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TCCC > Bleeding > Flashcards

Bleeding Flashcards

1
Q

During circulation check in the P-MARCH-P algorithm how does TQ application differ?

A

Apply directly to skin 2-3 inches above wound

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2
Q

What is the CoTCCC hemostatic dressing of choice for compressible hemorrhage not amenable to limb TQ use?

A

Combat gauze

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3
Q

What are the alternate hemostatic adjucnts?

A

Celox (Sell-ox)
Chitogauze (kite-o gauze)
XSTAT

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4
Q

What type of wounds is XSTAT best for?

A

deep narrow tract-junctional wounds

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5
Q

How long must you hold pressure with hemostatic dressings?

A

at least 3 minutes

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6
Q

What three criteria must be met before converting a TQ to a hemostatic or pressure dressing?

A

Casualty is not in shock
It is possible to monitor the wound closely
TQ is not controlling bleeding from an ambutation

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7
Q

What are the steps for TQ conversion?

A

Apply combat gauze and pressure dressing
Gradually loosen high and tight TQ and move it down to just above pressure dressing
Monitor

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8
Q

If the transition to combat gauze at 2 hours failed when should you try again?

A

at 6 hours

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9
Q

Can you transition a TQ after six hours?

A

no, unless you have lab support for metabolic complications

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10
Q

Do not convert TQ if:

A 
Casualty is in shock
You cannot monitor
Traumatic amputation
TQ on longer than 6 hours
Casualty will arrive at MTF within 2 hours
Tactical consideration
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11
Q

What is the active ingredient of chito gauze?

A

chitosan (mucoadhesive) (Kite-O)

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12
Q

What is combat gauze impregnated with?

A

Kaolin (material that cause the blood to clot)

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13
Q

XSTAT is contraindicated in what areas?

A

thorax, pleural cavity, mediastinum, abdomen, retroperitoneal, sacral above the inguinal ligament or tissues above the clavicle

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14
Q

What are the XSTAT 30 coated with?

A

chitosan

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15
Q

How many XSTAT 30 applicators are recommended to have on hand at the point of injury?

A

three

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16
Q

What are the three CoTCCC recommended junctional TQs?

A

Combat ready Clamp (CRoC)
The Junctional Emergency Treatment Tool (JETT)
The SAM Junctional TQ (SJT)

17
Q

What are the contraindications to using EZ-IO in the sternum?

A 
Fx of manubrium
Previous surgical procedure
IO within last 24-48 hrs
Infection at site
Inability to locate landmarks
18
Q

What can be used to reduce blood loss from internal hemorrhage?

A

Tranexamic Acid (TXA)

19
Q

What is the dose of tranexamic acid?

A

1 gram in 100 cc of NS or LR

Begin second dose after Hextend or fluid treament

20
Q

When is the survival benefit the greatest with tranexamic acid use?

A

given within 1 hour

21
Q

What is the trade name of TXA?

A

Cyklokapron

22
Q

What are possible side effects of TXA?

A

Nausea, vomiting, diarrhea,
Visual disturbances
Possible increase injury blood clots
Hypotension if given bolus

23
Q

What is the recommended temperature range of TXA?

A

59-89 degrees F

24
Q

at what rate should you infuse TXA?

A

over 10 minutes

25
Q

What are the best tactical indicators of shock?

A

Decreased state of consciousness

Abnormal character of radial pulse

26
Q

What are the resuscitation fluids of choice for casualties in hemorrhagic shock?

A 
Whole blood
Plasma:RBCs:Platelets 1:1:1
Plasma and RBCs 1:1
Plasma or RBCs alone
Hextend
Crystalloid (LR or Plasma lyte A)
27
Q

What is the goal of fluid resuscitation in the TBI patient?

A

maintain SBP of 90mmHG

28
Q

what does apheresis mean?

A

taking away (apheresis platelets - when platelets are taken away by themselves)

29
Q

Why is NS not recommend for fluid resuscitation?

A

can cause hyperchloremic acidosis

30
Q

at what interval would you give hextend?

A

after 30 minutes if no improvement in pulse and/or level of consciousness

TCCC (3 decks)

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