Damage Control

Question 1

This stage of shock shows tachycardia only

Answer 1

Stage 2: loss of 750-1500cc blood

Question 2

This stage of shock shows tachy and hypotension as well as lethargy

Answer 2

Stage 3: 1500-2000cc blood.

• will also see decreasing UOP
• decreasing pH

Question 3

Stage IV Shock:

Answer 3

tachy >140
hypotensive
negligible urine output
acidosis
lethargic mental status

Question 4

Indicators of adequate resuscitation:

Answer 4

MAP >60
HR <100
UOP 30cc per hour
serum lactate <2.5mmol/L
base deficit -2 to 2
gastric mucosal pH >7.3 (normal)

Question 5

Possible complications of massive transfusion protocol (1:1:1 ratio)

Answer 5

hypokalemia
metabolic disturbances
transfusion associated lung injury

Question 6

This platelet count in the polytrauma patient defines “in extremis” and indicates need for DCO

Answer 6

<70,000