ADVANCED TRAUMA LIFE SUPPORT ATLS QUESTIONS AND ANSWERS 2024 GRADED A+, Exams of Nursing

Download ADVANCED TRAUMA LIFE SUPPORT ATLS QUESTIONS AND ANSWERS 2024 GRADED A+ and more Exams Nursing in PDF only on Docsity! 60 minutes after injury to treat after the 60 mins morbidity and mortality significantly increases after 1st year of life injury is most frequent cause of death in babies too 31%- 48% golden hour rib fractures on child # of left posterior 8th rib Brainpower Read More •Performs Trauma Series - Lat C Spine, CXR, Pelvis • •Acts as liaison with CT suite. radiographer role in trauma team leader- most important stand back and keep overview of whats happening in the room and helicopter ODP- support anaesthetics ADVANCED TRAUMA LIFE SUPPORT ATLS QUESTIONS AND ANSWERS 2024 GRADED A+ nurse x2 scribe- wirtting whats happening radiographer •Team Leader •Anaesthetic SpR •Cardiac/Thoracic Surgeon •A & E Consultant/SpR •Orthopaedic SpR trauma team (not important) airway management cervical spine control- any signs there breathing or snoring is bad sign of upper airway obstruction sokve with head tilt chin lift snoring will stop. they need a patent airway to breath breathing & ventilation - check lungs are rising and falling equally good depth volume listen to breath sounds or absent breath sounds on one side due to pnemothorax listen with stethoscope. if you hear crackles- fluid purcusion- use two fingers to look for a echo looking for hyper resenant- sign of pnemothorax if dull then its fluid. are they using accesory muscles struggling to breath -asthmatic or see saw effect with abdomen probe on finger to look at oxygen saturation should be breath 94-90% oxyegen saturaton of room air circulation -check for pulse of corotid pulse not just radial as they may be in shcok so blood pressure cant suport organs so shut down so cant feel radial pulse well so feel for corotid pulse and blood pressure. capilary re fill test good way to test if pt has shut down- press finger for 5 seconds finger should pink up within 2 seconds if not shut down haemorrage control - 5 liters circulating volume if you lose one litre you'll be out of it . disability - awareness is key. GCS can be replaced with- avpue if easier - measure are u alert b responsive to voice do they respond to pain u- unconcious e-exposure - any rashes bleeding wounds primary survery ABCD Not Breathing/Occasional gasps?• call for help then start CPR •Call Resuscitation Team - 2222 •Commence CPR 30:2 Adult (15:2 Child/Infant) 30 compressions to 2 ventilations at a rate of 120 per minute bag valve mask for ventilations 85-90% oxygen given •Change CPR provider after every 2 minutes MAX! left side posterior and higher right ventricle more on left side right heart border is right atrium label heart •Blunt trauma - crush/deceleration – caridac up check right side more anterior so more chnace of survival to trauma to right side of heart as it isn't as thick lower pressure not going as far to pump. cardicac chamber can cuase tamponade blood in pericaridal sack acts as constrictive band heart cant relax in diastoyle needs a needle blood aspiration •Penetrating trauma –Knives, bullets never take a knife or anything out as its blocking the hole it has caused Iatrogenic- medically caused somthing staff have done -Complications of arterial/venous punctures, Insertion of PPM or Chest Drain, Surgical Trauma for example putting a pace making in puncturing when putting valves ext in could cause subcalvian puncture into subclavian vein thoracic trauma cardiac tamponade cardiac tamponade - large heart cardiac tamponade on ct in need of a needle aspiration to get it out penetrating trauma by knife to heart to right ventricle cxr ct if pt haemodynamicaly stable blood pressure stable throaxic trauma imaging options prev to xray: when brochial stent put in trauma caused pt not haemodynamically stable at time of chest xray had surgical emphysema put chest drains in after on right side of chest this xray shows: also been a pnemothroax on left but drains cause it to then be tension pnemothroax thoracic cavity filled with air that cant escape every time they take a breath in diaphram has inverted depressed on left endotracheal tube has moved to the right treatment pop baloon of air in the thoracic cavity to release the air then put chest drains in. •ET Tube •ECG Leads •Intercostal Drains •NG tubes- trauma pt always has one in place to aspirate any contents you can get back to prevent vomiting which can cause pt to aspirate drown in vomit and cause death want to decompress stomach dont want it fill with air and bring diaphram up want lungs to have proper inflation tubes seen on chest xray •Fractures •Pneumothoraces •Haemothoraces •Pleural Effusions •Lung Injury pathologies seen on chest xray •Arterial puncture •Seldinger technique, •Guide wire •Introducer sheath •Catheter traditional angiography - risky could cause damage aorta can disect angiography is to see complications? Venous puncture into antecubital fossa ct angiography easy and get to see whole aorta safer than traditional angiography ct angiography aorta Vascular Dissection can be caused by angiography or deceleration of a vehicle A separation of the layers of the vessel wall caused by - A tear in the diseased intima directly exposing the underlying media to the pulse pressure of intraluminal blood. 3 layers inner - intima then media then adventitia - not spelt right disection - rip in intema so blood can flow into normal lumen but also through intema and media which is bad thorax - deceleration injuries, vehicle suddenly stopping tethered two places in thorax ligamentum nksn and diaphram aorta is free on a large area vehicle stops then you stop the organs stop this whipping of aorta can cuase rippping of intima media/ aortic disection aorta Vascular Dissection Axial CT showing dissection of descending aorta (tennis ball appearance above vertebrae.) brighter contrast in true lumen grey contrast in false lumen going down between intim and lumen on image intima flap flops over oculde true lumen trasnverse nail put through femur for treatment to put the traction on rta motorbike got hit by landrover angiogram of right femoral artery to prove he had circulation rta motorbike got hit by landrover TEVAR- Thoracic EndoVascular Aortic Repair of proximal descending aorta with stent in situ and pigtail catheter stent put in through femoral artery to help blood flow rta motorbike got hit by landrover CXR showing Right chest drain, right central catheter, endo tracheal tube, and aortic stent (circle at the arch) ng tube seen stent seen rta motorbike got hit by landrover Right hip view showing K nail in femur and acetabular repair femur and pelvis plated rta motorbike got hit by landrover Right femur from knee up after surgery rta motorbike got hit by landrover case study 4 year old getting photo taken stone collapsed onto the child Initial traumatic amputation of left hand at the level of carpal bones Successful reattachment with pins 15 year old RTA playing 'chicken' with friends hit @ 60 mph Coronal view and axial view of face showing fluid in maxillary sinuses and disruption of Right zygoma. Axial view of chest showing bilateral chest drains (circles) and residual pneumothorax on Left side Fractured left wrist Zygoma blow out fracture sinus full of blood fluid Fractures around face Fractured ribs •An anaphylactic reaction is an exaggerated response of a previously sensitised individual to foreign antigenic material symptoms in order of how they happen and acronym finding faint friends flushing is itchy rash ****ing facial swelling brilliant brochioconstriction veronicas vomiting dad diarrhoea howeled hypovolaemia (collapse) anaphylaxis what it is and treatment