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IMF-044-01-0001-en	In acute care, why is a single normal observation not enough to stop worrying about a patient?	Acute care prioritises reversible threats before diagnosis, and trajectory and treatment response carry more weight than any one normal observation.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0002-en	During the trauma primary survey, what do you do when a life threat is found, and when is the patient reassessed?	Each life threat is treated as soon as it is found rather than after completing the survey, and the patient is reassessed after every intervention and whenever condition changes.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0003-en	How is a tourniquet applied for severe limb bleeding, and what practice must be avoided?	It is placed proximal to the bleeding, tightened until bleeding stops, and the time documented; it must not be periodically loosened outside a controlled plan.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0004-en	How is the airway opened when cervical injury is possible, and what guides the choice of adjunct?	Jaw thrust is used, followed by suction, removal of visible obstruction and oxygen; adjuncts are chosen according to the patient's reflexes and anatomy.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0005-en	When is a definitive airway indicated in trauma?	When airway protection, ventilation, oxygenation, anticipated swelling, transport, or the expected clinical course cannot otherwise be secured.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0006-en	Rapid-sequence intubation can precipitate hypotension and arrest in which states, and how is this risk reduced?	In severe hypovolaemia, right-heart obstruction, or metabolic acidosis; physiology is resuscitated first, drugs chosen carefully, a failed-airway plan prepared, and placement confirmed with continuous waveform carbon dioxide.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0007-en	Why should rigid spinal immobilisation not be prolonged or allowed to delay airway or haemorrhage control?	Prolonged rigid immobilisation causes pressure injury, aspiration risk, pain and raised intracranial pressure, so the spine is cleared through validated clinical or radiological pathways.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0008-en	Why is suspected tension pneumothorax with shock treated before imaging?	When shock or severe respiratory compromise accompanies suspected raised pleural pressure, the threat is immediately life-threatening, so treatment must not wait for imaging.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0009-en	How do flail segments and pulmonary contusion harm gas exchange, and what forms the core of management?	They cause pain, impaired ventilation and delayed hypoxaemia, so analgesia, physiotherapy and selective ventilatory support are central.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0010-en	Why can blood pressure be falsely reassuring in trauma shock, and which factors alter the signs?	Young patients can maintain pressure until late, so earlier signs such as tachycardia, cool skin, narrow pulse pressure and reduced urine matter; beta blockade, pacing, pregnancy and age alter them.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0011-en	Why is excess crystalloid harmful in major haemorrhage?	It dilutes clotting factors, worsens oedema, and causes hypothermia and acidosis, so warmed blood components are used to restore perfusion.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0012-en	Why is permissive hypotension in damage-control resuscitation inappropriate in severe traumatic brain injury?	Cerebral perfusion requires a higher pressure in severe brain injury, so accepting low pressure until haemostasis would risk the brain.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0013-en	What makes the lethal triad self-reinforcing, and how is the cycle broken?	Hypothermia, acidosis and coagulopathy each worsen the others, aggravated by exposure, cold fluid, shock and long procedures; warm everything, control bleeding, restore perfusion and shorten definitive procedures when physiology is exhausted.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0014-en	Why should the components of a simple coma scale be recorded, not just the total score?	Eye, verbal and motor responses are affected by intoxication, sedation, language, hearing, paralysis and intubation, so a total alone can mislead.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0015-en	Which empirical treatments are given in altered consciousness, and what must they not delay?	Glucose for documented or strongly suspected hypoglycaemia, naloxone for likely opioid toxicity with respiratory depression, and anticonvulsant treatment for ongoing seizure; none should delay ventilation or imaging.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0016-en	Which signs suggest brain herniation, and what response do they demand?	An expanding pupil, declining consciousness or new posturing; they require urgent hyperosmolar therapy, controlled rescue ventilation when imminent, imaging, and neurosurgical intervention.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0017-en	Why is the head-to-toe secondary survey repeated rather than done once?	Pain, distraction, shock and evolution of injury conceal findings, so a single examination can miss injuries that later become apparent.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0018-en	What are the limits of focused ultrasound and computed tomography in trauma?	Focused ultrasound rapidly detects selected pericardial, pleural and intraperitoneal fluid but cannot exclude all injury; tomography suits stable patients and must not delay surgery for obvious ongoing haemorrhage.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0019-en	What causes neurogenic shock, and what distinguishes its presentation?	Loss of sympathetic tone after spinal-cord injury causes hypotension, often with relative bradycardia, and the diagnosis is made only after haemorrhage is excluded.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0020-en	Why must neurovascular status be documented before and after interventions for limb injury?	Limb tissue is threatened by arterial disruption, compartment syndrome, open fracture or crush, so change after an intervention can only be recognised against a documented baseline.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0021-en	In cardiac arrest, why must airway interventions not degrade compressions, and what does waveform carbon dioxide add?	Minimising interruptions to high-quality compressions is central to arrest care; waveform carbon dioxide confirms tube placement and can indicate compression quality or return of circulation.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0022-en	Why is definitive neurological prognosis delayed after return of spontaneous circulation?	Confounders must be addressed and an appropriate time must pass before prognosis is reliable, so it is not declared early.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0023-en	Why is preoperative testing limited to tests that can change management?	Preoperative assessment is risk modification, not clearance; a normal test does not neutralise poor functional status, and routine indiscriminate testing creates false positives.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending
IMF-044-01-0024-en	Why are sodium-glucose cotransporter inhibitors withheld before surgery, and what must diabetes plans prevent?	They can cause euglycaemic ketoacidosis around fasting and surgery, and diabetes plans must prevent both hypoglycaemia and ketosis.	Integrated Medical Foundations; chapter 44, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 40864e6ed1d22a48ef86d84f291d25140ba0eb71b5b38cd723c4f2df086d73fd; editorial review pending	imf lang::en chapter::044 module::044-01 review::pending