Trauma And Burns Flashcards
Axis of impact
Forward: well tolerated
Vertical: moderately tolerated
Lateral: poorly tolerated
MVA: Frontal Impact
Down and under
- Lower extremity and abdominal trauma
Up and over
MVA: Lateral impacts
Shearing forces
MVA: Rear impact
High likelihood for c-spine injury
Shock index
Heart Rate/Systolic BP
Critical Shock
SBP <100
HR > 100
HCT <32%
pH <7.25
Disseminated Intravascular Coagulation (DIC)
Abnormal coagulation
Continuous bleeding
Lethal Triad
Hypothermia
Acidosis
Coagulopathy
(Calcium now as well for lethal diamond”
TXA
Prevents plasmin from stabilizing the fibrin matrix
Must be given within 3 hours of injury
pH of Fluids
NSS (pH 5.5)
Lactated ringers (pH 6.5)
Ratio for blood products
1:1:1 ratio of PRBC:Plasma:platelets
Permissive hypotension
SBP minimum goal: 90-100 mmHg
-110 mmHg if associated CNS involvement
Transfusion reactions
Hemolytic
Fever, chills, flank pain
Febrile
Non-hemolytic
Managed with acetaminophen
TACO
Circulatory overload
TRALI
Acute lung injury, similar to ARDS
Aortic injury chest x-ray finding
*Widened mediastinum
Enlarged aortic knob
Treatment for Aortic injury
Anti-impulse
60-70 Bpm
SBP less than 100 mmHg