Major Trauma (Adult) Flashcards
(23 cards)
Recite the Major Trauma CPG
Part 1
Recite the Major Trauma CPG
Part 2
Recite the Major Trauma CPG
Part 3
What should be addressed before any airway or breathing interventions in trauma patients?
Major haemorrhage control.
When should an NPA be used for airway management?
Only if the airway is not patent and the patient tolerates it.
What is the backup airway technique if NPA/OPA fails and gag reflex is absent?
Insert an SGA (Supraglottic Airway).
When is RSI indicated in trauma?
If required, as per CPG A0302 Endotracheal Intubation.
What ventilation targets should be aimed for?
Vt: 6–8 mL/kg, RR: 12–16 (adjust to target ETCO₂), SpO₂: >94%, ETCO₂: 30–35 mmHg.
When should chest decompression be considered?
As per CPG A0802 Chest Injury, if indicated.
What is the first-line fluid resuscitation for trauma without TBI?
Target SBP 70–90 mmHg, Use normal saline 250 mL IV as required (max 2 L), PRBC preferred if available.
What is the fluid target for trauma with TBI?
SBP > 120 mmHg.
When should a pelvic splint be applied?
For blunt trauma to the pelvis or in all unconscious multi-trauma patients.
What is the second-line agent for inadequate response to fluids and PRBC?
Metaraminol 0.5–1 mg IV every 2 minutes.
What is the third-line treatment for haemorrhagic shock?
Noradrenaline infusion: Start: 5 mcg/min, Increase: 5 mcg/min at 2 min intervals, Max: 25 mcg/min.
When is adrenaline infusion considered (fourth-line)?
If max dose noradrenaline is ineffective.
Adrenaline infusion dosing for shock?
Start: 5 mcg/min, Increase: 5 mcg/min every 2 minutes, Max: 25 mcg/min.
What general supportive care measures should be undertaken in trauma?
Warm the patient, Pain relief, Spinal immobilisation if required, Manage wounds/fractures, Manage seizures (CPG A0703), Treat hypoglycaemia (CPG A0702), Pressure care.
When is TXA indicated in trauma?
Severe injury with SBP < 90 mmHg OR COAST score ≥ 3 OR < 2 hours since injury.
What is the dose of TXA?
1 gram IV over 10 minutes or IM.
When should calcium be administered in trauma?
After 4 units PRBC or if iCa < 1.12 mmol/L.
What is the dose of calcium?
Calcium Gluconate 4.4 mmol (2 g) IV. Repeat 2.2–4.4 mmol (1–2 g) if iCa still < 1.12 mmol/L.
When is Sodium Chloride 3% indicated?
Intubated neurotrauma, Signs of deterioration (e.g. dilated pupils), HEMS transport > 20 minutes.
What is the dose of hypertonic saline in neurotrauma?
Sodium Chloride 3% 250 mL IV (MFP only).
