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Trauma Radiography
| Trauma | severe injury or damage to the body caused by an accident or violence and requires immediate and specialized care |
| Blunt trauma | MVA, motorcycle accident, collision with pedestrian, falls, aggravated assaults |
| Penetrating trauma | GSW, stab wounds, impalement injuries, foreign body ingestion, aspiration |
| Explosive trauma | pressure shock waves, high-velocity projectiles, burns |
| Heat trauma | fire, steam, water, chemicals, electricity, frostbite |
| Most common trauma injuries | falls, MTVAs, firearms |
| How many levels of emergency medical care are there? | 4 |
| Trauma Center | specific level of emergency medical care as defined by the American College of Surgeons Commission on Trauma. |
| Level 1 trauma | most comprehensive, offer 24-hour care |
| Level 2 trauma | provides specialized care but is not a research or teaching hospital |
| Level 3 trauma | located in smaller communities, resuscitate, stabilize, assess, and prepares patients for transfer to a larger trauma center |
| Level 4 trauma | located in clinics or other outpatient settings, provide care for minor injuries and offer stabilization |
| motion | Patient _____ is always a consideration in trauma |
| _____________ that can be set should be used in all trauma procedures. | Shortest possible exposure time |
| The primary challenge of the radiographer is to obtain a __________ on the first attempt when the patient is unable to move into the desired position | high quality diagnostic image |
| Common and practical goals for the radiology department? | Adaptability, efficiency, productivity |
| _____________ in the ED is paramount to an accurate, timely, and often lifesaving diagnosis. | Diagnostic imaging |
| ________ is a crucial element in the care of a trauma patient. | time |
| To minimize the risk of aggravating the patient’s condition: Position the x-ray tube and IR instead of the _______ or _____ | patient or part |
| Place the stretcher ________ to the vertical bucky | adjacent |
| Obtain all AP projections moving ________ to _________. | superiorly to inferiorly |
| Obtain all lateral projections moving _______ to _______. | inferiorly to superiorly |
| Radiographer’s role in trauma - primary responsibilities: | Perform quality diagnostic imaging procedures, practice ethical radiation protection, provide competent patient care |
| Radiation protection practices | Close collimation ,gonadal shielding, lead aprons, exposure factors, announcement |
| Patient status changes are common in trauma, the radiographer should constantly | Assess the patient’s condition, recognize signs of deterioration or distress, report any change in status of the patient’s condition to the attending physician |
| Normal ranges for adult vital signs; temperature | 98.6° F |
| Normal ranges for adult vital signs; pulse rate | 60-100 bpm |
| Normal ranges for adult vital signs; respiratory rate | 12-20 bpm |
| Normal ranges for adult vital signs; blood pressure | 120/80 mmHg |
| Level of consciousness #1 | Alert and conscious |
| Level of consciousness #2 | Drowsy but responsive |
| Level of consciousness #3 | Unconscious but reactive to painful stimuli |
| Level of consciousness #4 | Comastose |
| Skin color- cyanotic | bluish coloration indicates lack of oxygen |
| Skin Temperature- Pale, cool, cold sweat | acutely ill |
| Skin Temperature- Hot, dry skin | may indicate fever |
| Skin Temperature- Cool, moist skin, shaking hands, difficulty to concentrate | acute anxiety |
| Breathing | Wheezing, gasping, coughing/choking, hyperventilating, flat vs. upright position |
| Medical emergencies- allergies | Latex, adhesives, betadine |
| Medical emergencies- respiratory | airway obstruction, pleural effusion, pneumothorax, hemothorax |
| Medical emergencies- cardiac | heart attack, cardiac arrest |
| Medical emergencies- trauma | head injuries, spinal injuries, chest injuries, extremity injuries, wounds burns, shock, syncope |
| Hypovolemic shock | large amount of blood or plasma loss |
| Septic shock | shock from infection |
| Neurogenic shock | head or spinal trauma, injury to nervous system |
| Cardiogenic shock | cardiac failure |
| Allergic shock | anaphylaxis |
| Psychological shock | mental trauma, PTSD |
| Recognizing shock | Restlessness/apprehensive, increased pulse rate, pallor accompanied by weakness or change in mental status, cool, clammy skin, drop in blood pressure of 30mm Hg below baseline, decreased urination, increased and shallow respiration |
| Best practices in trauma radiography | Speed, accuracy, quality, positioning, practice standard precautions, immobilization, anticipation, attention to detail, attention to ED protocol and scope of practice, professionalism |
| Displacement | bone that is no longer in contact with its normal articulation |
| Dislocation | an injury where a joint is forced out of normal position |
| Subluxation | partial dislocation of a joint |
| Sprain | forced wrenching or twisting of a joint resulting in partial rupture or tearing of supporting ligaments |
| Contusion | a “bruise” type of injury |
| Fracture | disruption of bone caused by mechanical forces |
| Apposition | relationship of long axes of fracture fragments |
| Types of apposition | Anatomic, lack of apposition, bayonet |
| Angulation | loss of alignment |
| Apex angulation | describes direction or angle of apex of fracture |
| Varus | apex angulation away from body midline, forces distal portion of bone medially |
| Valgus | apex angulation toward body midline, forces distal portion of bone laterally |
| Simple fracture | bone does not break through skin (closed fracture) |
| Compound fracture | bone protrudes through skin (open fracture) |
| Incomplete fracture | fracture does not traverse through entire bone (torus, greenstick, plastic) |
| Complete fracture | results in two pieces (transverse, oblique, spiral) |
| Comminuted | two or more fractured fragments (segmental, butterfly, splintered) |
| Impacted fracture | one fragment driven into another (ends of bones) |
| Baseball (mallet) | fracture of distal phalanx caused by ball striking extended finger |
| Bennett fracture | longitudinal fracture of base of 1st metacarpal |
| Boxer fracture | distal 5th metacarpal usually results from punching |
| Colles fracture | posterior displacement of distal radius |
| Smith fracture | anterior displacement of distal radius |
| Monteggia fracture | proximal ulna along with dislocation of radial head |
| Pott’s fracture | ankle fracture of distal fibula with medial malleolus |
| Hangman fracture | fracture of pedicles of C2 |
| Barton fracture | intra-articular fracture of distal radius |
| Hutchinson fracture | intra-articular fracture of radial styloid process |
| Trimalleolar fracture | medial and lateral malleoli, posterior lip of distal tibia |
| Stress fracture | repeated stress on a bone (marching or running); midshaft of metatarsal, distal shaft of tibia |
| Pathological fracture | due to disease process within the bone |
| Tuft fracture | comminuted fracture of distal phalanx |
| Stellate fracture | fracture lines radiate from center point of injury |
| Depressed fracture | fracture of skull, fragment is depressed |
| Compression fracture | anterior vertebral body collapses or is crushed |
| Blowout/tripod fracture | direct blow to orbit, fractures to orbital floor and lateral orbital margins |
| Chip fracture | isolated bone fragment |
| Avulsion fracture | results from severe stress to a tendon or ligament in a joint region |
Created by:
npat00
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