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AP II > Trauma > Flashcards

Trauma Flashcards

1
Q

What is the leading cause of death in the first 4 decades?

A

trauma injury

50% of all deaths between 5-34

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2
Q

what percentage of trauma related deaths are immediate?

A

50%

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3
Q

what are the ABCDE of trauma evaluation?

A 
A = airway
B = breathing
C = circulation
D = disability
E = exposure
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4
Q

what is the assumed induction plan for a trauma patient?

A

RSI !!!

C-spine precautions for every pt until cleared

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5
Q

In the event of a PTX what is one thing you should never give?

A

N2O

will exacerbate it

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6
Q

define tension PTX

A

progressive build up of air in the pleural space due to lung laceration which causes a one way valve for air flow into pleural space

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7
Q

what is the main role of anesthesia in the OR for trauma?

A

management of shock!

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8
Q

define shock

A

circulatory failure leading to inadequate organ perfusion and oxygen delivery

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9
Q

what are the symptoms of shock?

A 
pallor
diaphoresis
agitation
hypotension
tachycardia
diminished urine output
narrow pulse pressure
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10
Q

what are the 4 main types of shock?

A

hypovolemic (blood loss)
cardiogenic (pump failure/dysrhythmias)
obstructive (PTX/tamponade/PE)
distributive (septic/neurogenic)

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11
Q

a glascow coma score of ___ usually requires intubation

A

<8

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12
Q

What is an ISS?

A

Injury Severity Score

  • muti-injury scoring system
  • assigns a score to six regions of body
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13
Q

What is FAST?

A

Focused Assessment by Sonography in Trauma

+ result means there’s blood somewhere there shouldn’t be

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14
Q

TBI short for ____ ______ _____ are responsible for _____% of trauma deaths

A

Traumatic Brain Injury

50%

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15
Q

what is the cushing triad?

A

Hypertension
Bradycardia
Respiratory disturbance

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16
Q

what is a normal CPP value? and how is it calculated?

A

80-100mmHg

CPP = MAP - ICP

17
Q

what induction drug can you not give 48hrs post-trauma?

A

sux

18
Q

what is cardiac tamponade? and how can it be diagnosed?

A

collection of fluid/blood in pericardial sac
Beck’s triad = JVD, hypotension, muffled heart tones
TEE or + FAST

19
Q

What is the motto for Cardiac Tamponade treatment?

A

“Tight, light, fast, full”

  • Tight vessels
  • Light anesthesia
  • Fast HR
  • Full of fluids
20
Q

What is the induction agent of choice for cardiac tamponade?

A

ketamine

21
Q

what are the most common abdominal trauma seen in OR?

A

Spleen and Liver lacerations

22
Q

GSW require what type of procedure?

A

laparotomy…unknown bullet path

23
Q

what is an important consideration for pelvic and femur fx?

A

hypovolemic shock

high occurance of sepsis

24
Q

what is compartment syndrome and when is immediate surgical intervention needed?

A

swelling within a compartment of an extremity that causes decreased perfusion and nerve damage due to pressure build up
-30mmHg req. fasciotomy

25
Q

What is the induction agent of choice for the unstable trauma patient?…..if they are hemodynamically unstable?

A

etomidate

ketamine (no brain injuries)

26
Q

why can propofol be dangerous for a pt in shock?

A

drop in SVR could cause cv collapse

27
Q

what are the main fluid resuscitation goals for the trauma patient?

A
  1. maintain circulating volume
  2. restore oxygen carrying capacity
  3. correction of coagulopathy
28
Q

PRBC universal donor?

A

O neg

29
Q

what qualifies as a massive transfusion?

A
  • one blood volume loss in 24 hrs (5-7L)
  • 4 or more PRBC in 1 hr
  • 50% blood volume loss in 3 hrs
30
Q

What is an important consideration when administering fluids to a trauma pt?

A

warm them!

31
Q

what is a main concern/complication from transfusions?

A

dilutional coagulopathy

32
Q

citrate intoxication causes a serious decrease in what ion?

A

Calcium

33
Q

after admistering several units of PRBC, you can expect what of the K+ levels?

A

increase

34
Q

Why is temperature management so important?

A

<34*C severely inhibits enzymatic reactions of coagulation cascade

35
Q

What is TIC? and how can it be combatted?

A

Trauma induced Coagulopathy
give FFP (warmed)
give cryo
give platelets

AP II (32 decks)

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