Term
Tri-modal Distribution of Death |
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Definition
•Death within minutes - usually lethal injuries resulting in death at the scene of the accident
•Death in the first hours - life threatening injuries requiring urgent attention
•Death in days/weeks - resulting from the complications of initial injuries sustained
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Term
Trauma Mortality has a Trimodal Distribution |
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Definition
1st Hour: Most Deaths
1-4 Hours: 2nd peak. Death mainly because of blood loss “golden hours”. Death can be prevented.
2 weeks and beyond: Death due to late complications
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Term
Initial Assessment of Trauma |
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Definition
•Resuscitation
•Primary survey
•Detailed secondary survey
•Initiation of definitive care
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Term
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Definition
•A: Airway maintenance with cervical spine control
•B: Breathing and ventilation
•C: Circulation
•D: Disability (neurological status)
•E: Exposure
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Term
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Definition
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•This is a detailed head to toe examination of the patient undertaken after the patient has been resuscitated and stabilized
•"tubes and fingers in every orifice”
•A detailed history is mandatory at this point.
Remember the mnemonic-AMPLE
An AMPLE history A Allergies
M Medication
P Past medical history
L Time of last food or drink
E Events and environment related to injury
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Term
Multiple Trauma Patients are treated with well defined stages |
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Definition
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Term
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Definition
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1.The only immediate demand for treatment is:
a.Vascular compromise due to position of the fracture or
b.Bleeding from an open fracture
2.Apply dressing pressure for stopping bleeding.
3.Splint promptly and effectively
4.Remove all rings and constricting jewelry
5.Force is rarely necessary for the reduction of a fracture
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Term
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Definition
Fractures occur by:
1.Single traumatic event
2.Repetitive stress
3.Abnormal weakening of the bone
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Term
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Definition
A.History of trauma
B.When patient complains of pain and when the part is moved
C.When edema and hemorrhage is present
D.Crepitus (bone grating on bone)
E.Gross angulatory deformity
CONFIRMED BY XRAY FROM TWO VIEWS
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Term
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Definition
1.Inflammatory phase
2.Reparative phase (Soft Callus)
3.Remodeling phase (Hard Callus)
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Term
Delayed Union And Nonunion |
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Definition
Delayed- Takes longer than supposed to
Nonunion- no union after 6 months
Causes:
A.Smoking
B.Low Vitamin D
C.Inaccurate reduction
D.Inadequate or interrupted immobilization
E.Severe local trauma, degloving injury, devascularisation
F.Infection
G.Loss of bone substance
H.Distraction of fragments
I.Metabolic disease
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Term
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Definition
•Type I
–Clean wound less than 1cm
–Inside/out injury
–Simple fractures
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•Example: Ski injury
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Term
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Definition
•Type II
–Skin laceration larger than 1cm
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–Some minor contusion around the laceration
–Minimal comminution
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•Example: Low velocity Automobile Accident
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Term
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Definition
•Type III-A
–Moderate soft tissue injury
–Adequate soft tissue coverage of fractured bone
•Type III-B
–Extensive soft tissue injury
–Periosteal stripping with significant bone exposure
•Type III-C
–All of III-B and VASCULAR INJURY
–AMPUTATION RISK
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Term
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Definition
Initally Dress Wounds, Splint Fracturs, Irrigation and Debridement
•Close Treatment
–Splint
–Cast
–Bed rest, Traction
•Open Treatment
–InternaL Fixation
–External Fixation
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Term
Complications of Fractures |
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Definition
•Fat embolism
•Venous thrombosis and pulmonary embolism
•Infection
•Death
•Tetanus (Clostridium tetani)
•Gas gangrene(Clostridial myonecrosis)
•Avascular necrosis
•Amputation
•Malunion
•Delayed Union
•Non Union
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Term
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Definition
•Compartment syndrome involves the compression of nerves and blood vessels within an enclosed space, leading to impaired blood flow and nerve damage
•Compartment syndrome is most common in the lower leg and forearm, although it can also occur in the hand, foot, thigh and upper arm.
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Term
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Definition
–The affected bone,
–Location of the fracture,
–Orientation of the fracture line,
–Displacement of the fracture fragments,
–The integrity of the soft tissue envelope around the fracture.
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