Formulas & #s Flashcards
Lethal blood loss=
40%–> class 4 hemorrhage
How to estimate PEDI ET tube size: Uncuffed
Cuffed
Uncuffed ET: (Age /4) + 4 OR (Age + 16) /4
Cuffed ET = (Age /4) + 3.5
Pedi intubation ETT location=
ETT Insertion is 2-3 cm below the vocal cords
Suctioning catheter sizing form/=
Intubation ETT size # X 2
Suctioning time limits:
Adults 15 secs max,
Children= 10 secs max,
Infants=5 secs max,
ET/Trach tube= 5-10 secs max
ETT size range~
Adults (6.0-9.0) women~7-8 & man~8-9
Pedi tubes(2.5-5.5)
DISS =Fitting diameter index setting system > oxy tanks
2:5 pins
Normal blood pH range=
7.35 - 7.45 mmHg
Respiration ratio=
1 sec inhalation 2 sec exhalation
“rule of thumb” for estimating the proper depth of an ETT=
Depth should be ~3x ETT size
% of drug concentration=
Gs in 100mLs
How to estimate pedi weight
(Age + 4) x 2 = Approximate weight in kg (Old Way)
(Age x 3) + 7 = Approximate weight in kg (New Way
(60%) Fluid compartments % of water:
45% intracellular
15% extracellular (outside cell)
Interstitial 10.5% Intravascular 4.5%
Adult Men weight from:
Adult Women weight from:
=50 kg + 2.3 kg X (Height (in)- 60)
=45.5 kg + 2.3 kg X (Height (in)-60)
Suction catheter size w/ ETT~ form:
ETT# x2
BP bladder width should cover at least:
BP bladder length should cover between:
BP cuff should cover:
= 40 - 50% of the mid-arm circumference.
= 80-100% of the arm circumference.
= 2/3 of distance of upper arm (from the acromion to the olecranon)
Pulse pressure:
MAP:
CPP Cerebral Perfusion:
= SBP-DBP
= (PP/3) + DBP
= (MAP-ICP) + 10
RSI Ideal Body Weight) Men formula
Women formula
Men= 50 kg + (2.3 kg X (Height (in) - 60)
Women= 45.5 kg + (2.3 kg X (Height (in) - 60)
Celsius# to degrees Fahrenheit form
Fahrenheit# to Celsius form
C# to F=(C# -32) / 1.8
F# to C= (1.8 x F) + 32
Cardiac Output:
Cardiac Output Formula:
Blood Pressure formula:
= amount of blood pumped by the heart in 1 min (70mL)
= SV x HR
= (SV x HR) x SVR
CUPS:
C:
U:
P:
S:
= Categories of PT severity
= Critical: ABCs FUCKed
= Unstable: hypotension, comp to decomp
= Potentially unstable: pelvic fracture, stable can unstable
= Stable: stable ex toenail fracture
Kinetic energy:
Kinetic Energy form:
=energy of a object in motion (by objects mass & its velocity
= (Mass x Velocity ^2)/ 2 ½ x mv^2
Force:
Force formula:
= force related to a objects mass(weight) and/or achange in velocity
= mass x Acceleration
(Blood vol/ loss) Pelvis:
Femur:
Humorous:
= 2-3Liters
= 1.5Liters per femur
= 750ml per humorous
Kinetic energy:
kinetic energy formula:
Increasing mass vs. velocity directly increases what:
= energy of an object in motion (Fn. of object’s mass & its velocity)
= Kinetic energy=Mass(weight)×Velocity(speed)22
= kinetic energy > +velocity exponentially increases kinetic energy
The blood volume of an infant or young child is proportionally:
Population most at risk for trauma & trauma death:
= ~20%> than that of an adult
= Young adult male
ETCO2 Lvs in head-injured intubated PT shouldn’t drop below:
When vent/ing a adult PT, each breath should have tidal volume of:
= 30 mmHg
= approximately 500mL
(Class I Hemorrhage) 1 injuries:
2Compensation for blood:
3Blood Loss:
4Pulse:
5Vent rate, BP & Pulse Pressure:
6Cap-Refill:
7Urine Output (mL/hr):
8Mental Status:
1= Broken humorous 750mL
2= Healthy PTs can easily compensate for such blood volume loss
3= Blood Loss: < 15% (<750 mL’s)
4= Pulse: Slightly Tachy
5= all Normal
6= Cap-Refill <2secs
7= 30mL/Hr or more
8= Slightly Anxious
(Class II Hemorrhage) 1 injuries:
2Compensation for blood:
3Blood Loss: 15 - 30%
4Pulse:
5Blood Pressure:
6Pulse Pressure:
7Capillary Refill:
8Ventilation Rate:
9Urine Output (mL/hr):
10Mental Status:
1= 1/2 Humorous fractures, a femur fracture, 1 full Hemopneumo
2= 1st line comp/ no longer maintain perfusion & 2ndary employed
3= 15 - 30% 750mLs-1.5L
4= > 100BPM
5= Normal
6= Starts to narrow
7= 2-3 secs
8= 20-30RR
9= (mL/hr) 20-30
10= Mildly Anxious
(Class IV Hemorrhage) 1 injuries:
2= Compensation to blood:
3= blood loss:
4= Pulse:
5= Blood Pressure:
6= Pulse Pressure:
7= Capillary Refill:
8= Ventilation Rate:
9= Urine Output (mL/hr):
10= Mental Status:
1= GSWs, multiple major fractures, Pelvis
2= Irreversible Shock!
3= > 40% (>2000mLs) of total blood
4= > 140 & barely palpable in central arteries
5= Very low
6= Narrows more
7= > 5 seconds
8= > 40 or agonal
9= Negligible
10= Lethargic or Unconscious
(Class III Hemorrhage)1 injuries/fractures:
2 Compensation to blood:
3 Blood Loss:
4 Pulse:
5 Blood Pressure:
6 Pulse Pressure:
7 Capillary Refill:
8 Ventilation Rate:
9 Urine Output (mL/hr):
10 Mental Status:
1= 2 Humorous, 1-2femur, 1 full Hemopneumo
2= Both 1&2nd comp/ responses failing to maintain perfusion & entering/in Decompensated Shock! (SBP <90)
3= Blood Loss: 30 - 40%, (1500 - 2000 mL’s)
4= >120
5= Starts to decrease
6= Narrows more
7= 3-4secs
8= 30-40
9= 5-10mL/hr
10= Anxious/Confused
(Non& Hemorrhagic treatment) If hemorrhage can be controlled:
If hemorrhage cannot be controlled:
Med for Sig/hemorrhage, in/external (after external controlled)
= IV/IO therapy (don’t delay transport) can administer 20 mL/kg bolus.
=administer just enough IV fluid to obtain a radial pulse (permissive hypotension therapy!)NO MORE SBP 80-90 (IV fluids Warm)
= Tranexamic Acid (TXA) Adult 1G/10 mins (mix in 50 mL of NS) follwed w/ 1G/8Hrs (500 mL bag) & Pediatric Not recommended
Fluid accounts for ~% of the body’s weight, Only ~% of the fluid is contained in our vascular system
= 60% of the body’s weight, Only about 7% of the fluid is contained in our vascular system
Blood:
Plasma:
Leukocytes:
Erythrocytes:
= Mixture of water, cells, proteins, & suspended elements.
= makes up 55% of the blood volume
= WBC & platelets make up the “Buffy Coat”
= RBC make up 45%
Jacksons Theory of Thermal Burns 3 burn zones:
1st Zone of Coagulation 2nd Zone of Stasis 3rd Zone of Hyperemia
(Jacksons Theory) Zone of Coagulation:
Area of burn nearest to the heat source (most damage & tissue necrosis)Most damaged area
Zone of Hyperemia:
surrounding Area of erythema, damage with more RBC coming to area b/c/& cap/s more permeable (increased blood supply) trying to get phagocytes to inside for healing process
Sig burns have sig swelling from shift of fluid
Zone of Stasis / “Ischemia”:
Less damaged area adjacent to the Zone of Coagulation (treatable & posible reversible damage)
Thermal burn phases:
Emergent, Fluid-shift, Hypermetabolic, & Resolution phase
(Thermal burn phases) Emergent phase:
Vtach, cells anaerobic Body’s initial reaction to burn; pain response (afferent nerves damage> Nor/Epi release > tachycardia ; unless on beta blockers
(Thermal burn phases) Fluid-shift phase:
2nd phase; can last up to 24 hours; larger than 15 to 20%(BSA) of total body surface area
vasodilates & capillaries more permeable for phagocytosis
(Thermal burn phases) Hypermetabolic phase:
3rd phase Days or weeks depending on burn severity; increase in body’s demands for nutrients; begins process of repairing damaged tissue (needs Glucose, amino acids, carbohydrates, O2 to support damage)
(Thermal burn phases) Resolution phase:
4th phase Scar tissue laid down and remodeled; rehabilitate and return to normal function (weeks to months) new collagen & usually doesnt remodel to original state & makes escar (burn keloid) bc overgrowth
(Wallace Rule of 9s) used only for:
Adult %s:
infants (0-1):
Form:
= burns >10%
= 1 genitals, 9 head thoracic & ABDMN, distal anterior (applies to other areas) arm 4 ½
= head 18, arm 9, legs 13.5, 18 front thoracic & ABDMN
= # of child -1 > take away from head then give to each leg (Applicable up 10y/o) For every year beyond age 1, subtract 1 from head / that # & add it evenly between the 2 legs.
!!!Parkland Burn Form for:
form:
= (BSA >20% only 2 & 3 degree burns)
= 4 mL x BSA x Weight (kg) = ½ 1st 8 Hrs & ½ next 16Hrs
(Parkland Burn Form) EX: 32yo male found with 10% BSA 1st degree burns, 10% BSA 2nd degree burns, and 10% BSA 3rd degree burns. The patient is 110 pounds.
1. 4 mL x BSA x Weight (kg)
2. Total mL / 2 = (Amount to give for:
3. How many mL’s per hr?
4. How many gtts/min using a 10 gtt/mL IV drip set?
5. Know w/ formula:
- 4mL X 20 (2nd + 3rd degree burns) X 50 (kg) = 4000 mL
- 4000 mL / 2 = 2000 mL (Amount to give 1st 8 hours then next 16Hrs)
- 2000 mL / 8 = 250 mL per/hour for 1st 8 hrs
- 42 gtts/min
- Pick closest option choice for gtts & Vol calculated. Use biggest bores& macro drips
1 Children for the Rules of Nines, the head is awarded:
2 Children for the Rules of Nines, each leg is awarded:
3 Children for the Rules of Nines, each arm is awarded:
4 Children for the Rules of Nines, the anterior trunk is awarded:
5 Children for the Rules of Nines, the posterior trunk is awarded:
1= 18 % of body surface area.
2= 13.5% of body surface area.
3= 9% of body surface area.
4= 18% of body surface area.
5= 18% of body surface area.
1 Adults for the Rules of Nines, the head is awarded:
2 Adults for the Rules of Nines, the genitalia is awarded:
3 Adults for the Rules of Nines, the posterior trunk is awarded:
4 Adult for the Rules of Nines, each arm is awarded:
5 Adults for the Rules of Nines, each leg is awarded:
6 Adults for the Rules of Nines, the anterior trunk is awarded:
1= 9 % of body surface area.
2= 1 % of body surface area.
3= 9 % of body surface area.
4= 18 % of body surface area.
5= 18 % of body surface area.
6= 18 % of body surface area.
(Class I Hemorrhage) 1 injuries:
2Compensation for blood:
3Blood Loss:
4Pulse:
5Vent rate, BP & Pulse Pressure:
6Cap-Refill:
7Urine Output (mL/hr):
8Mental Status:
1= Broken humorous 750mL
2= Healthy PTs can easily compensate for such blood volume loss
3= Blood Loss: < 15% (<750 mL’s)
4= Pulse: Slightly Tachy
5= all Normal
6= Cap-Refill <2secs
7= 30mL/Hr or more
8= Slightly Anxious
(Class II Hemorrhage) 1 injuries:
2Compensation for blood:
3Blood Loss: 15 - 30%
4Pulse:
5Blood Pressure:
6Pulse Pressure:
7Capillary Refill:
8Ventilation Rate:
9Urine Output (mL/hr):
10Mental Status:
1= 1/2 Humorous fractures, a femur fracture, 1 full Hemopneumo
2= 1st line comp/ no longer maintain perfusion & 2ndary employed
3= 15 - 30% 750mLs-1.5L
4= > 100BPM
5= Normal
6= Starts to narrow
7= 2-3 secs
8= 20-30RR
9= (mL/hr) 20-30
10= Mildly Anxious
(Class IV Hemorrhage) 1 injuries:
2= Compensation to blood:
3= blood loss:
4= Pulse:
5= Blood Pressure:
6= Pulse Pressure:
7= Capillary Refill:
8= Ventilation Rate:
9= Urine Output (mL/hr):
10= Mental Status:
1= GSWs, multiple major fractures, Pelvis
2= Irreversible Shock!
3= > 40% (>2000mLs) of total blood
4= > 140 & barely palpable in central arteries
5= Very low
6= Narrows more
7= > 5 seconds
8= > 40 or agonal
9= Negligible
10= Lethargic or Unconscious
(Class III Hemorrhage)1 injuries/fractures:
2 Compensation to blood:
3 Blood Loss:
4 Pulse:
5 Blood Pressure:
6 Pulse Pressure:
7 Capillary Refill:
8 Ventilation Rate:
9 Urine Output (mL/hr):
10 Mental Status:
1= 2 Humorous, 1-2femur, 1 full Hemopneumo
2= Both 1&2nd comp/ responses failing to maintain perfusion & entering/in Decompensated Shock! (SBP <90)
3= Blood Loss: 30 - 40%, (1500 - 2000 mL’s)
4= >120
5= Starts to decrease
6= Narrows more
7= 3-4secs
8= 30-40
9= 5-10mL/hr
10= Anxious/Confused
Fluid accounts for ~% of the body’s weight, Only ~% of the fluid is contained in our vascular system
= 60% of the body’s weight, Only about 7% of the fluid is contained in our vascular system
Blood:
Plasma:
Leukocytes:
Erythrocytes:
= Mixture of water, cells, proteins, & suspended elements.
= makes up 55% of the blood volume
= WBC & platelets make up the “Buffy Coat”
= RBC make up 45%
Jacksons Theory of Thermal Burns 3 burn zones:
1st Zone of Coagulation 2nd Zone of Stasis 3rd Zone of Hyperemia
(Jacksons Theory) Zone of Coagulation:
Area of burn nearest to the heat source (most damage & tissue necrosis)Most damaged area
Zone of Hyperemia:
surrounding Area of erythema, damage with more RBC coming to area b/c/& cap/s more permeable (increased blood supply) trying to get phagocytes to inside for healing process
Sig burns have sig swelling from shift of fluid
Zone of Stasis / “Ischemia”:
Less damaged area adjacent to the Zone of Coagulation (treatable & posible reversible damage)
Thermal burn phases:
Emergent, Fluid-shift, Hypermetabolic, & Resolution phase
(Thermal burn phases) Emergent phase:
Vtach, cells anaerobic Body’s initial reaction to burn; pain response (afferent nerves damage> Nor/Epi release > tachycardia ; unless on beta blockers
(Thermal burn phases) Fluid-shift phase:
2nd phase; can last up to 24 hours; larger than 15 to 20%(BSA) of total body surface area
vasodilates & capillaries more permeable for phagocytosis
(Thermal burn phases) Hypermetabolic phase:
3rd phase Days or weeks depending on burn severity; increase in body’s demands for nutrients; begins process of repairing damaged tissue (needs Glucose, amino acids, carbohydrates, O2 to support damage)
(Thermal burn phases) Resolution phase:
4th phase Scar tissue laid down and remodeled; rehabilitate and return to normal function (weeks to months) new collagen & usually doesnt remodel to original state & makes escar (burn keloid) bc overgrowth
(Wallace Rule of 9s) used only for:
Adult %s:
infants (0-1):
Form:
= burns >10%
= 1 genitals, 9 head thoracic & ABDMN, distal anterior (applies to other areas) arm 4 ½
= head 18, arm 9, legs 13.5, 18 front thoracic & ABDMN
= # of child -1 > take away from head then give to each leg (Applicable up 10y/o) For every year beyond age 1, subtract 1 from head / that # & add it evenly between the 2 legs.
!!!Parkland Burn Form for:
form:
= (BSA >20% only 2 & 3 degree burns)
= 4 mL x BSA x Weight (kg) = ½ 1st 8 Hrs & ½ next 16Hrs
(Parkland Burn Form) EX: 32yo male found with 10% BSA 1st degree burns, 10% BSA 2nd degree burns, and 10% BSA 3rd degree burns. The patient is 110 pounds.
1. 4 mL x BSA x Weight (kg)
2. Total mL / 2 = (Amount to give for:
3. How many mL’s per hr?
4. How many gtts/min using a 10 gtt/mL IV drip set?
5. Know w/ formula:
- 4mL X 20 (2nd + 3rd degree burns) X 50 (kg) = 4000 mL
- 4000 mL / 2 = 2000 mL (Amount to give 1st 8 hours then next 16Hrs)
- 2000 mL / 8 = 250 mL per/hour for 1st 8 hrs
- 42 gtts/min
- Pick closest option choice for gtts & Vol calculated. Use biggest bores& macro drips
1 Children for the Rules of Nines, the head is awarded:
2 Children for the Rules of Nines, each leg is awarded:
3 Children for the Rules of Nines, each arm is awarded:
4 Children for the Rules of Nines, the anterior trunk is awarded:
5 Children for the Rules of Nines, the posterior trunk is awarded:
1= 18 % of body surface area.
2= 13.5% of body surface area.
3= 9% of body surface area.
4= 18% of body surface area.
5= 18% of body surface area.
1 Adults for the Rules of Nines, the head is awarded:
2 Adults for the Rules of Nines, the genitalia is awarded:
3 Adults for the Rules of Nines, the posterior trunk is awarded:
4 Adult for the Rules of Nines, each arm is awarded:
5 Adults for the Rules of Nines, each leg is awarded:
6 Adults for the Rules of Nines, the anterior trunk is awarded:
1= 9 % of body surface area.
2= 1 % of body surface area.
3= 9 % of body surface area.
4= 18 % of body surface area.
5= 18 % of body surface area.
6= 18 % of body surface area.
