OB/Gyn, AMS, procedures, ortho Flashcards
Physiologic changes in pregnancy
Blood volume inc 50%
HR increased 10-15%
RR increased 10-15%
CO increased
BP decreased or normal (only thing that stays relatively normal)
Pre E without severe features
BP > 140 or >90 diastolic AND proteinuria
Pre-eclampsia with severe features
BP >160 systolic or >110 systolic OR HTN meeting criteria for pre e and evidence of end organ damage
APGAR
Appearance (color): blue (0), extremities blue body pink (1), pink (2)
Pulse: absent (0), < 100 (1), > 100 (2)
Grimace (reflex irritability): no response (0), grimace or weak cry (1), vigorous cry (2)
Activity (tone): floppy (0), some flexion (1), well flexed (2)
Respiration: Apneic (0), slow (1), strong cry (2)
Minor trauma may cause what in pregnancy
Placental abruption
Attach what to BVM to deliver oxygen weather squeezing bag or not?
PEEP
ideally self inflating bag
LMA vs Igel
Igel has no balloon
Pediatric ET tube size
4 + (age / 4)
Pediatric ET tube depth
(Age / 2 ) + 12
What is Drug Facilitated Intubation
Use of IV sedative and/or neuromuscular blocking agents to facilitate ETI in patient with intact protective airway reflexes
- i.e RSI, RSA
-increases first past success rate
Humerus fx, what artery and nerve can get injured
Axillary
Most commonly fractured long bone
Tibia
Highest risk of hemodynamic instability in what pelvic fx mechanism
AP injury
3 ortho injury areas at highest risk for neurovascular injury
- Hip
- Knee
- Elbow
When is a traction splint contraindicated? When done?
Done for isolated mineshaft femur fx
Contra: known or suspected pelvic fx, knee fx, mangled limb
Traction splint nerve risk
Peroneal nerve
Trauma priorities prehospital vs hospital
Differing priories
Scene safety
MOI assessment
Scene oversight
Revised trauma score uses what
GCS + Systolic BP + RR
Phases of mgmt in extracation
- Arrival and size up
- Hazard control
- Patient access
- Medical treatment
- Disentanglement
- Patient packaging
- Removal/transport
High risk intrusion
12-18 inches
Turnkeys trimodal approach
Approach to death and disability in trauma
3 phases when injured patients most likely to die
Initial: immediate death
Secondary: 2-3 hours after injury - bleeding or physiologic disruption (potentially reversible)
Third risk: days later, sepsis
Red vs yellow CDC trauma center guidelines
Red: Anatomic and physiologic (injury patterns and mental status and vital signs) (high risk)
Yellow: MOA And EMS judgement
First step in SALT
Walk - assess 3rd
Wave - assess 2nd
Still - assess 1st
4 steps for trauma triage
- Physiologic
- Anatomic
- Mechanism
- Special considerations
Spine board increases risk of death in what type of trauma
Penetrating trauma
Pediatric rule of 9s
Head - 18
Trunk front - 18
Trunk Back - 18
Legs - 14 each
Arms - 9 each
2 burn center referral criteria in old and new list
- Burns that involved the face, hands, feet genitals, perineum, or major joints
- Inhalation injuries
Brooke formula for burns
2 ml/kg x TBSA in first 24
3 ml/kg in children
Burn rule of 10s
(%TBSA x 10) to calculate initial rate for patients weighing 40-80 kg
Increase fluid rate by 100 ml/h for every 10kg of body weight over 80 kg
Two type of crush injuries
Axial: traumatic asphyxia and suffocation
Appendicular: crush syndrome and compartment syndrome
Compartment pressures for compartment syndrome
< 10 mmhg normal
30-50 can cause tissue toxicity over a few hours
Delta P less than 20-30
Crush injury labs
Hyper K
Hypocalcemia
Acidosis
What from compartment syndrome can cause DIC
Thromboplastin release
