TCAR Exam Questions and Answers (Solved Papers)
- questions to ask in trauma - Correct Answers ✅-what
- q's to ask in GSW - Correct Answers ✅caliber
was the dose of energy?-where did it go?-what injuries are likely?
type of gun # of entrance/exit wounds high/low velocity 1st question to ask in any traumatic injury? - Correct Answers ✅what was the dose of energy involved?(was it high or low?) what is the caliber of a bullet? - Correct Answers ✅diameter aka diameter of a bullet - Correct Answers ✅caliber what happens to projectiles when they enter the body - Correct Answers ✅projectiles don't travel in a straight line consider temporary cavity wound 1 / 4
TCAR Exam Questions and Answers (Solved Papers) what should you consider about tissue a projectile enounters
- Correct Answers ✅temporary cavitation
primary goal of GSW surgery - Correct Answers ✅usually damage repair & not bullet removal -if superficial, it may migrate the surface with time important thing to remember about retained projectiles - Correct Answers ✅they may migrate over time. bullett migration might explain unexplained clinical findings (VP Cheney accidentally shot his friend while hunting in 2006.ICU and did great. moved to an inpatient unit. had a silent MI bc a shot gun pellets migrated into a canary artery causing an infract. so had a MI but fibrinolytic not the answer in this case b/c it was a "projectile embolus" aka brestbone - Correct Answers ✅sternum what attaches the ribs to the sternum - Correct Answers ✅cartliage what breaks thoracic bones - Correct Answers ✅significant force -1-2nd ribs, posterior ribs, sternum, scapulae, T2-10 gives us info about the force aka "dose" of energy received 2 / 4
TCAR Exam Questions and Answers (Solved Papers) consider injury to internal structures b/c force ribs that are the most frequently broken - Correct Answers ✅ribs 4-9 b/c long, thin, and poorly protecte it is harder to break a short pencil (T1-2) and easier to break a longer one *ask how many and where to understand the force involved what is the significance of posterior rib fractures - Correct Answers ✅unusual direction of injury shorter stubby ribs good muscle profection **posterior rib fractures have a lot of force so need a high dose.***PRF need a lot of force so high dose of energy. big red flag for t-spine injury indication of c-spine injury - Correct Answers ✅to injure c- spine, you don't need a big energy blow. all it takes is shaking around.c spine versus t spine fractures - Correct Answers ✅c-spine doesn't need a big energy blow. just some shaking around t-spine needs a great strong direct blow (not just a shock_ 3 / 4
TCAR Exam Questions and Answers (Solved Papers) treatment for rib fractures - Correct Answers ✅largely supportive nursing care like pulmonary toilet CXR and rib fractures - Correct Answers ✅simple rib fractures are difficult to see on CXR and can be commonly missed (1/2 of all rib fractures aren't identified at the POI CXR) identify a previous rib fracture on CXR - Correct Answers ✅once healed, rib fractures form bony callouses and become more visible on CXR how to tell a pt has a pneumonia from a CXR - Correct Answers ✅dark spot that is not equal to the opposite side consider if a pt has a lower rib fracture - Correct Answers ✅liver & spleen injury acts like BBQ/marshmellow skewers how high does the diaphragm rise on inspiration - Correct Answers ✅level of 4th ICS risk of rib fractures - Correct Answers ✅can puncture liver, spleen,, diaphragm
- / 4