Flashcards in Acute Care Deck (13)
If a child has a TBI and is initially alert, but then deteriorates, what do you suspect?
What is a major cause of morbidity/mortality post-TBI?
disruption of autoregulatory mechanisms of the brain, resulting in inability to tolerate hypotension and ischemia
signs of increased ICP
headache, decreased LOC, cushing's triad (hypertension, bradycardia and irregular respirations), 6th or 3rd nerve palsy (eye down and out, dilated pupil)
what is a chance fracture?
lap belt # of upper lumbar spine, often due to wearing lapbelt in MVC. high association with intrabdominal injuries.
how do you manage a TCA overdose?
sodium bicarbonate, bolus 1-2 mEq/kg followed by continuous infusion IV
what would concern you during a TCA overdose?
QRS widening (>100ms), hemodynamic instability
management of increased ICP
- elevated head of bed to 30 degrees
- mannitol or hypertonic saline
indications for CT imaging in TBI
LOC > 5 mins, dizziness, mental status changes, seizures, neurologic defects, skull fractor, drug or EtOH use, age < 2 yrs
best inotrope for cold shock
best inotrope for warm shock
apnea test requirements
CO2 increase by 20 mmHg, AND above 60 mmHg AND pH <= 7.28
pCO2 affected by
minute ventilation = rate x tidal volume