trauma Flashcards
what are the 3 types of shock and what do they result in?
hypovolemic, distributive, hypoxic
decrease in tissue perfusion and oxygen delivery
most common type of shock seen in polytrauma cases
hemorrhagic shock resulting in decreased cardiac output and mean arterial pressure that leads to tissue hyperperfusion
General approach to the polytrauma patient
- assess cardiac output, blood volume and signs of shock
- if hemorrhagic shock check dorso-pedal pulses, blood pressure and ECG
- check for any thoracic trauma
- check for neuro signs
- check urinary system
- check for fractures/wounds
T/F: the neurologic system should be evaluated after the respiratory and cardiovascular
T
most common injuries causing thoracic trauma
pulmonary contusions and pneumothorax
normal urine output
1-2 ml/kg/hr
what should you place in an unstable patient?
IV catheter
how would you diagnose uroabdomen based on bw and abdomincentesis?
compare the belly fluid to serum creatinine, uroabdomen will have 2x creatine that of the the serum
crystalloids
Normasol R or Plasmalyte
First line treatment thats a balanced electrolyte solution that can be bolused 10 to 30ml/kg over 20 to 30 min.
Colloids
we dont love her bc it may cause renal injury or coagulation impairment
Hypertonic saline
This causes a marked osmotic fluid shift from intracellular to extracellular space. This increases the heart rate and contractility, reduces peripheral vascular resistance and may improve microcirculatory hemodynamics.
explain hypotensive fluid resuscitation
This is due to concerns of uncontrolled hemorrhage where we purposely allow the BP to remain lower than normal and smaller amounts of fluid are administered to avoid the side effects of aggressive fluid therapy. The target BP is 70-100 mmHg
T/F: blood products can be used during fluid resuscitation
T
acute traumatic coagulopathy
syndrome that may contribute to ongoing hemorrhage and needs a blood transfusion. Tranexamic Acid and Epsilon Aminocaproic Acid may be used to help treat.
