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CSB337 TRAUMA tree of knowledge - Coggle Diagram

- - - - meninges
      - brain stem
      - leaking CSF
      - scalp and skull
      - brain perfusion and metabolism
      - lobes of brain
      - MOI
        
        coup/contracoup
        
        DAI
        
        concussion
        
        intracranial haematomas
    - - primary vs secondary
      - Cushing's triad
- - - - TxA
        
        COAST score
      - IV fluids
    - - hypothermia -> coagulopathy -> metabolic acidosis
- - - - primary (shock wave), secondary (shrapnel), tertiary (fall), quatenary (burns,crush, toxic dust)
- - - - binder
      - pain
    - - solid and hollow organs
- - - - wong-baker
    - - appearance
        
        work of breathing
        
        skin
- - - - symptoms occured at
        
        descent
        
        barotrauma
        
        depth
        
        nitrogen narcosis
        
        ascent
        
        rapid
        
        barotrauma
        
        middle ear
        
        teeth
        
        GI
        
        PO
        
        long/deep
        
        DCS
        
        signs
        
        pain
        
        numbness
        
        dizziness
        
        motor weakness
        
        CAGE (cerebral arterial gas embolism) -> seizures
    - - check pneumo
        
        O2 to reduce cerebral edema and increase perfusion. Dalton's law, increase O2/N2 gradient to wash N2
        
        seizure management
        
        supine or lateral, no trendelenberg
        
        IV fluids
        
        hypothermia,
        
        Hx - depth, time, presentation., air supply, dive type, decompression stops. dive computer or buddy
        
        retrieval service
        
        hyperbaric chamber
  - - - acute mountain sickness - caused by rapid exporsure to low O2 conc
      - PO (HAPE)
        
        management
        
        hyperbaric
        
        o2
        
        nifedipine (Ca2+ blocker to reduce pulmonary artery pressure)
        
        patho
        
        caused by pulmonary venous constriction in response to hypoxaemia, causing capillary leak
      - cerebral oedema (HACE)
        
        management
        
        hyperbaric chmaber
        
        o2
        
        dexamethosone
        
        signs
        
        ataxia, ALOC, retinal haemorrhage
        
        patho
        
        caused by vasodilation in response to hypoxaemia
    - - rest fluids
        
        mild analgesics
        
        acetazolamide - prevents alkylosis
- - - - extent - surface area?
        
        estimation
        
        Lund and Bowder - more accurate
        
        rule of 9s
        
        faster, not accurate for children or obese
        
        rule of palm - palmer surface=1% of TBSA in all age groups
      - depth - how many layers?
        
        superficial - epidermis
        
        partial - dermis
        
        full - underlying structures
    - - paeds - thin skin, large SA/weight, poor immune response, small airways and lungs
      - geri - thin skin, poor circulation, underlysing disease
    - - trauma bypasss
        
        burns over 20% or 10% in adults or children respectively, to the hand, face, genitals, airway or respiratory tract
      - A - swelling -> intubation
        B - smoke inhalation, chest burns restrict expansion
        C - shock, IV fluids 15ml/hr x TBSA (nearest 10%) additional 200ml/hr if over 100kg (consult for paeds)
        physical - rapid estimation, remove bands, cool with running water, prevent hypothermia with cling wrap, cover with dry sheets. burn aid dressing if less than 10% or 5% in adults or paed
      - drugs
        
        hydroxycobalamin - smoke inhalation
    - - upper airway - neck, face, singing of hairs
      - lower airway - LOC, closed space, tachypnoea, carbonaceous sputum
      - carbon monoxide - binds to haemoglobin 250x stronger than o2, headache, ataxic, confusion, tachycardic
    - - zone of coagulation, stasis and hyperaemia
  - - - types of current
        
        dc
        
        ac - 3x more dangerous, produces tetanic cotnraction, 50hz, muscular tissue is sensitive to 50-150hz, potential for VF
      - voltage - 1000V is high
      - resistance
      - current path
      - contact duration
    - - heart
        
        nervous system
        
        high tension vs flash
    - - facts
      - mechanism
    - - danger - AC hot stick
  - - - BGL
        
        12 lead
        
        consider - EEA, removal of probes (not if in eyes, genitals, face or neck), manage 2nd injuries