Chapters 1-3 Flashcards
(79 cards)
1
Q
GCS
A
8
2
Q
flail chest is accompanied by what?
A
pulmonary contusion
3
Q
HYPOTN is caused by ____ until proven otherwise
A
hypovolemia
4
Q
what should crystalloid be heated to?
A
29 celcius
5
Q
5 signs of urethral injury
A
blood at urethral meatus perineal ecchymosis blood in sctorum high riding prostate pelvic fracture
6
Q
2 limitations for a FAST exam
A
obesity
intraluminal bowel gas
7
Q
AMPLE history
A
allergies meds PMH/ pregancy alst meal event/ environment
8
Q
minimum UOP for adults
A
0.5 mL/kg/hour
9
Q
minimum UOP for kids
A
1.0 ml?kg/Hour
10
Q
when will a bougie deviate R or L
A
at 40 cm
11
Q
RSI dose for etomidate
A
0-3 mg/kg (usually 20 mg)
12
Q
RSI for succinchycholine
A
1-2 mg/kg (usually 100 mg)
13
Q
how will ketamine affect BP
A
increase
14
Q
how does etomidate affect BP
A
it doesn’t
15
Q
how will propofol and thiopental affect BP
A
they will drop it
16
Q
RSI dose of succinylcholine lasts for how long
A
about 5 minutes
17
Q
why do you not give sux for burn patients, crush injuries, hyperkalemia, chronic NM disease
A
risk for hyperkalemia
18
Q
size needle for needle cric in adults? kids?
A
adults 12-14 gauge kids 16-18 gauge
19
Q
surgical cric is not recommended under what age?
A
12
20
Q
things to try before a surgical airway
A
chin lift, jaw thrust , OPANPA, LMA
21
Q
what airway maneuver can you not do while maintaining c-spine precuations
A
jaw thrust
22
Q
OPA size
A
corner of patient’s mouth to external auditory canal
23
Q
LMA size for kid? women? man?
A
3,4,5
24
Q
ET size for infant
A
size of nostril or little finger
3 for infants 3.5 for neonates
25
ET tube size for emergency cricothyroidotomy
5 or 6
26
how to calculate ET tube size for toddlers and kids
age/4 + 4= internal diameter
27
how much percentage of blood is located in the venous circulation
70
28
should vasopressors be used for hemorrhagic shock?
No, they will worsen it, only use volume replacement
29
SBP will drop once ___% is lost
30%
30
tachycardia for infants/ toddlers
>160 (infants)
>140 for preschool
>120 prepubescent
>100 adults
31
the blood loss of an obese person is based on what?
their ideal weight
32
class I hemorrhage
up to 15%
| 500 mL= ~10%
33
how do you treat class I hemorrhage?
you don't usually. blood volume restored within 24 hours
34
blood volume loss with class II hemorrhage
15-30 % (750-1500 mL in a 70 kg adult)
35
Tx for class II hemorrhage
crystalloid
36
what CNS changes will you see with Class II hemorrhage
anxiety, fright, hostility
37
blood loss with Class III hemorrhage
30-40% (2000 mL)
38
loss of >___ % of blood leads to LOC
50%
39
blood loss with class IV hemorrhage
>40%
40
what class hemorrhage is associated with a drop in SBP
Class III and >
41
Up to how much blood is lost with a femur fx
1500 mL
42
unexplained HPOTN/ dysrhythmias are often caused by what in children
gastric distention
43
blood on the floor x four more (what are the 4)
chest
pelvis
retroperitoneum
thigh
44
rapid responders to fluid resuscitation typically have what type hemorrhage
class I or II
45
transient responders are associated with what class of hemorrhage
II or III
46
do most patients receiving blood transfusions need calcium replacement
no
47
where do you make the incision for a saphenous vein cutdown and low long should the incision be?
1 cm anterior and 1 cm superior to the medial malleolus
| make a 2.5cm transverse incision though skin and SQ
48
how to tell difference b/w hemothorax and pneumo
pneumo will be hyperresonant with percussion hemo will be dull
49
mass hemothorax
1500 mL or 1/3 or more of patient's total blood loss
| continuous blood loss of 200 mL/ hour for 2-4 hours
50
common chest tube size
#38 French
51
where is a chest tube inserted
4th or 5th intercostal space just anterior to mid axillary line
52
who can get an ED thoracotomy
PEA with penetrating thoracic injuries (not with blunt!)
53
why should any hemothorax be drained
it can lead to lung entrapment or empyema
54
a pneumothorax with persistent large air leak after tube thoracostomy suggest a ____ injury
tracheobronchial
55
fracture of ribs 10-12 could cause an injury to what
lower ribs 10-12
56
4 places for FAST exam
mediastinum
hepatorenal fossa
splenorenal fossa
pouch od Douglas
57
only absolute c/i for DPL
pre exiisting condition requiring laparotomy
58
relative DPL contraindications
morbid obesity, acirrhosis, coagulopathy, previous abdominal surgery (adhesions)
59
2 reasons to use a supraumbilical approach for DPL
pelvic fractures and advanced pregnancy
60
DPL that indicates need for laparotomy (initial, not lab)
free blood (>10 mL) or GI contents
61
if DPL is not positive initially what do you do
Add 1,000 mL of warm isotonic crystalloid (or 10 mL/ kg) for kid
62
lab findings from DPL fluid that indicate need for laparotomy
>100,000 red cells, 500 whit ecells or bacteria (on gram stain)
63
inidications for peritoneal laparotomy with penetrating wounds
unstable, GSW
64
what type of pelvic fractures are more common?
closed book
65
2 things to decompress before DPL
bladder adn stomach
66
adequate fluid return when getting DPL fluid back
30%
67
normal ICP in resting state
10 mm Hg
68
why might you hyperventilate people w/ brain injuries
high levels of CO@ cause cerebral vasculature to dilate
69
a midline shift great than what indicates need for neurosurgery
5 mm
70
mannitol dose
0.25-1.0g/kg via rapid bolus
71
when should a cast cutter be used to remove a trauma victim's helmet
patient experience pain or paresthesias during inital attempt to remove helment of evidence of c-spien injury
72
most common type of C1 fracture
Jefferson (burst fracture)
73
any patient with more than __% of body burned should receive fluid resus.
20%
74
difference between partial and full thickness burns
full thickness burns go through dermis and into/beyond subQ
75
parkland formula (burns)
4*(wegiht in kg)*percentage BSA burned= volume in 24 hours (1st 1/2 in 8 hours 2nd over 16)
76
partial or full thickness burns of __% warrant transfer to a burn center (age
10%
77
partial or full thickness burns of a patient over 10 necessitate transfer to a burn center
20%
78
Tx for frostbite
soat water in 40 degree C water for 20-30 minutes.
79
how to estimate a child's total circulating volume
80 mL/kg
