Sydney Shared "Exam 2: Neuro Trauma, Shock, Burns" - 18 Picmonics
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Exam 2: Neuro Trauma, Shock, Burns
Rule of 9's for Burns
- Total Body Surface Area (TBSA)
- Head
- Anterior Torso (18%)
- Chest
- Abdomen
- Posterior Torso (18%)
- Upper Back
- Lower Back
- Extremities
- Posterior Leg (each)
- Anterior Leg (each)
- Each Arm
- Genitalia 1%
2 mins
Parkland Formula
- Burn victims
- 24 hours
- TBSA% x Weight x 4 = Fluids
- TBSA %
- x Weight (kg)
- x 4
- = Fluid Requirement (in first 24 hrs)
- Fluids in first 8 hours
- 1/2 of fluid given in first 8 hours
1 min
Types of Burns
- Superficial Thickness
- Sunburn
- Superficial Partial Thickness
- Blisters
- Blanching
- Deep Partial Thickness
- Little or Non-blanching
- Full Thickness
- Waxy White, Yellow or Black
- Decreased Pain
2 mins
Stages of Burn Care
- Phase / Stage 1
- Resuscitative/Emergent Phase
- Injury to Return of Capillary Permeability
- 48-72 hours
- IV Fluid Replacement
- Phase / Stage 2
- Acute Phase
- Diuresis to Near Wound Closure
- Phase / Stage 3
- Wound Closure to Return of Optimal Level
2 mins
Burns Assessment
- Stage and Extent of Burn
- Dyspnea
- Singed Nasal Hairs
- Pain
- Initial Decrease Urinary Output
- Paralytic Ileus
- Signs of Inadequate Hydration
- Shock
- Hypothermia
- Hyperkalemia
2 mins
Burns Interventions
- Ensure Airway Patency
- O2
- IV Fluid Replacement
- Dry Sterile Dressing
- Debridement
- Elevate Burned Limbs
- Analgesics
- Silver Sulfadiazine
- Escharotomy
2 mins
Burns Considerations
- Maintain Body Temperature
- Increased Risk of Infection
- Venous Thromboembolism (VTE) Prophylaxis
- Curling's Ulcer
- Excision and Grafting
- Adequate Nutrition
- Contractures
2 mins
Systemic Inflammatory Response Syndrome (SIRS) Criteria
- Must have 2 or more of the following:
- Temperature < 36C or > 38C
- Pulse > 90 beats per minute
- Respirations > 20/min or PCO2 < 32
- WBC < 4,000 or > 12,000 or 10% bands
- Mechanism
- Subset of Cytokine Storm and Related to Sepsis
2 mins
Types of Shock
- Hypovolemic
- Depleted Volume
- Cardiogenic
- Pump Failure
- Obstructive
- Indirect Pump Failure
- Distributive
- Lost Vascular Tone
- Neurogenic
- Anaphylactic
- Septic
2 mins
Sepsis Assessment
- Signs and Symptoms
- Systemic Infectious Process
- Fever
- Hypotension
- Change in LOC
- Increased WBC
- Shift to the Left
- Tachycardia
- Tachypnea
- Hyperglycemia
- Edema
2 mins
Severe Sepsis and Septic Shock Assessment
- Microthrombi
- DIC
- Decreased Oxygen Saturation
- Decreased WBC
- Oliguria
- High Output Heart Failure
- Multiple Organ Failure
2 mins
Compartment Syndrome Assessment
- Mechanism
- Trauma
- Increased Pressure
- Compressed Nerves and Blood Vessels
- Assessment
- 1 or more of 6 P's
- Ankle-Brachial Index (ABI)
- Considerations
- May take Days to develop
- Early Detection
- Ischemia
- Damage often Irreversible
2 mins
Compartment Syndrome Interventions
- Interventions
- Frequent Neurovascular Assessments
- Evaluate Pain
- Do Not Elevate Extremity
- Remove or Loosen Restrictive Items
- Fasciotomy
- Amputation
- Considerations
- Infection
- Monitor Urine Output
2 mins
Types of Head Injuries
- Open Head Injury
- Linear Fracture
- Comminuted Fracture
- Depressed Fracture
- Open Fracture
- Basilar Skull Fracture
- Closed Head Injury
- Coup and Contrecoup
- Brain Contusion
- Concussion
2 mins
Traumatic Brain Injury Assessment
- Assessment
- Change in LOC
- Personality Changes
- Amnesia
- Increased Intracranial Pressure
- Diplopia
- Posturing
- Location of Injury
- Basilar Skull Fracture
- Halo or Ring Sign
- Considerations
- Intracranial Bleeding
2 mins
Increased Intracranial Pressure (ICP) Assessment
- Change in LOC
- Headache
- Cushings Triad
- Irregular Respirations
- Widening Pulse Pressure
- Bradycardia
- Projectile Vomiting
- Abnormal Pupils
- Papilledema
- Posturing
2 mins
Increased Intracranial Pressure (ICP) Interventions
- Interventions
- Elevate Head Of Bed
- Foley Catheter
- Mannitol (Osmitrol)
- High Dose Barbiturates
- Passive Hyperventilation
- Dexamethasone (Neoplasm or Infection)
- Considerations
- Neuro Assessment
- Maintain Normal Temperature
- Avoid Activities That Increase ICP
- Intracranial Monitoring System
2 mins
Lesions of the Brain and Presentations
- Lesions of the Brain and Presentations
- Frontal Lobe
- Parietal Lobe
- Temporal Lobe
- Occipital Lobe
- Brainstem
- Cerebellum
- Main TBI Lesions
- Epidural Hematoma
- Subdural Hematoma
- Contusion/ Parenchymal Hemorrhage
- Intraventricular Hematoma
- Subarachnoid Hemorrhage
- Diffuse Axonal Injury
3 mins
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