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Flashcards in Trauma Triad Deck (41)
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1

What are the 3 'components' of the trauma triad?

Hypothermia
Coagulopathy
Acidosis

2

Under what temperature is a patient HYPOthermic?

<35C

3

How does the body generate heat?

Metabolism in muscle and livers

4

What are 5 means of heat loss?

1. Conduction
2. Convection
3. Radiation (60%)
4. Evaporation
5. Respiration

5

What are some risk factors in patients for developing hypothermia?

ET tube, Trauma score, Low BP, Fluid bolus, head trauma and clothing (lack of)

6

Where are thermoreceptors?

Skin and Hypothalamus

7

Where is the thermal control centre?

Preoptic area of the hypothalamus

8

What are mechanisms to help increase body temperature?

1. Vasoconstriction
2. Adrenaline and NA release
3. Shivering
4. Increase in metabolic rate

9

How can haemorrhagic shock cause hypothermia?

A loss of blood volume

10

How can a brain injury lead to hypothermia?

Distruption of the central control centre

11

How can intoxication lead to hypothermia?

Peripheral vasodilation leads to heat loss

12

How can exposure lead to hypothermia?

Increased radiant heat loss

13

How can burns lead to hypothermia?

Skin damage leading to a loss of fluid and plasma

14

How can the administration of IV fluids lead to hypothermia?

Temperature of fluids leads to cooling of circulating fluid

15

What ECG changes are seen in hypothermia?

J wave (due to increased Calcium)
ST elevation (early repolarisation)

16

How is it best to warm patients prehospitally?

Dry the patient
Cover the patient
Cover wounds and burns
Increase the surrounding temperature

17

How can hypothermia cause coagulopathy?

A reduction in enzyme activity and the decrease in activity of clotting factors and platelets

18

Why must you be cautious when administering drugs to hypothermic patients?

A reduction in metabolism and elimination leads to slower responses. This means it is possible to overdose these patients more easily

19

What is 'normal coagulation' defined as?

A complex set of reactions that form blood clots preventing haemorrhage

20

What is normal coagulation dependent on?

Temperature (HYPOTHERMIA)
Blood pH (ACIDOSIS)

21

What two things are essential for coagulation?

Calcium ions and Platelets?

22

What are the two coagulation pathways?

Extrinsic
Intrinsic

23

What causes the extrinsic pathway to be activated?

Tissue Trauma

24

What causes the intrinsic pathway to be activated?

Blood/Vessel trauma
Collagen fibre and platelet exposure

25

What is produced to activate the extrinsic pathway?

Tissue Factor
(calcium)

26

What is produced to activate the intrinsic pathway?

Activated clotting factor 12 and Activated platelets
(calcium)

27

Prothrombinase catalyses what reaction?

Prothrombin --> Thrombin

28

What does thrombin catalyse?

Fibrinogen --> Fibrin

29

What 5 things can loss of blood lead to in coagulopathy?

1. Loss of clotting factors
2. Haemodilution (fluids)
3. Hypothermia (clotting and enzymes)
4. Acidosis (clotting, enzymes and platelets)
5. Hypocalcaemia (haemodilution)

30

What is blood calcium essential for?

Normal clotting mechanisms