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7364 Critical Care Block 1 > Trauma Related Infections > Flashcards

Trauma Related Infections Flashcards

1
Q

Gustilo Classification System for Fractures:

Which grade is for wounds < 1cm with no skin crushing?

A

Grade I

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2
Q

Gustilo Classification System for Fractures:

Which grade is for wounds > 1m with no significant soft tissue crushing?

A

grade II

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3
Q

Gustilo Classification System for Fractures:

Which grade has extensive soft tissue injury?

A

grade III

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4
Q

What kind of cultures are best for open fractures?

A

surgical fractures

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5
Q

Should you get fracture wound cultures before or after antibiotics?

A

before

to get a better yield

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6
Q

Two common skin flora pathogens found in open fracture wounds?

A

Staph aureus

Strep spp.

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7
Q

More extensive open fractures such as grade 3 and open fractures with delayed wound closure are more likely to have what kind of pathogens?

A

gram negative rods

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8
Q

Open fracture prophylactic antibiotics:

What drug is used for grade I or II?

A

cefazolin

most hospitals dose 2g IV q8h

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9
Q

Open fracture prophylactic antibiotics:

What drug is used for grade III?

A

ceftriaxone

most hospitals dose as 2g IV q24h

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10
Q

What is cefazolin dose for grade I or II prophylaxis?

A

2g IV q8h

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11
Q

What is ceftriaxone dose for grade III prophylaxis?

A

2g IV q24h

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12
Q

Open fracture antibiotics are given for __ to __ hr duration of for __ hours after wound closure

A

48, 72, 24

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13
Q

What immunization is recommended for immunoglobulin pts with highly contaminated wounds with incomplete or uncertain vaccination Hx?

A

tetanus

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14
Q

If the pts vaccination Hx is unknown you should administer tetanus booster.

a. true
b. false

A

a. true

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15
Q

Penetrating wounds are injury from an object penetrating the skin with __

A

velocity

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16
Q

Penetrating abdominal trauma prophylactic antibiotics are warranted for __ hours if there is a hollow viscous injury

A

24

NOT warranted if there is no hollow viscous injury

17
Q

A patient comes in with penetrating abdominal trauma, with no hollow viscous injury.

Should you give prophylactic antibiotics?

A

no

18
Q

Most penetrating wounds don’t need antibiotics.

a. true
b. false

A

a. true

19
Q

Treatment of bite wounds is __ to _ days

A

3, 5

20
Q

3 main indications for pre-emptive Tx of bite wounds:

A
  • immunocompromised
  • edema of affected area
  • hands/face
21
Q

Common anaerobe in bite wound?

A

Pasturella species

22
Q

Staph and Strep are associated with __ bite wounds

a. purulent
b. nonpurulent

A

b. nonpurulent

23
Q

Preferred Tx for a human bite?

A

amox-clav

24
Q

Tx for animal bite?

A

amox-clav

metronidazole + ceftriaxone

25
Q

What is main predictor of infections with burns?

A

infections

75% of cases

26
Q

The head is __% of BSA

A

9

27
Q

Each arm is __ % of BSA

A

9

so both together = 18%

28
Q

Each leg is __ % BSA

A

18

both = 36%

29
Q

What % BSA his the chest/torso?

A

18% front
18% back

so entire torso is 36%

30
Q

The groin is __% BSA

A

1

31
Q

Most common infectious complications of burns?

A
  • pneumonia
  • cellulitis
  • sepsis

also UTI

32
Q

What organisms grow 5-7 days after burn?

A

gram positives
gram negatives
yeast

33
Q

Burn hospital stays of __ to __ days are more likely to get fungal infection

A

14, 28

more common in older pts
more common with higher BSA %

34
Q

3 gram negatives with higher resistance profiles in burns?

A

Pseudomonas
Klebsiella
Acinteobacter

35
Q

Burn pts have __ metabolic rate

a. higher
b. lower

A

a. higher

36
Q

Burn pts have __ clearance of medications

a. increased
b. decreased

A

a. increased

37
Q

What is DOC for Aspergillus?

A

voriconazole

38
Q

What is DOC for Candida?

A

micafungin

echinocandin

39
Q

DOC for Mucor?

A

posiconazole

7364 Critical Care Block 1 (11 decks)

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