DECM Flashcards
What is DECM and when is it employed?
Delayed Evacuation Casualty Management is required when evacuation is prolonged due to distance, lack of evacuation platform, or cannot be performed within the allotted time frame doctrinally dictated based on priority of patients
TRUE/FALSE
DECM is an algorithm that replaces TC3 as an improved modality for casualty management
False
Define the lethal triad
A combination of acidosis, coagulopathy and hypothermia that usually leads to death in a patient experiencing trauma
Describe Acidosis
Lower than normal pH due to increased hydrogen ion concentration
Describe coagulopathy
Any disorder of the blood that makes it difficult for blood to coagulate
Describe hypothermia
A lower than normal body temperature (96.0)
Normal body temp is 98.6
What is a healthy pH range for human arterial blood
7.35-7.45
The carbonic acid-bicarbonate buffer systems in maintaining the body’s pH is best described as
When hydrogen concentration increases the body responds by telling the kidneys to release bicarbonate while conversely attempting to eliminate hydrogen in urine. Bicarbonate bonds with hydrogen in the blood creating carbonic acid. Carbonic acid is then carried to the lungs and broken down into exhaled carbon dioxide and water.
What describes the relationship between acidosis and hypothermia in relation to coagulopathy?
The coagulation system is pH and temperature dependent
What is the most significant mode of heat loss in a trauma patient?
Radiation
There’s also convection and conduction
As little as ___ whole blood administration can result in a fatal hemolytic reaction?
30ml
In regards to whole blood what is the universal donor blood type?
O negative
Signs and symptoms of hemolytic reaction include:
Pain warmth and inflammation of infusion sight?
Increase in core temperature greater than 2 degrees?
Define hypovolemic shock
Life threatening condition that results when you lose more than 20% if body’s blood supply.
Most common type of shock.
Makes it impossible for heart to pump blood to body
What are common shock treatments?
Lay person down
Loosen tight clothing
Cover to keep warm
Give fluids if necessary
Normal urinary output for an adult is defined as
30ml - 50ml per hour
T/F
Insertion of an indwelling Foley catheter is considered a clean procedure
True
T/F is it safe to force a foley when resistance is met?
False
Describe indications for indwelling foley
An unconscious or immobile casualty who requires monitoring of urinary output
Describe contraindications for indwelling foley
Trauma to casualties genitalia
Cleaning from least contaminated area to most contaminated prevents introduction of organisms into wound T/F
True
T/F dressing changes should be done using sterile techniques to decrease further contamination to the wound
True
When preparing to conduct wound cleaning and irrigation what is assessed prior?
- inspect wound for foreign objects
- assess Neurovascular status
- assess area for inflammation
What are the fluid administration recommendations for crush injuries immediately following extrication (phase 3) and during prolonged field care? (Phase 4)
Solution to pollution is dilution
