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NSG 233 Med Surg 3 Exam 2 2023 Study Guide (Verified)
1.Traumatic Injury: Includes injuries caused by kinetic energy,
including motor vehicle accidents, firearms and falls.
Risk Factors:
Age (#1 cause of death b/w age 1 & 42) Gender (More common in adolescent/ young adult males) Alcohol (60% of trauma pts. 60% + for narcs, 60% polypharm)
2.Getting Trauma Pts to the Hospital: EMTs (BLS)
Paramedics (ACLS) Critical Care Transport To get patients to a higher level of care (critically ill, unstable) Which trauma patient's do well? (the ones who get to trauma center 1 / 4
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the fastest) Field treatment should include the following:
O2 (93-95%)
LOW VOLUME fluid resuscitation (can be a little hypotensive if theyre talking and have a pulse) Control Bleeding Stabilize Injury Pain Meds (morphine) Environmental Control (warm them up) Manage the Medical Problem - MI? Arrythmias?
3.Trauma Triad:
Hypothermia Acidosis Coagulopathy
PREVENT THIS
4.Flight for Life: Transports patients to trauma hospitals from the scene
of a trauma or from a lower level of care to a higher level of care.
How to package pt for transport:
350 lbs of evenly distributed weight (pt) Good IV in upper extremity Written report to FFL RN with basic 2 / 4
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labs Pt must be stabilized 3 / 4
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Help load the pt Dont go near the back of the chopper Dont approach chopper until pilot waves you forward
5.Geriatric Trauma Patients: Don't have physiologic
reserve. Most have pre-existing conditions.#1 cause of injury is ground level falls. Mortality is 4.4% #1 cause of death is MVA LOOK OUT for anticoagulants (especially plavix which you can't reverse) and B Blockers!!85% have a bad outcome if on coumadin Watch for dentures if intubating Glasgow < 8 = 80% mortality Resuscitate w/ limited fluids TBI = 25X higher mortality 6.Mechanism of Injury: Manner in which traumatic event occurred:
Blunt trauma (MVA, punches, falls):
Acceleration-deceleration
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