Test #2 Trauma in the OR-Josh Flashcards
Trauma is a severe blunt or penetrating injury primarily caused by what?
- Automobile Crashes
- Gunshots
- Knife wounds
- Falls
- Battery
- Burns
B/t the ages of ____ to ____ trauma kills more people than any other diesease
birth to 30 y.o.
Trauma Scoring:
What are the 3 categories the scoring system is based off?
- BP
- GCS
- RR
Trauma Scoring:
what is the points range?
- 4
- 3
- 2
- 1
- 0
Trauma Scoring:
Give the correct Values for BP
- 4
- 3
- 2
- 1
- >90
- 76-89
- 50-75
- 1-49
- 0
(0-50-25-15-10)
Trauma Scoring:
Give values for GCS
- 4
- 3
- 2
- 1
- 0
- 13-15
- 9-12
- 6-8
- 4-5
- 3
Trauma Scoring:
Givw the values for RR
- 4
- 3
- 2
- 1
- 0
- 10-29
- >29
- 6-9
- 1-5
- 0
Trauma Scoring:
what are the chances of survival based on thre following trauma scores
- 8
- 6
- 4
- 2
- 1
- 0
- 98
- 92
- 60
- 17
- 7
- 3
put trauma table here
put other trauma table here
War and the advancement of trauma resuscitation:
when were blood transfusions developed
WWI
War and the advancement of trauma resuscitation:
what was created in WWII (2 things)
- Antibiotic use
- reduce transport time to 4 hours
War and the advancement of trauma resuscitation:
what was created in the Korean war (2 things)
- Air ambulances
- early vascular repair
War and the advancement of trauma resuscitation:
what was the advancement made in the vietnam war? (2 things)
- helicopter use (reduced time of injury to surgery to 1 hour)
- More regulated guidlines for resuscitation tech
War and the advancement of trauma resuscitation:
what was the advancement made in fluid resuscitation in the vietnam war
- Aimed at avoiding renal failure and other consequences of hypotension
- However the asanguinous resuscitational fluids further diluted remaining plateletes and coag factors
True or False
The majority of deaths on the modern battlefield are non-survivable?
true
The improved methods of __ or _____-_____, noncompressible hemostasis combined w/ rapid evacuation to surgery may increase survival
IV
Intra-cavitary
What was 4 of the Major findings from the 2003 research on fluid rescusitation in Modern combat causualty care:
- Stop bleeding w/ tourniquets and better dressings
- Most casualties do not require resuscitation (use hextand)
- Titrate to radial pulse and mental status
- Use no more than 1000mLs of colloid
what are 3 PREVENTABLE causes of combat death
- Hemorrhage from extrmity wounds
- tension Pneumothorax
- Airway obstruction (facial trauma)
what is a CAT
not a thing that is all nibbly bibbly and meows in a damn tree
- It’s a combat Application Tourniquet
What are some examples of hemostatis agents (5)
- hemCon bandage
- HemCon Chitoflex tape
- QuikClot Powder
- QuickClot ACS
- Celox
what are the 3 Blood prodects to give for trauma
FFP
Platelets
Cryo
what does Cryo have that others dont?
- Factor VIII and I
- vWf and Fibrinogen
what are 2 machines that can assist you in getting blood into pt fast
Belmont
Rapid infuser
what is the trauma Triad of death
Hyperthermia
Acidosis
Coagulopathy
why does Hypothermia happen:
what are teh 4 ways we lose heat
- Evaporation
- Radiation
- Convection
- Conduction
Hypothermia:
Hypothermia causes increased what? (3 complications)
- Mortality
- Bloodloss
- Blood transfusion
Hypothermia:
what 2 physiological clotting complications can occur
- Platelet dysfunction
- Coagulopathy (biggest complication)
Hypothermia:
<___ degress C on admission = 100% mortality
- <32 degrees C
Hypothermia-Cardiac effects
what occur at 33-36 C
- Increased HR, BP, CO
Hypothermia-Cardiac effects
what happens at 32-33 C
opposite effect
- DECREASED HR, BP, CO
Hypothermia-Cardiac effects
< 31 C
- Inc atrial and Ventricular irritability
Hypothermia-Cardiac effects
< 30 C
Bradycardia profound and Vfib is likely
Hypothermia-Cardiac effects
19-20 C
Asystole usually occurs
Hypothermia-Renal function:
renal fx is dependent of what?
Cardiac Output
Hypothermia-Renal function:
At 33-35 C ______ pressure increases secondary to systemic vasoconstriction
Afferent
Hypothermia-Renal function:
@ temps < 33 C, GFR _____. and impairment of distal tubular reabsorption can cause ______.
- Decreases
- Polyuria
Hypothermia-Renal function:
in almost ALL states of HYPOthermia you will get ___uria
Polyuria
Hypothermia-Hematological effects:
what happens to HCT?
Increases
Hypothermia-Hematological effects:
whay does HCT increase
- results from fluid shift to interstitial space and loss of fluid due to decreased distal tubular reabsorption
Hypothermia-Hematological effects:
what happens to bleeding times?
Increased
Hypothermia-Hematological effects:
what are bleeding times increased?
- Platelets are sequestered in the spleen and liver resulting in increased bleeding times
Hypothermia Prevention:
what is a HPMK
Hypothermia prevention and Management Kit
Comes w/
- Reflective cap
- Self heating blanket
- heat reflecting shell
Acidosis and Outcomes:
pH < 7.2 postop in the ICU what % lived
0%
Acidosis and Outcomes:
pH of > 7.33 postop in the ICU what % lived
88%