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TRAUMA > Management of Circulation > Flashcards

Management of Circulation Flashcards

1
Q

What are the two main blood types?

A
  1. ABO
  2. Rh
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2
Q

When transfusion blood what blood types can males receive what type at all times?

A

O+ and O-

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3
Q

Females of childbearing age receiving blood will only receive what type?

A

O-

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4
Q

What class of hemorrhagic shock is classified with: (30 % of blood loss).
- 1,500-2,000 ml of blood loss
- > 120 HR
- Decreased B/P
- 30-40 RRPM
- Urine output 5-15 ml per hour.
- Level of Consciousness, confused demeanor.

A

Class III

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5
Q

What class of hemorrhagic shock is classified with: ( > 40% of blood loss).
- > 2000 ml of blood loss
- >140 HR
- Decreased B/P
- > 35 RR
- Urine output is negligible
- LOC lethargic demeanor
- Absent radial pulse/systolic B/P below 80 mmHg

A

Class IV

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6
Q

What is a potentially life-threatening reaction caused by acute intravascular hemolysis of transfused red blood cells?

A

Hemolytic Reactions

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7
Q

What are the severe hemolytic reactions; lethal with as little as how much?

A

10 - 30 ml

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8
Q

What condition has signs of fever, chills, flank pain, and Oozing from intravenous sites?

A

Hemolytic Reaction

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9
Q

What is the treatment of choice for hemolytic reactions?

A

a. Aggressive Rehydration
b. Diuretics ( prevent kidney damage)

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10
Q

Define any allergic reaction other than hives constitutes an anaphylactic transfusion reaction, including angioedema, wheezing, and/or hypotension.

A

Anaphylactic reaction

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11
Q

What is the treatment of choice for the anaphylactic reaction?

A

a. IM Epinephrine
b. Antihistamines
c. Vasopressors

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12
Q

What is the recommended dosage of Calcium Gluconate every 4 units of FWB avoid toxicity and hypocalcemia?

A

1 AMP

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13
Q

What is the treatment of choice for febrile non-Hemolytic Reaction?

A

Fever with 1 g of Tylenol Po/PR every 8 hours

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14
Q

Who does the screening for all service members for blood typing?

A

Armed Services Blood Program

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15
Q

If a member with allergies or a history of a previous allergic transfusion reaction member can be given what as a prophylactically?

A

25-50 mg diphenhydramine IM/PO/IV

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16
Q

If a member with a history of febrile reactions member can be given what as a prophylactically?

A

1 g acetaminophen PO/PR/IV

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17
Q

What is the recommended dose for TXA (Tranexamine Acid)?

A

administer 1 g of TXA in 100 ml normal saline or lactated ringers soon, no later than 3 hours after injuries. Over 10 mins.

18
Q

What is the recommended temperature for TXA?

A

59 - 86 F

19
Q

What are the three types of solution?

A
  1. Colloids
  2. Crystalloids
  3. Blood and blood products
20
Q

What is used to increase the blood volume following severe losses of blood (hemorrhage) or level of plasma ( Severe burns)?

A

Colloids ( Volume Expanders)

21
Q

What fluids consist of water and dissolved crystals, such as salts and sugar, and are used as maintenance fluids to correct body fluids and electrolyte deficit?

A

Crystalloids

22
Q

When the crystalloids contain the same amount of electrolytes as the plasma, it is referred to as?

A

Isotonic

23
Q

What crystalloids have a tonicity equal to the body?

A

Isotonic

24
Q

What are the most common types of Isotonic solutions?

A
  1. Lactated Ringers (LR)
  2. Normal Saline Solution (NSS)
  3. 5% Dextrose in water (D5W)
25
Q

If the crystalloids contain more electrolytes than the body plasma, it is concentrated and referred to as?

A

Hypertonic Solutions

26
Q

What are the uses for Normal Saline Solution (NSS)?

A
  1. Shock
  2. Resuscitation
  3. Fluid Challenges
  4. Blood Transfusions
  5. Metabolic alkalosis
  6. Hyponatremia
  7. DKA
27
Q

What are the uses for lactated Ringers (LR)?

A
  1. Dehydration
  2. Burns
  3. GI tract fluid loss
  4. Acute blood loss
  5. Hypovolemia
28
Q

What are some special considerations with the use of NSS?

A

!. Use in patients with Heart Failure, Edema, and Hypernatremia.
2. Can lead to volume overload.
3. Speeds up the lethal triad of hypothermia, coagulopathy, and acidosis.

29
Q

What is the special consideration for use of LR?

A
  1. Cause Hyperkalemia in renal patients
  2. Patients with liver disease cannot metabolize lactate.
  3. Lactste is converted into bicarb by the liver which with larger volumes can lead to metabolic alkalosis.
30
Q

What is the use for D 5 W?

A
  1. Fluid loss and Dehydration
  2. Hypernatremia
31
Q

What is the special consideration for use if D5W?

A
  1. Solution becomes hypotonic when dextrose is metabolized
  2. Do not use for resuscitation
  3. Use cautiously in renal and cardiac patients
32
Q

When the attempts of placing IV sites failed, or 90 seconds have gone by what is the next best thing?

A

Intraosseous fluids

33
Q

Dosage for Tylenol In Combat pill pack?

A

625 mg bilayer caplet, 2 Tabs PO every 8 hours. Max of 4 g over 24 hours.

34
Q

Dosage of Meloxicam in Combat pill pack?

A

7.5 to 15 mg Po Daily

35
Q

Dosage of oral Transmucosal Fentanyl Citrate in combat pill pack?

A

800 ug

36
Q

Dosage of Ketamine in Combat Pill pack?

A

50 mg IM or IN with repeat dose every 30 minutes or 20 mg IV or IO with repeat dose every 20 minutes.

37
Q

Dosage of Morphine in combat pill pack (CPP)?

A
  1. 5 mg IV/IO. Max 15 mg, reassessment in 10 minutes
38
Q

Dosage of Moxifloxacin in CPP?

A

400 mg IV/PO q 24 hours

39
Q

Dosage of Ertapenem in CPP?

A

1 g IV q 24 Hrs

40
Q

Dosage of Levofloxacin in CPP?

A

750 mg IV/Po q 24 Hrs

41
Q

Dosage of Cefazoline in CPP?

A

1 g IV q 8 hours for 7 days

42
Q

Dosage of Ceftriaxone in CPP?

A

2 g IV q 12 hours

TRAUMA (15 decks)

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