RDCR Flashcards
What is damage control resuscitation?
Life saving interventions only
When do we use damage control resuscitation?
- Severe bleeding (shock)
- Severe multiple trauma
- Suvivable brain injury 4.Contamination (bowel, debris)
What are the components of damage control resuscitation?
- Permissive hypotension
- Whole blood
- TXA
- Avoid acidosis/hypothermia
- Stop the bleeding
- Stop contamination
What is the benefit from permissive hypotension?
We limit the risk of rebleeding
What should you constantly monitor during permissive hypotension?
- LOC
- Respiration rate
- Radial, femoral or carotid pulse
- Heart rate
- Blood pressure
- Lactate
- (Diuresis)
What is an acceptable BP for a casualty in shock who can be evacuated to definitive care within short time
Around 80 systolic
What is the preferred BP for a casualty in shock whom you attend to for a longer period before evacuation?
100-110 systolic
What does the citrate in the blood products do?
Binds calcium causing hypocalcemia
What blood product is most effective in providing coagulation factors?
Whole blood
What is a normal lactate level for a healthy person at rest?
Around 2mmol/ml
Name some bad things about clear fluid and resuscitation?
- No O2 carrying capacity
- Only 30% stays in vessels
- Causes damage to endothelium and therefor occupies coagulationfactors
- Dilutes coagulation factors
What do we need blood for?
- Carry O2 (RBC)
- Immune response (WBC)
- Clotting (Platelets + clotting factors)
- pH buffer
- Hormones transport
- Nutrients transport
- Water
- Proteins
What is the biggest player in oxygendelivery?
Cardiac output
DO2=1,34 x Hgb x SaO2 x CO
What is primary hemostasis?
- Activation of platelets
- Vasoconstriction
What is secondary homeostasis?
- Activation of coagulation factors cascade (calcium is needed in every step)
