Adult Traumatic Hemorrhage Control

Question 1

Adult Traumatic Hemorrhage Control - Bleeding internal Tx?

Answer 1

Pelvic binding

Question 2

Adult Traumatic Hemorrhage Control - External bleeding Tx? (6)

Answer 2

Bandage 
Direct pressure
Hemostatics
Tourniquet
Wound Packing
Analgesia

Question 3

Adult Traumatic Hemorrhage Control - Hypotension Tx?

Answer 3

500 ml bolus max 2 L goal MAP 65

Question 4

Adult Traumatic Hemorrhage Control - TXA treatment criteria?

Answer 4

Within 3 hours
>16yo
HR >110 or BP <90

Question 5

Adult Traumatic Hemorrhage Control - Transport time > 30 min and refractory hypotension Tx?

Answer 5

Mandatory OLMC

Norepinephrine 0.1-0.3 mcg/kg/min

Question 6

Adult Traumatic Hemorrhage Control - TXA indications?

Answer 6

Within 3 hours
>16yo
HR >110 or BP <90

Question 7

Adult Traumatic Hemorrhage Control - TXA dose?

Answer 7

1 g IV/IO in 250 mL D5W or NS

Question 8

Adult Traumatic Hemorrhage Control - TXA contraindications?

Answer 8

Hypersensitivity to tranexamic acid

Active thromboembolic disease

Question 9

Adult Traumatic Hemorrhage Control - TXA precautions?

Answer 9

To infuse 250 mL over 10 minutes

May cause nausea and vomiting

Question 10

Adult Traumatic Hemorrhage Control - TXA preparation?

Answer 10

1 g IV/IO in 250 mL D5W or NS and over 10 min

Question 11

Adult Traumatic Hemorrhage Control - norepinephrine indications?

Answer 11

Hypotension refractory to fluid resuscitation

Question 12

Adult Traumatic Hemorrhage Control - norepinephrine dose?

Answer 12

0.1-0.3 mcg/kg/min

Titrate to effect, increasing dose q 3 minutes

Question 13

Adult Traumatic Hemorrhage Control - norepinephrine contraindications?

Answer 13

Mesenteric or peripheral vascular thrombosis
Pregnancy
Profound hypoxia
Hypovolemia

Question 14

Adult Traumatic Hemorrhage Control - norepinephrine preparation?

Answer 14

4 mg in 246 ml NS or D5W = 16 mcg/ml