TRAUMA Flashcards
First peak for trauma deaths (0-30 min)
lacs of heart, aorta, brain, brainstem or spinal cord
2nd peak for trauma deaths (30 min-4 hrs)
head injury (#1) and hemorrhage (#2) –> can be saved with rapid assessment (golden hr!)
2 biggest predictors of fall survival
age and body orientation
LD 50 for falls
4 stories
MCC death in first hour
hemorrhage
BP usually ok until how much blood volume is lost
30%
MCC upper airway obstruction
tongue
best cutdown site for venous access if large bore IV and central access not possible
saphenous vein
hemostatic resuscitation indications
> or = 4 units PRBC in 1st hour or >/= 10U prbc in 24 hrs
Positive DPL
>10 cc blood >100,000 RBCs/cc food particles bile bacteria >500 WBC/cc
If pelvic fx present where to do DPL?
supra umbilical
2 things missed by DPL
retroperitoneal bleed
contained hematoma
FAST scan may not detect free fluid < what amt
50-80 mL
final common pathway for decreased CO in ACS
IVC compression
When do catecholamines peak after injury
24-48 hours
Universal donor blood
type O
GCS : M3
flexion with pain (decorticate)
GCS : M2
extension with pain (decerebrate)
head CT if GCS = to
10
most important prognostic indicator on GCS
motor
when to perform crani in epidural hematoma
shift > 5 mm or significant neurologic deteroiation
CPP =
MAP - ICP
ICP monitors indicated for
GCS < or = 8
suspected increased ICP
or pts with moderate to severe head injury and inability to follow clinical exam
Want CPP > ??
60 to improve MAP