Haemorrhage and shock Flashcards
(36 cards)
Q: What is the definition of shock?
A: A physiological state characterized by a systemic reduction in tissue perfusion, leading to decreased oxygen delivery to tissues.
What is Homeostasis?
‘the body’s maintenance of a
relatively constant internal environment in the face
of an ever-changing external environment’.
* Regulation of this constant environment occurs
through ‘feedback loops’ in the body.
* If the level of a regulated variable deviates from the
‘set point’, the feedback loop will cause an error
signal (negative feedback) to be sent to the effector
organ, which will generate a corrective response.
* Set point → receptors → control centre → error
signal → effector organ
* If any part of the feedback loop is damaged or
missing, a loss of homeostasis may occur.
Q: What are the 3 stages of shock?
A: Compensated, Decompensated, and Irreversible shock.
Q: What are the classic signs of compensated shock?
A: Mild confusion, tachycardia, pale/cool skin, and increased respiratory rate.
Q: What is the ‘triad of death’ in trauma?
A: Hypothermia, acidosis, and coagulopathy.
Q: What is the primary goal in managing haemorrhagic shock?
A: Stop the bleeding, support oxygen delivery, and prevent/treat the lethal triad.
Q: When should a tourniquet be used?
A: For significant limb haemorrhage not controlled by direct pressure.
Q: What is the first-line intervention for external bleeding?
A: Direct pressure.
Q: When are haemostatic agents indicated?
A: For junctional wounds where tourniquets can’t be applied.
Q: What’s the purpose of wound packing?
A: To control bleeding from deep wounds, especially junctional injuries.
Q: What fluid is preferred if blood products aren’t available?
A: Compound Sodium Lactate (Hartmann’s).
Q: What is permissive hypotension?
A: Maintaining a lower SBP (~70 mmHg) to avoid “popping the clot” in trauma without TBI.
Q: What is the target SBP in suspected TBI?
A: 100–120 mmHg.
Q: What complications are associated with excessive fluid resuscitation?
A: Dilutional coagulopathy, anaemia, hypothermia, and acidosis.
Q: What are the typical fluid boluses for adults and children?
A: Adults: 250 mL boluses; Children: 10 mL/kg.
Q: What is the effect of hypocalcaemia in trauma patients?
A: It worsens coagulopathy.
Q: What is TXA used for in trauma?
A: To reduce the need for transfusion and control bleeding—especially if used early.
: What are the ideal fluids in trauma resuscitation?
A: Whole blood > PRBC + FFP + platelets > Crystalloids (if blood unavailable).
Q: Why are colloids avoided in TBI?
A: They are associated with worsened outcomes including coagulopathy and renal dysfunction.
Q: In trauma, which patient takes priority—mother or fetus?
A: Always treat the mother first.
Q: What is the “4-minute rule” for perimortem caesarean?
A: Deliver fetus by 5 minutes if no ROSC after 4 minutes of maternal CPR.
Q: What position should pregnant trauma patients be placed in?
A: Tilted to the left (or lateral) to avoid aortocaval compression.
Q: What trauma can result in fetal death during pregnancy?
A: Placental abruption, uterine rupture, and maternal shock or death.
