Trauma Flashcards

1
Q

What is the leading cause of death in the first 4 decades?

A

trauma injury

50% of all deaths between 5-34

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2
Q

what percentage of trauma related deaths are immediate?

A

50%

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3
Q

what are the ABCDE of trauma evaluation?

A
A = airway
B = breathing
C = circulation
D = disability
E = exposure
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4
Q

what is the assumed induction plan for a trauma patient?

A

RSI !!!

C-spine precautions for every pt until cleared

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5
Q

In the event of a PTX what is one thing you should never give?

A

N2O

will exacerbate it

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6
Q

define tension PTX

A

progressive build up of air in the pleural space due to lung laceration which causes a one way valve for air flow into pleural space

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7
Q

what is the main role of anesthesia in the OR for trauma?

A

management of shock!

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8
Q

define shock

A

circulatory failure leading to inadequate organ perfusion and oxygen delivery

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9
Q

what are the symptoms of shock?

A
pallor
diaphoresis
agitation
hypotension
tachycardia
diminished urine output
narrow pulse pressure
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10
Q

what are the 4 main types of shock?

A

hypovolemic (blood loss)
cardiogenic (pump failure/dysrhythmias)
obstructive (PTX/tamponade/PE)
distributive (septic/neurogenic)

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11
Q

a glascow coma score of ___ usually requires intubation

A

<8

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12
Q

What is an ISS?

A

Injury Severity Score

  • muti-injury scoring system
  • assigns a score to six regions of body
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13
Q

What is FAST?

A

Focused Assessment by Sonography in Trauma

+ result means there’s blood somewhere there shouldn’t be

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14
Q

TBI short for ____ ______ _____ are responsible for _____% of trauma deaths

A

Traumatic Brain Injury

50%

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15
Q

what is the cushing triad?

A

Hypertension
Bradycardia
Respiratory disturbance

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16
Q

what is a normal CPP value? and how is it calculated?

A

80-100mmHg

CPP = MAP - ICP

17
Q

what induction drug can you not give 48hrs post-trauma?

18
Q

what is cardiac tamponade? and how can it be diagnosed?

A

collection of fluid/blood in pericardial sac
Beck’s triad = JVD, hypotension, muffled heart tones
TEE or + FAST

19
Q

What is the motto for Cardiac Tamponade treatment?

A

“Tight, light, fast, full”

  • Tight vessels
  • Light anesthesia
  • Fast HR
  • Full of fluids
20
Q

What is the induction agent of choice for cardiac tamponade?

21
Q

what are the most common abdominal trauma seen in OR?

A

Spleen and Liver lacerations

22
Q

GSW require what type of procedure?

A

laparotomy…unknown bullet path

23
Q

what is an important consideration for pelvic and femur fx?

A

hypovolemic shock

high occurance of sepsis

24
Q

what is compartment syndrome and when is immediate surgical intervention needed?

A

swelling within a compartment of an extremity that causes decreased perfusion and nerve damage due to pressure build up
-30mmHg req. fasciotomy

25
What is the induction agent of choice for the unstable trauma patient?.....if they are hemodynamically unstable?
etomidate | ketamine (no brain injuries)
26
why can propofol be dangerous for a pt in shock?
drop in SVR could cause cv collapse
27
what are the main fluid resuscitation goals for the trauma patient?
1. maintain circulating volume 2. restore oxygen carrying capacity 3. correction of coagulopathy
28
PRBC universal donor?
O neg
29
what qualifies as a massive transfusion?
- one blood volume loss in 24 hrs (5-7L) - 4 or more PRBC in 1 hr - 50% blood volume loss in 3 hrs
30
What is an important consideration when administering fluids to a trauma pt?
warm them!
31
what is a main concern/complication from transfusions?
dilutional coagulopathy
32
citrate intoxication causes a serious decrease in what ion?
Calcium
33
after admistering several units of PRBC, you can expect what of the K+ levels?
increase
34
Why is temperature management so important?
<34*C severely inhibits enzymatic reactions of coagulation cascade
35
What is TIC? and how can it be combatted?
Trauma induced Coagulopathy give FFP (warmed) give cryo give platelets