Burns/Trauma/Neurogenic Flashcards
Parkland formula?
4mL/kg/BSA of LR
Consensus formula?
2-4 mL/kg/BSA of LR
Target urine output for an adult?
0.5mL/kg/hr
Target urine output for pediatric?
1mL/kg/hr
Target urine output for neonate?
2mL/kg/hr
Target urine output for Rhabdo/electrical burns?
2-3mL/kg/hr
In the first 6 hours of a burn, what is likely to develop?
Hyponatremia and hyperkalemia
How do you treat a spinal injury w/ HTN and distended abdomen? Autonomic
Foley catheter
Range for ICP
0-15
Anything greater than 20 is critical
Range for CPP
60-80
Calculate CPP
CPP=MAP-ICP
What does CPP stand for?
Cerebral Perfusion Pressure
What do you want your MAP to be in a neuro Pt?
Above 80
What head bleed is arterial in nature?
Epidural
What artery is effected in an epidural bleed?
Middle Meningeal Artery
How does someone present with an epidural bleed?
LOC-Lucid-LOC
What head bleed is venous in nature?
Subdural Hematoma
Which head bleed, bleeds into the ventricles?
Subarachnoid Hemorrhage
Where is a Subarachnoid Hemorrhage located?
Below arachnoid layer
How to detect Hydrocephalus on a CT?
Dilated ventricles
How to fix hydrocephalus
VP shunt or ventriculoperitoneal.
Drains CSF into abdomen
ICP reducing agents
Mannitol and hypertonic saline
Mannitol causes diuresis
HTN management in neuro Pt w/ ischemic or hemorrhagic stroke
Labetalol: 10 mg
Nicardipine: 5-15 mg/hr
Diagnose:
AMS, fever, Petechiae and or Brudzinski/Kernigs sign
Meningitis
Give fluids and anticonvulsants
Loss of motor, pain, and sensation below sit of injury
Anterior cord syndrome
Weakness in upper extremities that is greater than lower
Central cord syndrome
Ipsilateral loss of motor function w/ loss of pain/sensation on opposing side
Browns-Sequard Syndrome
Cord injury Dermatomes
Phrenic nerve damage and loss of diaphragm innervation
C3-C5
Cord injury Dermatomes
Controls elbow FLEXION
C6
Cord injury Dermatomes
Controls elbow EXTENSION
C7
Cord injury Dermatomes
Located at nipple line
T4
Cord injury Dermatomes
Located at umbilicus
T10
Ratio of mass transfusion
1 to 1 to 1 ration of FFP, Platelets, and RBC’s
Blood products cause what kind of shift on the oxyhemoglobin dissociative curve
Leftward shift
What does the citrate that is preserved in blood products remove?
DPG and calcium
Where do you perform a Thoracostomy?
4th intercostal anterior axillary line
After performing Thoracostomy, where is the atrium to be placed and at what pressure?
Below the level of the heart
20 cm/h2O
What does persistent bubbling in the atrium chamber indicate?
Significant air leak or Tracheobronchial tear or injury
When to give TXA and the dose? Time frame*
Given within 3 hours of injury
1g over 10 minutes. 1g over 8 hours
What does REBOA stand for?
Resuscitative Endovascular Balloon Occlusion of the Aorta
When is REBOA indicated?
Used in severe shock to occlude above the site of injury to eliminate bleeding as a bridge to surgery
Define mild hypothermia
32-35 degrees C
Define moderate hypothermia
28-32 degrees C
Define severe hypothermia
Less than 28 degrees C
What can hypothermia do to an ECG?
Osborne waves
If hypothermic Pt is in cardiac arrest what must you warn the pt to before providing meds and defibrillation?
30 degrees C
What temp to achieve a heat stroke?
Greater than 104 F
