Trauma & Emergency Surgery Flashcards

During a trauma laparotomy, the scrub tech notices a sponge count discrepancy at closure. The CORRECT action is:

Answer: Immediately notify the surgeon to halt closure and perform a search for the missing sponge

Any sponge count discrepancy requires immediate notification of the surgeon to stop closure until the missing item is accounted for, per patient safety standards.

Which type of pelvic fracture pattern is associated with the HIGHEST risk of life-threatening hemorrhage?

Answer: Open book (AP compression type II–III) fracture

Open book (AP compression) pelvic fractures disrupt the pelvic ring and tear the venous plexus and iliac vessels, causing massive retroperitoneal hemorrhage.

A trauma patient requires emergency thoracotomy for a penetrating cardiac injury. The scrub tech should prepare which suture to repair a ventricular laceration?

Answer: 2-0 or 3-0 pledgeted prolene (polypropylene) on a tapered needle

Pledgeted polypropylene suture provides secure, hemostatic closure of ventricular lacerations; pledgets distribute tension and prevent suture pull-through in friable myocardium.

Which imaging study is considered the gold standard for identifying solid organ injuries in a hemodynamically STABLE trauma patient?

Answer: CT scan of the abdomen and pelvis with IV contrast

CT of the abdomen and pelvis with IV contrast provides detailed anatomic information about solid organ injuries, vascular injury, and free fluid in stable trauma patients.

In a trauma OR, the circulator's MOST critical responsibility during a massive hemorrhage emergency is:

Answer: Communicating with the blood bank, documenting accurately, and anticipating needs without entering the sterile field

The circulator coordinates blood product delivery, documents events in real time, and serves as the communication link between the OR team and blood bank or other departments.

During a trauma case, the surgeon requests a Fogarty embolectomy catheter. The scrub tech should know this instrument is used to:

Answer: Remove thrombus from a vessel lumen by inflating a distal balloon and withdrawing it

A Fogarty catheter is a balloon-tipped embolectomy catheter passed beyond a clot, inflated, then withdrawn to extract the thrombus from the vessel.

When performing a trauma thoracotomy, the left thoracic cavity is entered through which intercostal space?

Answer: 4th or 5th intercostal space along the anterolateral chest wall

The left anterolateral thoracotomy incision is made through the 4th or 5th intercostal space to provide access to the heart, descending aorta, and left lung.