Management of Circulation

Question 1

What are the two main blood types?

Answer 1

1. ABO
2. Rh

Question 2

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

Answer 2

O+ and O-

Question 3

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

Answer 3

O-

Question 4

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.

Answer 4

Class III

Question 5

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

Answer 5

Class IV

Question 6

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

Answer 6

Hemolytic Reactions

Question 7

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

Answer 7

10 - 30 ml

Question 8

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

Answer 8

Hemolytic Reaction

Question 9

What is the treatment of choice for hemolytic reactions?

Answer 9

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

Question 10

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

Answer 10

Anaphylactic reaction

Question 11

What is the treatment of choice for the anaphylactic reaction?

Answer 11

a. IM Epinephrine
b. Antihistamines
c. Vasopressors

Question 12

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

Answer 12

1 AMP

Question 13

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

Answer 13

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

Question 14

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

Answer 14

Armed Services Blood Program

Question 15

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

Answer 15

25-50 mg diphenhydramine IM/PO/IV

Question 16

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

Answer 16

1 g acetaminophen PO/PR/IV

Question 17

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

Answer 17

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

Question 18

What is the recommended temperature for TXA?

Answer 18

59 - 86 F

Question 19

What are the three types of solution?

Answer 19

1. Colloids
2. Crystalloids
3. Blood and blood products

Question 20

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

Answer 20

Colloids ( Volume Expanders)

Question 21

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?

Answer 21

Crystalloids

Question 22

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

Answer 22

Isotonic

Question 23

What crystalloids have a tonicity equal to the body?

Answer 23

Isotonic

Question 24

What are the most common types of Isotonic solutions?

Answer 24

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

Question 25

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

Answer 25

Hypertonic Solutions

Question 26

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

Answer 26

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

Question 27

What are the uses for lactated Ringers (LR)?

Answer 27

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

Question 28

What are some special considerations with the use of NSS?

Answer 28

!. 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.

Question 29

What is the special consideration for use of LR?

Answer 29

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.

Question 30

What is the use for D 5 W?

Answer 30

1. Fluid loss and Dehydration 2. Hypernatremia

Question 31

What is the special consideration for use if D5W?

Answer 31

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

Question 32

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

Answer 32

Intraosseous fluids

Question 33

Dosage for Tylenol In Combat pill pack?

Answer 33

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

Question 34

Dosage of Meloxicam in Combat pill pack?

Answer 34

7.5 to 15 mg Po Daily

Question 35

Dosage of oral Transmucosal Fentanyl Citrate in combat pill pack?

Answer 35

800 ug

Question 36

Dosage of Ketamine in Combat Pill pack?

Answer 36

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

Question 37

Dosage of Morphine in combat pill pack (CPP)?

Answer 37

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

Question 38

Dosage of Moxifloxacin in CPP?

Answer 38

400 mg IV/PO q 24 hours

Question 39

Dosage of Ertapenem in CPP?

Answer 39

1 g IV q 24 Hrs

Question 40

Dosage of Levofloxacin in CPP?

Answer 40

750 mg IV/Po q 24 Hrs

Question 41

Dosage of Cefazoline in CPP?

Answer 41

1 g IV q 8 hours for 7 days

Question 42

Dosage of Ceftriaxone in CPP?

Answer 42

2 g IV q 12 hours