Quiz 5

Question 1

5 CRITERIA FOR POTENTIAL CERVICAL SPINE INJURY

Answer 1

1) neck pain
2) severe distracting pain
3) any neurological signs and symptoms
4) intoxication
5) loss of consciousness at the scene

Question 2

To intubate a patient with a cervical spine injury the best way is

Answer 2

Manual inline stabilization (MILS)

Question 3

Avoid in trauma patients with a pneumothorax, pneumocephalus, or pneumoperitoneum.

Answer 3

N2O

Question 4

____________ can increase serum potassium levels if administered 24 hours after a burn, spinal cord or crush injury

Answer 4

Succinylcholine

Question 5

Postop after massive transfusions patients get _______________

Answer 5

metabolic alkalosis

Question 6

If transfusion rate exceeds 1 unit every 5 minutes you can see cardiac depression caused by

Answer 6

hypocalcemia

Question 7

In an anesthetized patient-hemolytic reactions are recognized by (5)

Answer 7

• increased temp
• tachycardia
• hypotension
• hemoglobinuria
• oozing at the field

Question 8

Hypothermia worsens and causes?

Answer 8

• acid/base balance
• Coagulopathies – platelet sequestration and red blood cell deformities
• Risking myocardial function

Question 9

Common cause of bleeding after massive transfusions is

Answer 9

dilutional thrombocytopenia

Question 10

Crystalloids- half life of ?

Colloids half life of ?

Answer 10

20 – 30 minutes

3 – 6 hours

Question 11

Dextrose solutions are ___________ in trauma, r/t it may exacerbate ischemic brain damage

Answer 11

contra-indicated

Question 12

With blood products, Factor VIII can decrease by ____ after ___ days in storage

Answer 12

50%

two

Question 13

Alveolar concentration is _________ in shock patients r/t a _______ in C.O. and increased ventilation.
Smaller intravascular volume so the intravenous anesthetics are _________.

Answer 13

increased

decrease

exaggerated

Question 14

Induction agents for trauma, which one not so great and why?

Answer 14

• Etomidate

- Ketamine - can increase ICP

Question 15

Any trauma patient with an altered consciousness —consider a? Other signs?

Answer 15

brain injury

• Restlessness
• Convulsions
• Cranial nerve dysfunction (non reactive pupils)

Question 16

Cushings triad

Answer 16

• Hypertension
• Bradycardia
• Respiratory disturbances

The Triad are late signs and is preceded by brain herniation

Question 17

Brain injury consideration: Anticholinergic meds-induces ____________ (robinol, spiriva, atrovent)

Answer 17

pupillary dilation

Question 18

First thing that signals cardiac tamponade? Avoid what?

Answer 18

Distended neck veins

AVOID PROPOFOL - can kill

Question 19

Pulsus paradoxus

Answer 19

> 10mmHg decline on BP during spontaneous ventilation diagnoses tamponade

Question 20

Abdominal trauma, what typically happens when they open the belly?

Answer 20

HYPOTENSION

Question 21

Femur fracture can mean __ units of blood loss

Answer 21

3

also risk of fat emboli with fractures

Question 22

Fat emboli labs

Answer 22

• Elevation of serum lipase
• Fat in urine
• thrombocytopenia

Question 23

which Lafort fractures do you never do nasal intubation/NG tubes?

Answer 23

II and III

Question 24

Look at slide 29

Answer 24

.

Question 25

Intracranial hypertension is controlled by

Answer 25

- fluid restrictions - diuretics (mannitol) - hypocapnia (paCO2 26-30 mmHg)

Question 26

Hypertension or tachycardia can be treated during intubation with ?

Answer 26

lidocaine and/or fentanyl

Question 27

Mild _________ can assist saving brain tissue in a head injury

Answer 27

hypothermia

Question 28

respiratory spinal levels? Cardiac Spinal levels?

Answer 28

C3,4,5 T1,2,3,4

Question 29

High cord injury

Answer 29

- hypotension - warm to the touch (Legs feel febrile) - bradycardia - areflexia - GI atony

Question 30

Autonomic hyperreflexia

Answer 30

(not associated in first 48h) - high blood pressure - change in heart rate - skin color changes (paleness, redness, blue-grey skin color) - excessive sweating

Question 31

Tension Pneumo. treatment?

Answer 31

-air in pleural space trapped and increases with inspiration and not escape with expiration—see the tracheal shift 14 gauge needle at second intercostal space at midclavicular line then a chest tube like for a simple pneumo

Question 32

Risk of simple pneumo turning into tension pneumo from?

Answer 32

with positive pressure (bagging or Ventilator)

Question 33

Hemothorax treatment

Answer 33

-DLT to isolate bleeding lung from healthy lung

Question 34

Causes of ARDS

Answer 34

- Sepsis - Thoracic injury - Aspiration - Head injury - Fat emboli - Massive transfusion

Question 35

ARDS requires what on ventilator?

Answer 35

high airway pressures, will make vent alarm