TCRN flashcards
TCRN · Build recall with a focused review session.
31 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Tension pneumothorax findings
- Tracheal deviation away from the affected side, absent breath sounds, hypotension, distended neck veins, and hyperresonance; treated with immediate needle decompression before any imaging.
- Beck triad
- Three signs of cardiac tamponade: hypotension, distended neck veins, and muffled heart sounds; pulsus paradoxus and a narrowed pulse pressure may also be present.
- Cullen sign
- Periumbilical ecchymosis suggesting retroperitoneal hemorrhage, often from pancreatic or duodenal injury; Grey Turner sign refers to flank ecchymosis from the same process.
- Battle sign
- Bruising over the mastoid process behind the ear that indicates a basilar skull fracture; it often appears hours after injury, along with raccoon eyes or cerebrospinal fluid rhinorrhea.
- Glasgow Coma Scale scoring
- Eye opening scored 1-4, verbal response 1-5, and motor response 1-6; the total ranges from 3 to 15, and a score of 8 or less signals need for intubation.
- Kehr sign
- Referred left shoulder pain caused by diaphragmatic irritation from splenic rupture or free intraperitoneal blood; the pain often worsens when the patient lies flat.
- Revised Trauma Score
- A physiologic triage score weighting coded GCS (0.9368), systolic blood pressure (0.7326), and respiratory rate (0.2908); values range 0-7.84 and 4 or less predicts high mortality.
- Permissive hypotension
- Deliberate limitation of intravenous fluids to keep systolic pressure near 80-90 mmHg until surgical hemorrhage control in penetrating trauma; it is contraindicated in traumatic brain injury.
- Lethal triad
- The self-reinforcing cycle of hypothermia, acidosis, and coagulopathy in massive hemorrhage; management requires active warming, rapid hemorrhage control, and balanced blood product transfusion.
- Abdominal compartment syndrome
- Sustained intra-abdominal pressure above 20 mmHg accompanied by new organ dysfunction; suspect it with a distended abdomen, rising peak airway pressures, and falling urine output.
- FAST examination
- Focused assessment with sonography for trauma, which detects free fluid in pericardial, perihepatic, perisplenic, and pelvic windows; it is rapid, repeatable, and noninvasive at the bedside.
- Spinal cord injury pressure goal
- For acute spinal cord injury, guidelines recommend maintaining mean arterial pressure of 85-90 mmHg for five to seven days to optimize perfusion of the injured cord.
- Neurogenic shock
- Hypotension with bradycardia caused by loss of sympathetic tone after cervical or high thoracic cord injury; treat with vasopressors and cautious fluids rather than large boluses.
- Raccoon eyes
- Periorbital ecchymosis that suggests a basilar skull fracture; avoid nasogastric and nasotracheal tubes because of the risk of intracranial tube passage.
- AMPLE history
- Secondary survey history covering Allergies, Medications, Past illness or pregnancy, Last meal, and Events of the injury; obtained after the primary survey and resuscitation.
- Rule of nines adult
- Estimates burn surface area: head 9%, each arm 9%, anterior trunk 18%, posterior trunk 18%, each leg 18%, and perineum 1%, totaling 100% in adults.
- Trauma hypothermia prevention
- Remove wet clothing, apply warm blankets, infuse intravenous fluids warmed to 39-42 degrees Celsius, and raise room temperature; hypothermia worsens coagulopathy and acidosis.
- Early mobility in ICU
- Progressive mobilization begun within 24-48 hours of intensive care admission reduces ICU-acquired weakness and ventilator days; hemodynamic and neurologic stability are screened first.
- Level I trauma center
- Provides 24-hour in-house general surgeon coverage, comprehensive specialty care, plus research and residency education; verified by the American College of Surgeons Committee on Trauma.
- Level II trauma center
- Provides definitive trauma care with 24-hour general surgeon availability but may lack in-house specialty coverage and research; complex patients may be transferred to a Level I center.
- Level III trauma center
- Provides prompt resuscitation, emergency surgery, and stabilization with transfer agreements to higher-level centers; the general surgeon may take call from outside the hospital.
- Trauma registry purpose
- A structured database of trauma patient demographics, injury details, care processes, and outcomes used for quality improvement, research, and injury prevention; data flow to the national data bank.
- EMTALA
- Federal law requiring Medicare-participating hospitals to perform a medical screening examination and provide stabilizing treatment regardless of insurance status or ability to pay.
- Forensic chain of custody
- Documented, unbroken control of evidence such as clothing or bullets, kept in separate labeled containers and released directly to law enforcement with signatures and time recorded.
- Haddon Matrix
- A grid crossing host, agent, and environment with pre-event, event, and post-event phases, used to design and organize injury prevention strategies across the continuum.
- Three E's of prevention
- Education, enforcement, and engineering or environmental modification; combining all three approaches is more effective at reducing injuries than relying on education alone.
- CDC field triage criteria
- Red criteria include GCS 13 or less, systolic pressure below 90 mmHg, respiratory rate below 10 or above 29, and penetrating injury to the torso; transport to the highest-level center.
- Trauma performance improvement
- A multidisciplinary cycle of identifying care issues, reviewing them including preventable death review, implementing corrective actions, and documenting re-measurement and loop closure.
- SBAR handoff
- Structured communication of Situation, Background, Assessment, and Recommendation used during trauma team handoffs and interfacility transfers to reduce omissions and errors.
- Crew resource management
- Team training emphasizing leadership, role clarity, closed-loop communication, and mutual monitoring; it reduces human error during high-stress trauma resuscitations and procedures.
- START triage
- Simple Triage and Rapid Treatment assigns black, red, yellow, or green categories within seconds using respirations, perfusion by capillary refill, and mental status in mass casualty events.