Trauma Flashcards
19-29
Abdominal Trauma Pregnant
- Increased risk of aspiration and gastric acidity
- Max O2
- Warm LR before crystalloids
- > 20 wks tilt 15 degrees
Lateral contusions
- Associated with 20% cance of internal injury
Pregnancy changes
+20 HR
50% more blood
How to immediately treat chemical burns
Flush area for 10-15 min
Eyes: Flush for 30
Hydrofluoric Acid: After irrigation, apply a CaGlu gel(75 mL + 25 mL 10% CaGlu)
Tear Gas: Flush
Alkali Burns to eye: 1-2 L per eye for 30 min
Most reliable guide for adequate resuscitation
Urine Output
Adult: 30-50 mL/hr(75-100 electric)
Child <40: 0.5 - 1 ml/kg/hr
BSA Child
Head: 18
Chest/Back: 18
Arms: 9 per
Legs: 14 per
Infant BSA
Look for better pic
Burn initial resus
10 x TBSA + 100ml/hr for every 10 kg over 80.
Adjust 20% up/down q1-2hr to target UO
Ped Burn Resus
3 x TBSA x Kg = 24 hrs
1/2 in 8 hrs.
Fluid resus best, better, min
LR
NS
Hextend(1L)
D5LR Maintenance for kids
<13
4 ml/kg for first 10 kg + 2 ml/kg for 2nd 10 kg + 1 ml/kg over 20 kg
SPO2 Goal for any chest trauma
> 90%
Crush prior to extraction
- 2 TQ side by side proximal to entrapment
IVF Crush
- 2L Bolus
- 1L/hr
- UOP Goal is >100-200
When to urgently treat hyperK?
Frequent PVCs, bradycardia, peripheral pulse decrease, peaked t waves, or K>5.5
How to treat hyperK
- 1 g Ca2+
- 10 U regular insulin followed by 50 mL of D50
- Albuterol 12 mL NEB(4 tubes)
ABX Eye
400 mg Moxifloxacin
Mild/Moderate/Severe TBI
13-15
9-12
3-8
TXA for TBI
Moderate to severe warrants 2 g
Keppra for what and how much?
1500 mg for severe TBI
Injuries incompatible with life?
Decapitation, massively deforming head/chest injury
Hemi corpectomy
Total body disruption
Incineration
Lividity/Rigor mortis
What to do for non-traumatic and non-cardiac shock
-2L of 30mL/kg IVF
- Consider Norepi 2-20/min
- SBP>90, MAP>65
Blood for Ped
10 mL/kg
Hypotension in peds
<70+(2*age)
