Sat13November1123AM 2

Are the following statements concerning the management of trauma patients true or false?

True / False

Suxamethonium can be administered safely within 24 hours following anextensive burn injury Correct

Blind nasal intubation is a safe technique in patients with a cervical spine injury Correct

Surgery on trauma patients should never be delayed Incorrect answer selected

Patients intoxicated with alcohol have a lower peri-operative morbidity than non-intoxicated patients Correct

Nasal intubation should be performed on head injured patients that require post-operative ventilation on ICU Correct

Explanation

Alcohol intoxication increases the risk of vomiting and aspiration, causes vasodilatation and cooling, increases the risk of arrhythmias and potentiates the effect of anaesthetic drugs.

Emergency surgery carries a higher risk than the same operation performed electively. Many elderly patients with hip fractures are frequently operated on during normal working hours, days after the injury.

Patients that require post-operative ventilation do not need to have a nasal endotracheal tube. Nasal intubation has a higher failure rate than oral intubation and potentially causes more damage. It is also contraindicated when a basal skull fracture exists. Studies have demonstrated that blind nasal intubation carries more risk of dislocation of fractured vertebrae than when performed using a laryngoscope. Manual in-line stabilization of the head and neck must be maintained whenever the cervical collar/sandbags or tape are removed in order to improve the view at laryngoscopy. The availability of a gum elastic bougie and other difficult intubation equipment should always be confirmed.

Patients with extensive burns have an increased number of extrajunctional acetylcholine receptors. Suxamethonium should be avoided in burns patients from 24-48 hours after the injury. Giving suxamethonium to these patients will lead to an increased release of potassium, causing arrhythmias and may lead to cardiac arrest.

Answer Statistics

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Average score: 89.44%

Times answered: 252