Trauma Overview and Statistics Flashcards
presentation by ms. daniel that had a lot of the same stuff from shore's slides.
What are the three “BIG” questions when it comes to trauma anesthesia?
awake / unconscious
stable / unstable
emergent / urgent
How is anesthesia different in a trauma? (5)
- many unknowns
- multiple injuries and mechanism of injuries
- do not know if patient is in optimal health
- often have no patient history
- decreased preparation and evaluation time
(remember: damage control surgery is a quick procedure, as opposed to definitive surgery)
If you have time to ask, the patient is awake, or there is a family member present, what questions should you ask? (5)
- allergies
- medications
- anesthetic history
- significant medical history
- NPO status
What information should you get from the first responders / emergency department? (7)
- access
- blood products given / available
- antibiotics given
- allergies
- pts ventilation status
- pts circulatory status
- pts mental status
In a trauma, you want to intubate early in these situations. (7)
- apneic
- poor ventilation or oxygenation
- decreased or changing mentation
- developing airway obstruction (stridor, snoring)
- airway burns (soot in nares, singed hair)
- shock
- combativeness (a sign of hypoxia)
If the ETCO2 is low, what are some differential diagnoses? (4… just to name a few)
- shock
- low cardiac output
- PE
- venous air embolus
When you are getting ready to induce your trauma patient, which is more important, the drug you choose or the dose of a given drug?
the dose that is given is more important than which drug you pick
Can you deliver oxygen without hemoglobin?
nope. well, not yet anyway.
PRBCs are concentrated to a Hct of about ___%.
75
Storing PRBCs (just above freezing) up to 42 days _______ the 2,3-DPG and _____ the platelets and neurtophils.
decreases
ruins
A unit of whole blood or packed red cells will raise the Hct by ___% and the Hgb by ___ gm/dL.
3%
1 gm/dL
FFP is used in bleeding patients with multiple coagulation factor deficiencies secondary to things such as? (3)
- liver disease
- disseminated intravascular coagulation (DIC)
- dilutional coagulopathy resulting from massive blood or volume replacement
Four to eight packs of FFP in a 70-kg adult for each blood volume lost should be given over ___–___ min to achieve a minimum of ___% of plasma factor concentration.
90-120 minutes
30%
One random unit of platelets will raise the platelet count in an adult by _____-_____/cumm
5,000-8,000
In children, ___-___ units/kg will increase the platelet count by _____-_____/cumm
0.1-0.2 units/kg
30,000-50,000
(The expected increase will be less if the patient has sepsis, splenomegaly, platelet auto- or allo- antibodies or is receiving chemotherapy)
