Management Of Trauma Patients - Assessment

8 Questions | By Mcxmr2 | Updated: Mar 22, 2022 | Attempts: 926

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Test your performance of what you have learned so far by undertaking a moulage review in the management of a trauma patient. A 23 year old male has been severely injured in a motorbike accident. He has sustained the following injuries:- Abdominal injuries Thoracic injuries Pelvic injury Head injury Multiple fractures Massive external haemorrhage (from an open right groin/thigh wound) You are now running the trauma team. � It is important for you to make the right clinical decisions in managing the patient and helping to organise the team. � Good luck!

Questions and Answers

1.
A 23 year old male has been severely injured in a motorbike accident. He has sustained the following injuries:-
- Abdominal injuries
- Thoracic injuries
- Pelvic injury
- Head injury
- Multiple fractures
- Massive external haemorrhage (from an open right groin/thigh wound)
The initial management of the patient involves the following:-
- A.
  
  MARCH
- B.
  
  UABCDE
- C.
  
  ABCDE
- D.
  
  CABCDE
2.

The first priority in the treatment of the patient (as with all patients with major trauma) is:-
- A.
  
  Protecting the patient's airway
- B.
  
  Treating an underlying thoracic/breathing problem (such as decompressing a tension pneumothorax)
- C.
  
  Control of massive external haemorrhage
- D.
  
  Restoring a patient's circulating blood volume using intravenous fluids
- E.
  
  Instigation of urgent treatment of a deteriorating head injury
- F.
  
  Inducing hypothermia in the presence of multiple severe injuries
3.

Effective procedures to control life-threatening massive bleeding of the patient's haemorrhaging right groin/thigh wound include:-
- A.
  
  Use of simple bandages
- B.
  
  Application of an arterial tourniquet
- C.
  
  Indirect pressure distal to the injury
- D.
  
  Direct pressure with gauze
- E.
  
  Use of haemostatic agents
- F.
  
  Application of a venous tourniquet
- G.
  
  Direct pressure is the least effective manoeuvre at controlling external major haemorrhage
- H.
  
  Use of pressure dressings
4.

Conditions for using haemostatic agents in the management of trauma patients include:-
- A.
  
  Cannot be applied to aggressively bleeding injuries
- B.
  
  Require immediate direct pressure after application
- C.
  
  Some agents can cause burns to the patient
- D.
  
  Must be washed out during surgery once haemorrhage has been controlled
- E.
  
  Haemostatic agents are not effective at controlling haemorrhage
- F.
  
  Haemostatic agents can only be used by in hospital doctors who are experienced trauma clinicians
5.

The patient's conscious level deteriorates. Management, as in any patient with depressed conscious level (reduced Glasgow Coma Scale - GCS) as a result of major trauma, requires one or more of the following interventions:-
- A.
  
  Insertion of a naso-pharyngeal airway
- B.
  
  Insertion of a definitive airway (endotracheal tube)
- C.
  
  A Guerdal (oropharyngeal) airway may be a useful temporising measure pending Rapid Sequence Induction (RSI)
- D.
  
  Invasive ventilation is a necessity for a patient with a decreasing GCS
6.

The following thoracic/respiratory problems may be encountered and/or interventions prove necessary during the treatment of the motorcycle patient and his injuries:-
- A.
  
  The patient is unlikely to have developed a tension pneumothorax
- B.
  
  Any patient with a tension pneumothorax will require immediate decompression
- C.
  
  Oxygen should be administered to any patient who has been subjected to severe trauma/major injuries
- D.
  
  Oxygen saturations are a useful indicator of indentifying respiratory/thoracic injuries and complications
- E.
  
  It is vital that a chest x-ray is performed to diagnose any underlying respiratory injury
- F.
  
  Bleeding from underlying thoracic injuries is a rare finding
7.

Which of the following are correct regarding the management of the motorcycle patient regarding the corrective treatment of his major blood loss following his severe traumatic injuries:-
- A.
  
  Hypotension is caused by blood loss until proved otherwise
- B.
  
  Hypotension requires immediate correction with the administration of intravenous fluids
- C.
  
  Correction of circulation problems is the priority in the management of major trauma patients
- D.
  
  The best replacement for blood loss is a combination of red blood cells (blood) with clotting factors in a comparable concentration
- E.
  
  Patients who have multiple traumatic injuries rarely require administration of clotting factors/products
- F.
  
  Hypotension is an accurate early sign in the presence of major bleeding from trauma
8.

The motorcycle patient has a head injury. Head injuries can rapidly become fatal. Most head injury patients (such as the motorcycle patient being treated) require the following:-
- A.
  
  Reduction of raised intracranial pressure
- B.
  
  Urgent neurosurgical decompression of bleeding/haematomas
- C.
  
  Maintenance of cerebral perfusion through ensuring adequate blood pressure to the brain
- D.
  
  All patients should be observed with the insertion of an intracranial bolt pressure transducer monitor
- E.
  
  Head injuries are the first priority in the management of any trauma patient
- F.
  
  Hypothermic cooling is bad for isolated head injuries