Spine_Trauma

Question 1

What factor increases mortality in patients with mild head trauma?

Answer 1

Intraoperative hypotension

Question 2

Flierl et al JOT

Glasgow Coma Score for Damage Control Orthopedics(DCO) v. Early Total Care(ETC)

Answer 2

GCS 3-13 = DCO

GCS 14-15 = ETC

Question 3

Parameters digesting DCO (9)

Answer 3

1. ISS > 40 without chest trauma
2. ISS > 20 with chest trauma
3. GCS of 8 or below
4. Multiple injuries with severe pelvic/abdominal trauma and hemorrhagic shock
5. Bilateral femoral fractures
6. Pulmonary contusion noted on radiographs
7. Hypothermia < 35C
8. Head injury with AIS(Abbreviated Injury Score) of 3 or greater
9. IL-6 values above 500pg/dL

Question 4

Acute Inflammatory Window

Risk of ARDS and multisystem failure

Answer 4

2-5 days

Question 5

Most important value in determining overall resuscitation status of a polytrauma patient and will dictate initial fracture management whe deciding between DCO and ETC.
List normal values mEq/L and mmol/L

Answer 5

Base excess ( or deficit)
Normal -2 to +2 mEq/L
And 0.6 to 1.7 mil/L

Question 6

Normal urine output

Answer 6

0.5 - 1.0 mg/kg/hr (30ml/hr)