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Flashcards in Surgical Critical Care Deck (71)
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1

examples of conditions that need surgical critical care

trauma
burns
severe pancreatitis
rupture aneurysms
cholangitis

2

what are some post op complications that can cause someone to be in the surgical ICU

renal failure
PE
myocardial infarction
sepsis

3

evaluation of the critically ill or injured patient

ABC
obtain history (AMPLE)
rapid primary survey and tx or correct problems
perform a secondary survey

4

what are some resuscitation fluids

crystalloid (NS, LC)
colloids (Hespan, Albumin)
blood products

5

typically into radial artery, get pulse by pulse BPs, can draw ABGs right from it

Arterial pressure monitoring

6

Measures cardiac output, mixed venous oxygen saturation, systemic venous resistance and most importantly, pulmonary artery diastolic pressure (PADP) and PAWP

Pulmonary Artery catheter

7

what are the pressures from teh pulmonary artery catheter used to estimate?

Left ventricular filling pressure and help guide fluid and vasoactive drug administration

8

Acute circulatory failure with inadequate or inappropriately distributed tissue perfusion resulting in inflammation which leads to generalized cellular hypoxia

Shock

9

caused by a problem with heart rate or stroke volume

low cardiac output

10

caused by a problem with heart rate or stroke volume

low blood pressure

11

hypovolemia with direct soft tissue injury and bone fractures

traumatic shock

12

compression of the heart or great veins

compressive cardiogenic shock

13

loss of autonomic control of the vasculature

neurogenic shock

14

intravascular volume depletion through hemorrhage or loss of plasma volume (3rd spacing, burns or GI losses)

Hypovolemic shocks

15

tx for hypovolemic shock

replace fluids
2-3 L crystalloid over 10-30 minutes
blood products if needed
stop volume loss

16

over what percent blood volume loss does your HR increase

15%

17

when does the BP start to drop with hemorrhagic shock

30-40%
(1500-2000 mL)

18

is BP reliable for blood loss?

No

19

what is the most reliable thing for blood loss

urine output (decrease)

20

tx for traumatic shock

volume and pressors

21

type of shock caused by Failure of the heart as an effective pump

intrinsic cardiogenic shock

22

causes of intrinsic cardiogenic shock

MI or arrhythmias are the most common

23

how do you tx cardiogenic shock

treat MI or underyling disorder
judicial use of fluids
ionotropes

24

signs of cardiogenic shock

edema- LE
crackles/ rales
JVD

25

compressive causes of cardiogenic shock

pericardial tamponade
tension pneumothorax (PTX)
mediastinal hematoma
positive pressure from mechanical ventilation

26

Causes of a tension PTX

known trauma or central line, cardiac cath vs. spontaneous

27

tx for Tension PTX

needle compression and tube thoracostomy

28

Tx for pericardial tamponade

pericardicentesis

29

beck's triad

JVD
muffled heart sounds
pulsus paradoxus/ HPOTN

30

type of shock with ↓ CVP, ↓ SVR), ↑ CO, , fever, tachypnea, tachycardia, HPOTN, end-organ dysfunction

Septic shock - hyper dynamic "warm"