Trauma

Question 2

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

Answer 2

trauma injury50% of all deaths between 5-34

Question 3

what percentage of trauma related deaths are immediate?

Answer 3

50%

Question 4

what are the ABCDE of trauma evaluation?

Answer 4

A = airwayB = breathingC = circulationD = disabilityE = exposure

Question 5

what is the assumed induction plan for a trauma patient?

Answer 5

RSI !!!C-spine precautions for every pt until cleared

Question 6

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

Answer 6

N2O will exacerbate it

Question 7

define tension PTX

Answer 7

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

Question 8

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

Answer 8

management of shock!

Question 9

define shock

Answer 9

circulatory failure leading to inadequate organ perfusion and oxygen delivery

Question 10

what are the symptoms of shock?

Answer 10

pallordiaphoresisagitationhypotensiontachycardiadiminished urine outputnarrow pulse pressure

Question 11

what are the 4 main types of shock?

Answer 11

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

Question 12

a glascow coma score of ___ usually requires intubation

Answer 12

<8

Question 13

What is an ISS?

Answer 13

Injury Severity Score-muti-injury scoring system-assigns a score to six regions of body

Question 14

What is FAST?

Answer 14

Focused Assessment by Sonography in Trauma (+ result means there’s blood somewhere there shouldn’t be)

Question 15

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

Answer 15

Traumatic Brain Injury50%

Question 16

what is the cushing triad?

Answer 16

HypotensionBradycardiaRespiratory disturbance

Question 17

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

Answer 17

80-100mmHgCPP = MAP - ICP

Question 18

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

Answer 18

sux

Question 19

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

Answer 19

collection of fluid/blood in pericardial sacBeck’s triad = JVD, hypotension, muffled heart tonesTEE or + FAST

Question 20

What is the motto for Cardiac Tamponade treatment?

Answer 20

“Tight, light, fast, full”-Tight vessels-Light anesthesia-Fast HR-Full of fluids

Question 21

What is the induction agent of choice for cardiac tamponade?

Answer 21

ketamine

Question 22

what are the most common abdominal trauma seen in OR?

Answer 22

Spleen and Liver lacerations

Question 23

GSW require what type of procedure?

Answer 23

laparotomy…unknown bullet path

Question 24

what is an important consideration for pelvic and femur fx?

Answer 24

hypovolemic shockhigh occurance of sepsis

Question 25

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

Answer 25

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

Question 26

What is the induction agent of choice for the unstable trauma patient?.....if they are hemodynamically unstable?

Answer 26

etomidateketamine (no brain injuries)

Question 27

why can propofol be dangerous for a pt in shock?

Answer 27

drop in SVR could cause cv collapse

Question 28

what are the main fluid resuscitation goals for the trauma patient?

Answer 28

1. maintain circulating volume2. restore oxygen carrying capacity3. correction of coagulopathy

Question 29

PRBC universal donor?

Answer 29

O neg

Question 30

what qualifies as a massive transfusion?

Answer 30

-one blood volume loss in 24 hrs (5-7L)-4 or more PRBC in 1 hr-50% blood volume loss in 3 hrs

Question 31

What is an important consideration when administering fluids to a trauma pt?

Answer 31

warm them!

Question 32

what is a main concern/complication from transfusions?

Answer 32

dilutional coagulopathy

Question 33

citrate intoxication causes a serious decrease in what ion?

Answer 33

Calcium

Question 34

after admistering several units of PRBC, you can expect what of the K+ levels?

Answer 34

increase

Question 35

Why is temperature management so important?

Answer 35

\<34\*C severely inhibits enzymatic reactions of coagulation cascade

Question 36

What is TIC? and how can it be combatted?

Answer 36

Trauma induced Coagulopathygive FFP (warmed)give cryogive platelets