Test #2 Trauma overview-Josh Flashcards by Diana Hathaway

Q

b/t the ages of ___ to ____ trauma kills more people than any other disease or illness

A

birth to 30

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Q

Trauma Systems:

what are the 4 main systems that treat traumas?

A

prevention
First responders
Acite care- Trauma Centers
Post- trauma care/ rehabilitation

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Q

Trauma Systems: Prevention

What are 3 main ways prevention is provided?

A

Education

Laws

Highway safety

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Q

Trauma Systems: First responders

What are 3 ways first responders aid in trauma prevention/decrease mortality w/ traumas

A

Shorter response times

Well educated rescuers

Life flights

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Q

Trauma Systems: Trauma Centers

what are the differnet levels

A

I and II

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Q

Trauma Systems: Trauma Centers

whichh level is a comprehensive regional resource that is a tertiary care facility central to the trauma system. And is capable of providing total care for every aspect of injury from From PREVENTION to RECOVERY

A

Level I

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Q

Trauma Systems: Trauma Centers

what are the elements of a Level I

A

24hr inhouse general surgeon and Prompt availablility of specilties (ortho, neuro, anesthesia, ER, radiology, peds, critical care, etc)
Referal resource for communnities in nearby regions
Leadership in prevention, public education
PROVIDES CE OF THE TRAUMA TEAM MEMBERS
comprehensive quality assessment program
teaching and research in trauma
Programs for substance abuse
Meets minimum req for annual volum eof severely injured pts

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Q

Trauma Systems: Trauma Centers

a Level ____ is able to initiate definative care for all injured pts

A

II

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Q

Trauma Systems: Trauma Centers

whata are the elements of a level II

A

24 hour immediate coverage by general surgeons as well as specialties
Tertiary care needs such as cardiac sx, hemodyalysis and microvascular may be refered to a level I
provides trauma prevention and CE programs for staff
Incorporateds comprehensive Quality assessment program

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Q

Emergent Vs Urgent

Awake and stable

A

Emergent

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Q

Emergent Vs Urgent

unconscious or unstable

A

Urgent

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Q

what makes trauma anesthesia so different?

A

Many unknowns
Multiple injuries and mechanisms of injuries
Pt’s health status unk
No pt hx
Decreased prep and evluation time

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Q

Trauma anesthesia:

the amount of pt info you gather preop is largely dependent on what?

A

the stability of the pt

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Q

Trauma anesthesia:

what are the main questions you must obtain from the trauma center?

A

Access
Blood products given/ avail
Abx given
Allergies
Pt’s ventilation/circulation/ mental status

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Q

Trauma anesthesia:

questions you want to ask the pt or pt’s family

A

Allergies
medications
Anesthesia hx
Significant medical hx
NPO status

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Q

Trauma anesthesia: Airway

what are 7 main conditions that require early intubation

A

Apnenic
Poor ventilation
Decreased/ Changing mentation
Devleoping airway obstruction (stidor/snoring)
Airway burns (soot in nares, singed hair)
Shock
combativness

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Q

Trauma anesthesia: Breathing

what are some ventilation management factors?

A

Location of incision
Hemnodynamic compromise
Presence of lung injury

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Q

Trauma anesthesia: Breathing

what is a big choice you must answer prior to tube placement

A

DLT or NO DLT

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Q

Trauma anesthesia: Breathing

if EtCO2 is low, don’t forget to differentially diagnose the cause. what are some of the causes

A

Shock
Low CO
PE
VAE

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Q

Trauma anesthesia: Circulation

what are your fluid choices for hemodynamic stability?

A

Crystalloid
Colloid
Blood

Q

Trauma anesthesia: Circulation

what are the 3 main accesses you need to get

A

Large IVs

Central Lines

A-line

Q

Trauma anesthesia: Management

what are 3 different ways to administer anesthesia

A

GETA

Regional

MAC

Q

Trauma anesthesia: Management

w/ induction agents whats more important? the agent or the dose?

A

Dose

Q

Trauma anesthesia: Management

what are some good induction drugs?

A

Etomadate
Ketamine
STP
Propofol

Trauma anesthesia: Management what are 4 main complications you can run into

Bleeding Hypoxia Acidosis Hypothermia

Trauma anesthesia: Management what are 2 big post-op concerns?

Do we extubate? ABCs

Trauma anesthesia: Management what are 6 treatments for hypotension

* Allow time * crystalloid/colloid * PRBC's * FFP * Platelets * Pressors

Trauma anesthesia: Management PRBC's are concentrated to a Hct of about \_\_\_% and a volume of \_\_\_mLs

75% 200mLs

Trauma anesthesia: Management storig PRBC's (just above freezing) up to \_\_\_days decreases the 2,3-DPG and ruins the platelets and neutrophils

42 days

Trauma anesthesia: Management \_\_\_\_ are the fastes way to increase the O2 delivering capacity of the blood

PRBCs

Trauma anesthesia: Management 1 unit of whole blood or PRBCS will rais ethe HCT by \_\_\_% and the Hgb by \_\_gm/dl

3% 1gm/dl

Trauma anesthesia: Fluid Management what is used in bleeding pts w/ multiple coagulation factor deficiencies 2nd to liver dz, DIC, and the dilutional coagulopathy from Massive transfusion

FFP

Trauma anesthesia: Fluid Management \_\_\_-\_\_ packs of FFP should be given for each blood volume lost, and given over 90-120 min to achive a min of 30% plasma factor concentration

4-8

Trauma anesthesia: Fluid Management 1 unit of platelets in adults will raise the plt count in an adult by \_\_\_-\_\_\_

5-8,000

Trauma anesthesia: Hypotension Management what are some commonly used pressors

* Phenylephrine * Ephedrine * Epinephrine * Dopamine * Levophed

Trauma anesthesia: Hypotension Management what are some others drugs used for hypotension management

NaHCO3 CaCl2 hydrocortisone

Trauma anesthesia: HYPERtension Management how is ot primarily treateted

Increasing Anesthesia

Trauma anesthesia: HYPERtension Management if antihypertensives are used, it is advisable to use what type?

shortacting

Trauma anesthesia: HYPERtension Management what are 2 examples of antihypertensives used

esmolol Nitro

Trauma anesthesia: Acidosis shift OHC to the \_\_\_

right

Trauma anesthesia: Acidosis w/ acidosis you get what 4 physiological effects

Myocardial depression Decreased SVR Hyperkalemia Alterations in drug potency

Trauma anesthesia: Acidosis what is treatment

NaHCO3 Avoiding Acidic crystalloids Correcting anemia Tham Hyperventilation

Trauma anesthesia: Bicarb generally not indicated if pH \> ?

7.25

Trauma anesthesia: Bicarb not indicated in what type of acidosis

respiratory

Trauma anesthesia: Bicarb large amounts should not be used w/o ?

controlled ventilation

Trauma anesthesia: Fluids what was developed for the treatment of hemophilia A and Von Willebrand dz

Cryoprecipitate

Trauma anesthesia: Fluids Cryo contains an abundant amount of \_\_\_\_\_\_\_, \_\_\_\_\_\_\_, and \_\_\_\_\_\_\_\_

* Fibrinogen * Von Willebrand-factor (VIII) * Fibrin stabilizing factor (XIII)

Trauma anesthesia: Fluids is cell saver whole blood?

Nope

thats it for this one

fuck yes