intraop management of the trauma pt

Question 1

RSI contraindicated for (2)?

Answer 1

airway tears, oro facial injury

Question 2

Hemorrhage and hypovolemia lead to?

Answer 2

higher than normal blood concen of IV agents, increased sensitivity of brain to anesthetics, preferential distribution of CO to brain and heart, cerebral hypoxia, acidosis, dilutional hypoproteinemia

Question 3

What happens to plasma concen of remifent and fent when in shock?

Answer 3

plasma concen increased

Question 4

Decreased VOD does what to etomidate and prop?

Answer 4

increases blood level of etomidate 20% and propofol to some degree

Question 5

2 drugs known to have significant cardiac depression activity?

Answer 5

thiopental, versed

Question 6

Is baroreceptor depression produced by IV agents greater than, equal to, or less than that produced by inhalational agents?

Answer 6

less than

Question 7

How do opioids cause hypotension?

Answer 7

inhibiting SNS effect

Question 8

IV dose of scopalamine to be given w anesthesia?

Answer 8

0.6 mg

Question 9

What solutions are contraindicated in trauma pts?

Answer 9

those w glucose in them

Question 10

Most common complication in trauma pt?

Answer 10

hypothermia

Question 11

How long does it take to warm the trauma pt one degree?

Answer 11

hour

Question 12

Is metabolic acidosis aggravated by massive transfusion?

Answer 12

yes

Question 13

Most desirable method for correction of met acidosis?

Answer 13

restore adequate perfusion

Question 14

3 disadvantages of sodium bicarb?

Answer 14

left shift carboxyhg, hyperosmolar state, alkalosis

Question 15

Lactate greater than what suggests lactic acidosis?

Answer 15

5

Question 16

Base deficit greater than what suggests hypovolemia?

Answer 16

14

Question 17

3 things to correct to correct met acidosis?

Answer 17

hypoxemia, CO, hypovolemia

Question 18

Deficiencies of what factors treated w FFP?

Answer 18

V and VIII

Question 19

Decision to extubate influenced by 5 factors?

Answer 19

duration/type of surgery, duration/degree hypotension, presence of chest injuries, vital capacity, hypothermia