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Flashcards in Acute Care Deck (13)
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1

If a child has a TBI and is initially alert, but then deteriorates, what do you suspect?

epidural hematoma

2

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

3

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)

4

what is a chance fracture?

lap belt # of upper lumbar spine, often due to wearing lapbelt in MVC. high association with intrabdominal injuries.

5

how do you manage a TCA overdose?

sodium bicarbonate, bolus 1-2 mEq/kg followed by continuous infusion IV

6

what would concern you during a TCA overdose?

QRS widening (>100ms), hemodynamic instability

7

management of increased ICP

- elevated head of bed to 30 degrees
- hyperventilation
- mannitol or hypertonic saline

8

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

9

best inotrope for cold shock

dopamine, epinephrine

10

best inotrope for warm shock

norepinephrine

11

apnea test requirements

CO2 increase by 20 mmHg, AND above 60 mmHg AND pH <= 7.28

12

pCO2 affected by

minute ventilation = rate x tidal volume

13

pO2 affected by

mean airway pressure and FiO2