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Clinical Life Sciences 2 > Trauma Triad > Flashcards

Trauma Triad Flashcards

(41 cards)

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1
Q

What are the 3 ‘components’ of the trauma triad?

A

Hypothermia
Coagulopathy
Acidosis

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2
Q

Under what temperature is a patient HYPOthermic?

A

<35C

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3
Q

How does the body generate heat?

A

Metabolism in muscle and livers

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4
Q

What are 5 means of heat loss?

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

What are some risk factors in patients for developing hypothermia?

A

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

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6
Q

Where are thermoreceptors?

A

Skin and Hypothalamus

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7
Q

Where is the thermal control centre?

A

Preoptic area of the hypothalamus

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8
Q

What are mechanisms to help increase body temperature?

A
  1. Vasoconstriction
  2. Adrenaline and NA release
  3. Shivering
  4. Increase in metabolic rate
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9
Q

How can haemorrhagic shock cause hypothermia?

A

A loss of blood volume

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10
Q

How can a brain injury lead to hypothermia?

A

Distruption of the central control centre

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11
Q

How can intoxication lead to hypothermia?

A

Peripheral vasodilation leads to heat loss

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12
Q

How can exposure lead to hypothermia?

A

Increased radiant heat loss

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13
Q

How can burns lead to hypothermia?

A

Skin damage leading to a loss of fluid and plasma

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14
Q

How can the administration of IV fluids lead to hypothermia?

A

Temperature of fluids leads to cooling of circulating fluid

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15
Q

What ECG changes are seen in hypothermia?

A 
J wave (due to increased Calcium)
ST elevation (early repolarisation)
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16
Q

How is it best to warm patients prehospitally?

A

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

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17
Q

How can hypothermia cause coagulopathy?

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A

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

18
Q

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

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A

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

19
Q

What is ‘normal coagulation’ defined as?

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A

A complex set of reactions that form blood clots preventing haemorrhage

20
Q

What is normal coagulation dependent on?

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A 
Temperature (HYPOTHERMIA)
Blood pH (ACIDOSIS)
21
Q

What two things are essential for coagulation?

Study These Flashcards
A

Calcium ions and Platelets?

22
Q

What are the two coagulation pathways?

Study These Flashcards
A

Extrinsic

Intrinsic

23
Q

What causes the extrinsic pathway to be activated?

Study These Flashcards
A

Tissue Trauma

24
Q

What causes the intrinsic pathway to be activated?

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A

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
31
What is normal blood pH?
7.35-7.45
32
Under what blood pH is it considered 'acidosis'?
<7.35
33
What 3 mechanisms are used to regulate blood pH normally?
1. Renal system (excreted H ions + reabsorbs HCO3) 2. Respiration (expire CO2) 3. Blood buffering
34
What is the Bohr effect equation?
CO2 + H2O --> H2CO3 --> HCO3- + H+ --> excretion
35
What are the two main 'types' of acidosis?
1. Metabolic acidosis | 2. Respiratory acidosis
36
How does metabolic acidosis occur?
Tissue hypoxia causes anaerobic metabolism to occur producing lactic acid which causes acidosis.
37
How does respiratory acidosis occur?
A reduction in respiratory rate leads to impaired CO2 expulsion. This leads to hypercapnia and thus acidosis.
38
What can cause respiratory acidosis (resp damage)?
- Trauma - Drugs and alcohol - Head injury - COPD
39
What can cause metabolic acidosis?
- Blood loss - Hypothermia - Decreased cardiac output
40
How does the administration of NaCl worsen acidosis?
Cl ions reduce bicarbonate reabsorption Cl ions affect ioinic balance Dilution of coagulation factors Acidosis (pH 4-5)
41
What is the equation for plasma pH?
[HCO3]/PCO2

Clinical Life Sciences 2 (7 decks)

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