) Paradoxical venous pressure (Kussmauls sign) - rise in venous pressure when breathing spontaneously PEA can be cause by cardiac tamponade FAST is 90% accurate in identifying pericardial fluid for the experienced operator. [10.4, pg69]

32.The 8 potentially lethal injuries that should be identified and

managed during the secondary survey: (BP THEFTS)

Blunt Cardiac Injury Pulmonary Contusion

Traumatic Aortic Disruption Hemothorax Esophageal Rupture Flail Chest Traumatic Diphragmatic Injury Simple Pneumothorax [10.4, pg72]

33. is most often encountered with concomitant rib

fractures and it is the most common potentially lethal chest injry:

Pulmonary contusion

[10.4, pg73]

34. flail chest treatment: Initial : humidified oxygen, adequate ventilation, cautious fluid resuscitation. -if significant hypoxia (PaO2<60mmHg, SpO2 <90%) may require intubation within the first hour Definitive Tx : adequate oxygenation, judicious fluids, analgesia
35. Blunt aortic injury: HR control with short acting beta blocker with a goal HR of <80BPM. Esmolol --> Nicardipine --> Nitroglycerine/Nipride BP control with a goal MAP of 60-70mmHg [10.4, pg76]
36. Esophageal Trauma most commonly results from : Penetrating injury [10.4, pg77]

37.Fractures of the lower rib cage (10 to 12) should increase

suspicion for

injury: hepatosplenic [10.4, pg78]