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Principles 4 > Test #2 Trauma overview-Josh > Flashcards

Test #2 Trauma overview-Josh Flashcards

1
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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2
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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3
Q

Trauma Systems: Prevention

What are 3 main ways prevention is provided?

A

Education

Laws

Highway safety

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4
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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5
Q

Trauma Systems: Trauma Centers

what are the differnet levels

A

I and II

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6
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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7
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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8
Q

Trauma Systems: Trauma Centers

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

A

II

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9
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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10
Q

Emergent Vs Urgent

Awake and stable

A

Emergent

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11
Q

Emergent Vs Urgent

unconscious or unstable

A

Urgent

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12
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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13
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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14
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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15
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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16
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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17
Q

Trauma anesthesia: Breathing

what are some ventilation management factors?

A
  • Location of incision
  • Hemnodynamic compromise
  • Presence of lung injury
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18
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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19
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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20
Q

Trauma anesthesia: Circulation

what are your fluid choices for hemodynamic stability?

A
  • Crystalloid
  • Colloid
  • Blood
21
Q

Trauma anesthesia: Circulation

what are the 3 main accesses you need to get

A

Large IVs

Central Lines

A-line

22
Q

Trauma anesthesia: Management

what are 3 different ways to administer anesthesia

A

GETA

Regional

MAC

23
Q

Trauma anesthesia: Management

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

24
Q

Trauma anesthesia: Management

what are some good induction drugs?

A
  • Etomadate
  • Ketamine
  • STP
  • Propofol
25
Q

Trauma anesthesia: Management

what are 4 main complications you can run into

A

Bleeding

Hypoxia

Acidosis

Hypothermia

26
Q

Trauma anesthesia: Management

what are 2 big post-op concerns?

A

Do we extubate?

ABCs

27
Q

Trauma anesthesia: Management

what are 6 treatments for hypotension

A
  • Allow time
  • crystalloid/colloid
  • PRBC’s
  • FFP
  • Platelets
  • Pressors
28
Q

Trauma anesthesia: Management

PRBC’s are concentrated to a Hct of about ___% and a volume of ___mLs

A

75%

200mLs

29
Q

Trauma anesthesia: Management

storig PRBC’s (just above freezing) up to ___days decreases the 2,3-DPG and ruins the platelets and neutrophils

30
Q

Trauma anesthesia: Management

____ are the fastes way to increase the O2 delivering capacity of the blood

31
Q

Trauma anesthesia: Management

1 unit of whole blood or PRBCS will rais ethe HCT by ___% and the Hgb by __gm/dl

32
Q

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

33
Q

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

34
Q

Trauma anesthesia: Fluid Management

1 unit of platelets in adults will raise the plt count in an adult by ___-___

35
Q

Trauma anesthesia: Hypotension Management

what are some commonly used pressors

A
  • Phenylephrine
  • Ephedrine
  • Epinephrine
  • Dopamine
  • Levophed
36
Q

Trauma anesthesia: Hypotension Management

what are some others drugs used for hypotension management

A

NaHCO3

CaCl2

hydrocortisone

37
Q

Trauma anesthesia: HYPERtension Management

how is ot primarily treateted

A

Increasing Anesthesia

38
Q

Trauma anesthesia: HYPERtension Management

if antihypertensives are used, it is advisable to use what type?

A

shortacting

39
Q

Trauma anesthesia: HYPERtension Management

what are 2 examples of antihypertensives used

A

esmolol

Nitro

40
Q

Trauma anesthesia: Acidosis

shift OHC to the ___

41
Q

Trauma anesthesia: Acidosis

w/ acidosis you get what 4 physiological effects

A

Myocardial depression

Decreased SVR

Hyperkalemia

Alterations in drug potency

42
Q

Trauma anesthesia: Acidosis

what is treatment

A

NaHCO3

Avoiding Acidic crystalloids

Correcting anemia

Tham

Hyperventilation

43
Q

Trauma anesthesia: Bicarb

generally not indicated if pH > ?

44
Q

Trauma anesthesia: Bicarb

not indicated in what type of acidosis

A

respiratory

45
Q

Trauma anesthesia: Bicarb

large amounts should not be used w/o ?

A

controlled ventilation

46
Q

Trauma anesthesia: Fluids

what was developed for the treatment of hemophilia A and Von Willebrand dz

A

Cryoprecipitate

47
Q

Trauma anesthesia: Fluids

Cryo contains an abundant amount of _______, _______, and ________

A
  • Fibrinogen
  • Von Willebrand-factor (VIII)
  • Fibrin stabilizing factor (XIII)
48
Q

Trauma anesthesia: Fluids

is cell saver whole blood?

49
Q

thats it for this one

Principles 4 (20 decks)

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