Deck 36: Emergency Trauma Surgery
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Deck 36: Emergency Trauma Surgery
1
Consent for invasive procedures, including emergency surgery, is obtained from the patient if he or she is able, or from _____________________, according to hospital policy.
A) another person
B) responsible individuals
C) the parents
D) none of the above
A) another person
B) responsible individuals
C) the parents
D) none of the above
B
2
____________, a vascular failure caused by prolonged, severe blood loss, is the most common cause of mortality in trauma.
A) Hypothermia
B) Coagulopathy
C) Hemorrhagic shock
D) Metabolic acidosis
A) Hypothermia
B) Coagulopathy
C) Hemorrhagic shock
D) Metabolic acidosis
C
3
Subnormal core body temperature for an extended period of time is known as __________.
A) metabolic acidosis
B) coagulopathy
C) hypothermia
D) hyperthermia
A) metabolic acidosis
B) coagulopathy
C) hypothermia
D) hyperthermia
C
4
Death from ______ is the second leading cause of mortality in the United States, and approximately 115,000 cases of _______ injury are treated each year.
A) firearms; firearm
B) stabbing; stabbing
C) trauma; trauma
D) motor vehicle accident; motor vehicle accident
A) firearms; firearm
B) stabbing; stabbing
C) trauma; trauma
D) motor vehicle accident; motor vehicle accident
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5
Clear _____________ is the pivot point of team efforts in an emergency.
A) teamwork
B) accuracy
C) preparation
D) communication
A) teamwork
B) accuracy
C) preparation
D) communication
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6
The secondary survey is also known as __________.
A) occult injury
B) hospital care
C) clinical care
D) emergency care
A) occult injury
B) hospital care
C) clinical care
D) emergency care
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7
___________ is/are the leading cause(s) of death between the ages of 1 and 45 and the third leading cause of death in all age groups.
A) Motorcycle accidents
B) Motor vehicle accidents
C) Boating accidents
D) Trauma
A) Motorcycle accidents
B) Motor vehicle accidents
C) Boating accidents
D) Trauma
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8
ATLS is __________.
A) Advanced Trauma Life System
B) Advanced Trauma Limited Support
C) Advanced Trauma Life Support
D) Advanced Trauma Limited System
A) Advanced Trauma Life System
B) Advanced Trauma Limited Support
C) Advanced Trauma Life Support
D) Advanced Trauma Limited System
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9
During a true surgical emergency, more so than in any other scenario, ___________ is key to a successful outcome for the patient.
A) teamwork
B) preparation
C) counting
D) instruments
A) teamwork
B) preparation
C) counting
D) instruments
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10
____________ is the process of restoring physiological balance in injury.
A) Metabolic acidosis
B) Hypothermia
C) Hyperthermia
D) Resuscitation
A) Metabolic acidosis
B) Hypothermia
C) Hyperthermia
D) Resuscitation
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11
The compensatory mechanisms in acute injury can lead to the condition called __________.
A) compartment syndrome
B) metabolic acidosis
C) hemorrhagic shock
D) hypothermia
A) compartment syndrome
B) metabolic acidosis
C) hemorrhagic shock
D) hypothermia
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12
One goal of damage control surgery is to focus solely on lifesaving maneuvers, including all of the following EXCEPT __________.
A) control of feeding
B) control of hemorrhage
C) control of fecal spillage
D) relief of compartment syndrome
A) control of feeding
B) control of hemorrhage
C) control of fecal spillage
D) relief of compartment syndrome
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13
Lower-than-normal blood pH is what condition?
A) Metabolic acidosis
B) Coagulopathy
C) Hypothermia
D) Hyperthermia
A) Metabolic acidosis
B) Coagulopathy
C) Hypothermia
D) Hyperthermia
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14
Hospitals should have basic setups for __________.
A) craniotomy
B) bowel resection
C) replantation
D) vasovasostomy
A) craniotomy
B) bowel resection
C) replantation
D) vasovasostomy
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15
If the patient is stabilized in 12 to 48 hours, he or she can then be returned to surgery for a ____________ procedure.
A) follow-up
B) emergency
C) schedule
D) definitive
A) follow-up
B) emergency
C) schedule
D) definitive
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16
____________ is/are treatment pathways in trauma surgery.
A) Signs and symptoms
B) Algorithms
C) Hemorrhagic shock
D) None of the above
A) Signs and symptoms
B) Algorithms
C) Hemorrhagic shock
D) None of the above
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17
Copious amounts of _________ solution are often needed during trauma surgery.
A) drug
B) irrigation
C) heparin
D) coagulation
A) drug
B) irrigation
C) heparin
D) coagulation
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18
Although the ability to respond quickly to the demand of surgery is important, so is _______________.
A) teamwork
B) accuracy
C) preparation
D) instruments
A) teamwork
B) accuracy
C) preparation
D) instruments
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19
To avoid having instrument sets opened but not used, specialty instruments can be placed on a __________ the operating room (OR) in the sterile core.
A) cart inside
B) cart outside
C) sterile uncovered Mayo stand in
D) sterile covered Mayo stand in
A) cart inside
B) cart outside
C) sterile uncovered Mayo stand in
D) sterile covered Mayo stand in
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20
When passing any instrument that will come in contact with a bullet, fragments, shrapnel, or other ballistic item, ensure that the _______ of the instrument are protected with rubber shod or completely covered with a sponge.
A) finger hold
B) ratchets
C) serrations
D) tips
A) finger hold
B) ratchets
C) serrations
D) tips
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21
Match the terms with the definitions. Not all answers will be used.
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Tearing of the atria or ventricles as a result of trauma
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Tearing of the atria or ventricles as a result of trauma
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22
Match the terms with the definitions. Not all answers will be used.
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Evidence-based diagnosis of a medical problem using normal investigative procedures, such as imaging studies
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Evidence-based diagnosis of a medical problem using normal investigative procedures, such as imaging studies
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23
You are scrubbed in on an emergency case when the circulator tells you that all standardized ____________ procedures may be suspended in life-threatening situations.
A) surgical
B) count
C) aseptic
D) anesthetic
A) surgical
B) count
C) aseptic
D) anesthetic
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24
The real potential for extending the patient's injuries exists during ___________ and _____________.
A) positioning; skin prep
B) moving; handling
C) induction; wake up
D) preoperative preparations; postoperative preparation
A) positioning; skin prep
B) moving; handling
C) induction; wake up
D) preoperative preparations; postoperative preparation
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25
Match the terms with the definitions. Not all answers will be used.
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Injury that results in air in the pleural space causing displacement or collapse of the respiratory structures
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Injury that results in air in the pleural space causing displacement or collapse of the respiratory structures
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26
Match the terms with the definitions. Not all answers will be used.
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Increased pressure in any compartment of the body
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Increased pressure in any compartment of the body
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27
Match the terms with the definitions. Not all answers will be used.
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
A type of shock characterized by vascular failure resulting from severe bleeding
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
A type of shock characterized by vascular failure resulting from severe bleeding
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28
Match the terms with the definitions. Not all answers will be used.
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Pressure on the heart causing restriction and damage to the conduction system
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Pressure on the heart causing restriction and damage to the conduction system
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29
Match the terms with the definitions. Not all answers will be used.
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
A protocol of ATLS in which ultrasound is used in a focus area to diagnose severe trauma
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
A protocol of ATLS in which ultrasound is used in a focus area to diagnose severe trauma
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30
You are called in on a motor vehicle accident; the patient is disoriented and scared. As a health care professional, it is important to provide some measure of _______ for the patient.
A) emotional comfort
B) distress relief
C) safety education
D) standard precaution
A) emotional comfort
B) distress relief
C) safety education
D) standard precaution
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31
Match the terms with the definitions. Not all answers will be used.
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Trauma that results in deep tissue injury without rupture of the skin
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Trauma that results in deep tissue injury without rupture of the skin
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32
Postoperative serosanguinous pooling is controlled with wound _________.
A) drains
B) dressings
C) clamps
D) pins
A) drains
B) dressings
C) clamps
D) pins
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33
Match the terms with the definitions. Not all answers will be used.
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Bruising
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Bruising
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34
Match the terms with the definitions. Not all answers will be used.
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Surgery whose objective is to stop hemorrhage and prevent sepsis without attempting reconstruction or anatomical continuity
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Surgery whose objective is to stop hemorrhage and prevent sepsis without attempting reconstruction or anatomical continuity
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35
Match the terms with the definitions. Not all answers will be used.
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
A planned surgical procedure, usually with specific objectives for reconstruction or restoring continuity of anatomical structures
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
A planned surgical procedure, usually with specific objectives for reconstruction or restoring continuity of anatomical structures
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36
Match the terms with the definitions. Not all answers will be used.
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Condition in which the body's normal blood clotting mechanism ceases to function; characteristic in severe multitrauma
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Condition in which the body's normal blood clotting mechanism ceases to function; characteristic in severe multitrauma
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37
Match the terms with the definitions. Not all answers will be used.
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Hemorrhage with the potential to deplete the patient's total blood volume
a.Blunt injury
b.Cardiac rupture
c.Cardiac tamponade
d.Coagulopathy
e.Compartment syndrome
f.Contusion
g.Damage control surgery
h.Definitive diagnosis
i.Definitive procedure
j.Exsanguinating
k.Flail chest
l.FAST
m.Hemorrhagic shock
n.Hemothorax
o.Metabolic acidosis
p.Occult injury
q.Penetrating injury
r.Pneumothorax
Hemorrhage with the potential to deplete the patient's total blood volume
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38
____________-based tissue sealants are used only if there is no coagulopathy present because these depend on an intact coagulation response.
A) Thrombin
B) Lidocaine
C) Heparin
D) Warfarin
A) Thrombin
B) Lidocaine
C) Heparin
D) Warfarin
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39
Normothermia is maintaining core body temperature __________.
A) at the absolute minimum that supports life.
B) as close to normal as possible.
C) as close to maximum as possible.
D) at 25 degrees Celsius.
A) at the absolute minimum that supports life.
B) as close to normal as possible.
C) as close to maximum as possible.
D) at 25 degrees Celsius.
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40
The term "up" means what during an emergency case?
A) Items are sterile and ready for use
B) On the Mayo ready for use
C) The patient's blood pressure is too high
D) The patient's heart rate is too high
A) Items are sterile and ready for use
B) On the Mayo ready for use
C) The patient's blood pressure is too high
D) The patient's heart rate is too high
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