Trauma

Question 1

Albuterol

Answer 1

It is indicated in crush syndrome for the treatment of hyperkalemia.

Albuterol aids in driving the potassium back into the cells.

Other medications indicated for hyperkalemia are calcium chloride and sodium bicarbonate.

Question 2

Compartment Syndrome

Answer 2

5 - P’s

Pain
Pallor
Paresthesia - Tingling or prickling, “pins-and-needles”
Pulselessness
Paralysis

The condition in which a structure like a nerve or tendon has been constricted within a space.

Edema/swelling increases pressure within Soft tissue compartment.

Can interfere w/circulation to that area.

More common in the extremities.

Can result in tissue death.

Question 3

Crush Syndrome

Answer 3

The result of compression forces on the body for 4-6 hours.

Prolonged continuous pressure on large muscles, like those of the legs or arms, which results in muscle disintegration.

The compression prevents muscle metabolism and circulation, causing the death of muscle tissue, which leads to harmful products being released in the circulatory system, called rhabdomyolysis.

Question 4

rhabdomyolysis

Answer 4

when harmful products are released into the circulatory system and causes impaired renal function, leading to hyperkalemia.

12 lead ECG indicated to check for hyperkalemia

Question 5

Lidocaine

Answer 5

Lidocaine has the ability to blunt the increase in ICP in patients with a TBI or head injury prior to intubation.

Question 6

Fractures of humerous or tibia/fibia can account for how much blood loss?

Answer 6

500-750mL

Question 7

Fractures of the femur can account for how much blood loss?

Answer 7

1500mL

Question 8

Appropriate management of a trauma patient with signs of hypovolemic shock from bleeding include: (5)

Answer 8

Oxygen administration

Keeping the patient warm

Giving crystalloid fluid boluses as needed

Immediate transport to a trauma center

Administration of tranexamic acid (TXA) if protocols allow

Question 9

Contraindications for tranexamic acid (TXA) administration?

Answer 9

Intracranial bleeding

> 3 hours from traumatic injury

History of venous/arterial thromboembolism

Active thromboembolic disease

Allergy to TXA

Known defective color vision.

Question 10

tPA

Answer 10

Tissue Plasminogen Activator

Question 11

TXA

Answer 11

Transexamic Acid

Anti-plasminogen, stops bleeding

Indications:

Blunt or penetrating trauma
Evidence of Hemodynamic instability
Time of injury < 3 HRS, preferably 1 HR

Dosage:
Dose: 1g in 100ml NS over 10 mins (A)
15mg/kg over 10 mins (Peds < 12 years old)

Contraindications:
Withhold in pregnant patients > 24 wks gestation