Trauma/SICU Flashcards by william hudson

Burn percent rules

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concerning compartment P cutoff?

what is delta P?

30mmhg

diastolic - comp P (<30 is bad)

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Decubitus Ulcer staging

Stage I: Superficial injury with intact skin, characterized by nonblanching erythema (in darker-skinned patients, the injury may simply appear darker without blanching), with possible tenderness
Stage II: Partial-thickness injury, with loss of dermis presenting as a shallow ulceration with a red or pink wound bed or intact blister or bullae
Stage III: (see above)
Stage IV: Full-thickness skin loss with exposed muscle, tendon, and bone, which is often accompanied by undermining and tunneling

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Most important first step for snake bite

local wound care

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Pancreas injury Grading and treatments

I - Drain
II - Drain
III- STaple
Iv - Panc J
V - Whipple

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What is an acceptable pH when trying to prevent ARDS in burn patients?

7.2

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Venous connection for hemorrhoids in Cirrhosis

Umbilical vein connects with these 2

IMV and SH connects with pudendal and inf hem

L portal and epigastric — cap medusae

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How is ascites created from portal htn

increased splanchnic arterial inflow from dilation leading to increased hydrostatic P in lymph

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Side effects of the burn medications:

Ag Sulf

Ag Nit

Mafenide acetate

Neutropenia

methemoglobinemia and low electrolytes

Metabolic acidosis

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Distance rule of thumb for choice of repair in vessel laceration

2cm without tension — primary anastomosis

otherwise contralateral vein with interpostition

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Pt with pain in anatomical snuffbox after fall. Neg XR. Next step and overall tx

CT or repeat radiographs in 2 weels

immobilization

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Which pathways go with PTT v PT/INR respectively

Intrinsic

extrinsic

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What is SvO2?

What is a normal %?

What is expected in each type of shock?

venous oxygen saturation

75% and up

All decreased except for distributive which decrease

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First line afib med in icu
What consideration must be taken and what is the alternatve

BB
amio

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What is the new med for alcohol withdrawal syndrome — proven benefit

barbs

less vent days

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Go to fungal coverage med for sick perfed gastric ulcers

benefit

micafungin(echinocandin)

mortality

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type 1 2 and 3 NSTI bugs

who gets what

1 - multi, T1DM/immun comp/alcohol/renal — fourniers and ludwig
2- GA strep pyogenes —TSS
3 - c perfringings — IV drugs and surgery

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tx for mucor

ampho b

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hepatorenal syndrome mech

3 part treatment

portal htn leads to splanchnic dilation and overal poor systemic art flow, poor renal perfusion

levo, octreotide, vol expansion

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West prospective findings on CT clearance
Who can we not clear

98.5% sensitivity for CT
3 had FN and central cord , presented with motor changes

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new thoughts on TPN causing more infection, trials?

what is a overall benefit?

no difference according to CALORIES and NUTRIREA

dec hypoglycemia

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New recs for lovenox dosing

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overall anti thrombotic ppx for patients

lovenox and SCDs

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necrotizing pneumonia is usually due to what bug

associated toxin

staph

panton-valentine leukocidin

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recommendation for oxygen support post intubation for moderate risk patients

HFNC

Preferred regional rib block on anticoag?

paravertebral

mech of heparin if main substrate is deficient in patient

antithrombin binding and enhancement add ffp

common infection after liver transplant in first 4 weeks after?

bacterial viral(cMV)

got to colon prep

high volume poly glycol

NG tube syndrome?

posterior cricoarytenoid ulcer vocal cord paralysis

oral vs j tube determinants for esophagectomy

pref oral but if frail, immun comp, poor conduit then j tube

BIS measures .....

level of concsiousness

5 detriments of hypothermia periop

increased blood loss and transfusion requirements, cardiac morbidity, surgical site infection, increased hospital length of stay. increases the effects of paralytics during surgery.

Dg of HIT, also has CKD, tx choice

argatroban

3 effects of hyperbarics physio

Safe alternative to epidrual anesth

On Q pump

how long can whole blood be stored

4 weeks

frost bite grading recs for grade 3 and 4 tx

thrombolytics

conventional vs contingency vs crisis level descriptions for icu capacity

greatest risk with whole blood

taco

in disaster situation, which interventions are deemed too time consuming/costly

whole blood transfusion, intubation

when talking about teg for trauma what specific alternative phrase is there

viscoelastic testing

rattlesnake treatment?

crofab

target CPP

cell mediated killing CD the other assigned mhc classees?

8 4 8-1 4-2

what ig goes across placenta? through milk?

G A

what ig is suppressed by splenectomy

4 'other' long term risks following splenectomy

DVT, PE, pneumonia, meningitis

uremias effect on immune system

depresses both

SEs: steroids tac cyclosporine mycophenolate sirolimus

wounds and adrenals nephro, neuro seizures, arrythmias pancytopenia, GIB wounds

supplement for wound healing in steroid users

vit a

mechs: infliximab adalimumab rituximab

TNFI TNFI B cell antag

transplant viruses and their treatments

CMV - gang EBV, post lymphoproliferative dis -- red immmun suppression

what is the only muscle recurrent laryngeal does not innervate

cricothyroid

greatest RF for pancreatitis post valve replacemt

prolong pump time

Gram neg bacteremia abx duration

7 days -

fastest cooling technique

arctic sun

new sepsis end goals

ANDROMEDA --- cap refill and LA for resus end goals uop not as hot now

urinary insulin-like growth factor-binding protein (IGFBP-7) and tissue inhibitor of metalloproteinase (TIMP-2). what are they good for

early aki detection

intitial labs for aki how are these read

fena FEna - <1 is prerenal FEur- < 35% is prerenal

When is the earliest we can start TPN in ICU? late group benefits? Thoughts on energy dense formulas

8 days significantly reduced infectious complications (22.8% vs 26.2%, p = .008), cholestasis, duration of mechanical ventilation, duration of renal replacement therapy, and healthcare costs. na dawg

COVID trach timing

21 days from dg

onyl thing to do for NOMI operative?

papaverine no mortality benefit

straight leg raise method what is the pathophys behind this change expected if hypoV

autotransfusion of 500ml more than 10% change in CO

new ppi recs in icu famotidine? enteral feeding?

shock coag liver dialysis vent tbi not good enough only a small trial so far

SMART trial rec

ALWAYS LR

new c diff test

tcdB gene perirectal swab

When to consider operation for extraperitoneal bladder injury

open book pelvis needing dissection, penetrating, neck of bladder, bony fragments or FBs, persistent hematuria

Trauma/SICU Flashcards

(69 cards)